Pharmacotherapy of adolescent major depression: beyond TCAs

To date, controlled studies of tricyclic antidepressant (TCA) treatment of adolescent major depression have failed to demonstrate efficacy of these compounds despite multiple lines of evidence suggesting that adolescent major depression is related to the adult form of the disorder. One possible means of increasing the power of such studies is explored: examination of the pattern of response to medication and separation of placebo responders from medication responders using the technique proposed by Quitkin and colleagues (1984). Open label studies of nontricyclic antidepressant agents in adolescents are reviewed, and suggestions are made for future pharmacological trials in this population.