Context

Adolescents suffering from major depression often receive treatment with antidepressants.

However the evidence for the efficacy of both newer antidepressants and tricyclic antidepressants in major depression in adolescence is very limited. Systematic reviews1 found a statistically significant difference in efficacy in favour of antidepressants versus placebo, which was not clinically relevant. However, they concluded that the large majority of studies on this topic shows serious methodological flaws, selecting patients with advertisements, excluding patients with suicide risk, high dropout rates and reporting bias. Regarding the use of selective serotonin reuptake inhibitors (SSRIs) there are indications of a slightly increased risk of suicide-related behaviour. Therefore, psychiatrists treating adolescents with major depression should consider psychological treatments such as cognitive behavioural therapy and other non-medication …