Maintenance study for adolescent depression

Although recent studies and meta-analyses confirm the efficacy of antidepressants in the acute phase of treatment for adolescent depression, there are few data available to allow assessment of the value of continued use of antidepressants in depressed adolescents after acute response. This study examines the benefit of maintenance treatment with sertraline in adolescents aged 13-19 years with major depression using a multi-site randomized placebo controlled discontinuation design.

Subjects with a diagnosis of depression who responded to open-label treatment with sertraline in a 12-week acute phase and did not relapse with open-label continuation treatment for 24 weeks were randomized to placebo or continued treatment with sertraline for 52 weeks.

Twenty-two subjects were randomized to maintenance treatment with sertraline (n = 13) versus placebo (n = 9). A higher proportion of subjects treated with sertraline (38%) remained well as compared to those on placebo (0%). Survival analyses found no significant differences between the groups (p = 0.17).

This is the first study to examine the outcome to maintenance treatment for adolescents with major depression. Although the sample size was small, the findings suggest a possible benefit of maintenance treatment with sertraline over placebo. A larger clinical trial with adequate power is required to confirm or disconfirm these findings.