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Q In adolescents with major depressive disorder (MDD), how do fluoxetine, cognitive behavioural therapy (CBT), and their combination compare for effectiveness?
Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Mental health ★★★★★★☆ Psychiatry ★★★★★★☆ Paediatrics ★★★★★★☆
2 x 2 factorial randomised placebo controlled trial.
blinded (patients and healthcare providers [fluoxetine v placebo comparison] and outcome assessors).*
Follow up period:
outpatient clinic in the US.
439 adolescents (mean age 14.6 y, 54% girls) who had a DSM-IV diagnosis of major depressive disorder, could attend an outpatient clinic, scored ⩾45 on the Children’s Depression Rating Scale–Revised (CDRS–R), had a full scale IQ ⩾80, and were not taking antidepressants. Exclusion criteria included bipolar disorder, severe conduct disorder, substance abuse/dependence, 2 failed selective serotonin reuptake inhibitor trials (SSRI), and poor response to CBT.
(1) fluoxetine, from 10 mg/day to a maximum of 40 mg/day …
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