Antidepressants and Kids, a Different Interpretation

Posting Date: 08/28/2003

Dr. Dean's Comment: This is a great example of how study results are all in the eye of the beholder. While the author's comments at the end of the study simply state that Zoloft was effective in these kids, there's more to the story. First, the study was funded by the manufacturer, not a biggie in and of itself. But the findings for me were distincly unimpressive. Yes 69% of the kids improved on Zoloft. But 59% improved on a sugar pill! That is not a big difference. And there were side effects in those taking the Zoloft. Diarrhea, nausea, loss of appetite, and agitation were all more common. Bottom line? Think very carefully in close consultation with a mental health professional before medicating your child. And remember that 59% of kids got better just by participating in the study, and receiving the extra attention from parents and the psychotherapy.

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Efficacy of Sertraline in the Treatment of Children and Adolescents With Major Depressive Disorder

Two Randomized Controlled Trials

Karen Dineen Wagner, MD, PhD; Paul Ambrosini, MD; Moira Rynn, MD; Christopher Wohlberg, MD, PhD; Ruoyong Yang, PhD; Michael S. Greenbaum, MD; Ann Childress, MD; Craig Donnelly, MD; Deborah Deas, MD; for the Sertraline Pediatric Depression Study Group

JAMA. 2003;290:1033-1041.

Context The efficacy, safety, and tolerability of selective serotonin reuptake inhibitors (SSRIs) in the treatment of adults with major depressive disorder (MDD) are well established. Comparatively few data are available on the effects of SSRIs in depressed children and adolescents.

Objective To evaluate the efficacy and safety of sertraline compared with placebo in treatment of pediatric patients with MDD.

Design and Setting Two multicenter randomized, double-blind, placebo-controlled trials were conducted at 53 hospital, general practice, and academic centers in the United States, India, Canada, Costa Rica, and Mexico between December 1999 and May 2001 and were pooled a priori.