Treatment options in the management of adolescent depression

Treatment for depression in children and adolescents often requires pharmacotherapy with tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs), followed by psychotherapy. Most studies have not found the TCAs to be more effective than placebo in the treatment of depression in children and adolescents. Initial reports, however, have found the SSRIs to be more effective and better tolerated. In the small proportion of children who have treatment-resistant depression, TCAs plus lithium, monoamine oxidase inhibitors (MAOIs) or electroconvulsive therapy (ECT) may be useful. More studies on the treatment of depression in children and adolescents are needed, as adult data cannot simply be extrapolated.