Ryan Neal D
Department of Psychiatry, University of Pittsburgh Medical Center, Pennsylvania, USA.
CNS Spectr. 2003 Apr;8(4):283-7. doi: 10.1017/s1092852900018496.
Depression in children and adolescents is relatively common and associated with significant morbidity and mortality-thus, it is strongly deserving of treatment. To date, there have been a number of randomized, controlled trials of both tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) in the acute treatment of depression in youths. Surprisingly, the available data do not demonstrate TCA superiority over placebo for this disorder in this age group. There is, however, evidence of SSRI superiority to placebo, and longer-term treatment with SSRIs may help prevent recurrence. There is almost no data on other pharmacologic approaches. Effective use of the efficacious treatments also depends on effective case-finding and providing treatment, which families and youths will take in adequate quantity and duration. The right approaches to these aspects of effective treatment are greatly understudied.
儿童和青少年抑郁症相对常见,且与严重的发病和死亡相关,因此非常值得治疗。迄今为止,已经有多项关于三环类抗抑郁药(TCA)和选择性5-羟色胺再摄取抑制剂(SSRI)用于青少年抑郁症急性治疗的随机对照试验。令人惊讶的是,现有数据并未表明在该年龄组中TCA治疗该疾病优于安慰剂。然而,有证据表明SSRI优于安慰剂,且长期使用SSRI可能有助于预防复发。几乎没有关于其他药物治疗方法的数据。有效治疗还取决于有效的病例发现和提供治疗,而家庭和青少年需要足量且持续地接受治疗。有效治疗这些方面的正确方法仍未得到充分研究。