What is the recommended treatment regimen of SSRIs in children and adolescents with major depressive disorder (clinical depression)?

Updated: Mar 28, 2019
  • Author: Jerry L Halverson, MD; Chief Editor: David Bienenfeld, MD  more...
  • Print
Answer

Except for lower initial doses, the administration of SSRIs in children and adolescents is similar to the treatment regimens used for adult patients. The clinician should treat patients with adequate and tolerable doses for at least 4 weeks. At 4 weeks, if the patient has not shown even minimal improvement, the clinician should consider increasing the dose. If, at this time, the patient shows improvement, the dose can be continued for at least 6 weeks. However, if no improvement is apparent at 6 weeks, other treatment strategies should be considered.

The clinician must cautiously apply the above recommendation; whether longer SSRI treatment increases the number of pediatric patients with late improvement is not clear. The Treatment of Adolescents with Depression Study (TADS) demonstrated significant increases in response to treatment over time (see Table 1, below). [185]

Table 1. Treatment Response Over Time in the Treatment of Adolescents with Depression Study (Open Table in a new window)

Treatment

Response Rate (%)

 

Week 12

Week 18

Week 36

Fluoxetine

62

69

81

Cognitive-behavioral therapy (CBT)

48

65

81

Fluoxetine plus CBT

73

85

86


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!