Citation

Seelinger G, Mannel M. Child Adolesc. Ment. Health 2007; 12(3): 143-149.

Copyright

(Copyright © 2007, John Wiley and Sons)

DOI

10.1111/j.1475-3588.2006.00435.x

PMID

unavailable

Abstract

Analyses of juvenile depression studies with long established anti-depressants (tricyclic anti-depressants) have revealed discouragingly little benefit, while side effects have been profound. Modern anti-depressants like selective serotonin reuptake inhibitors seemed to solve part of this problem until they were found to be associated with an increased risk of suicidal attempts and ideation, hostile behaviour and self-harm, while meta-analyses have revealed only marginal therapeutic effects for the majority. Actually, no drug is unequivocally accepted as the gold-standard for young depressive patients. St. John's Wort (SJW) has been traditionally used in Europe to treat symptoms associated with juvenile depression. Close to 50 clinical studies performed over the last two decades have been presented as evidence that standardized SJW preparations are equally effective as synthetic anti-depressants in the treatment of mild to moderate depression in adults. Tolerability is excellent, but some relevant drug interactions have to be considered. Today, SJW is by far the most frequently prescribed medication for child and adolescent depression in Germany. Some pilot and observational studies from Germany, Canada and the US have delivered promising results. However, randomised controlled trials amongst this age group have yet to be carried out and are long overdue. © 2007 Association for Child and Adolescent Mental Health.

Language: en

Keywords

human; abdominal pain; suicidal ideation; depression; suicide attempt; major depression; clinical trial; disease severity; mood disorder; fatigue; article; prescription; antidepressant agent; organic psychosyndrome; doxepin; amitriptyline; citalopram; fluoxetine; imipramine; mirtazapine; paroxetine; sedation; serotonin uptake inhibitor; sertraline; tricyclic antidepressant agent; venlafaxine; xerostomia; automutilation; priority journal; cognitive therapy; anxiety disorder; constipation; gastrointestinal symptom; hostility; confusion; drug safety; placebo; drug blood level; patient compliance; drug efficacy; risk benefit analysis; drug tolerability; nausea; weight gain; social phobia; drug withdrawal; restlessness; nightmare; side effect; withdrawal syndrome; allergic reaction; photosensitivity; child care; oral contraceptive agent; remission; warfarin; flatulence; obsessive compulsive disorder; phenprocoumon; psychological rating scale; Hypericum extract; indinavir; opipramol; cyclosporin A; enuresis; monotherapy; dizziness; drug eruption; increased appetite; skin allergy; unspecified side effect; Hypericum perforatum extract; attention disturbance; chill; drug induced headache; muscle cramp; serotonin noradrenalin reuptake inhibitor; loose feces; drug dose comparison; St. John's Wort; Clinical efficiency; Clinical safety; hyperforin; Juvenile depression