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Chapter 47. Antidepressants

Graham J. Emslie, M.D.; Paul Croarkin, D.O.; Taryn L. Mayes, M.S.
DOI: 10.1176/appi.books.9781585623921.468689

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Excerpt

Antidepressants are widely used in children and adolescents for a variety of disorders, with significant increases over the past 20 years. Primarily, antidepressants have been used for the same disorders as in adults (depression, anxiety), with additional potential use for attention-deficit/hyperactivity disorder (ADHD), repetitive behaviors (e.g., autism spectrum disorders), and reactive aggression. Newer antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), have demonstrated efficacy and safety in children and adolescents, with the greatest effect seen in obsessive-compulsive disorder (OCD) and anxiety disorders, followed by major depressive disorder (MDD). Yet, limited data are available on pharmacokinetics and dosing in this age group. For example, it is not known whether lower doses may be equally efficacious in children or whether this age group does, in fact, require adult dosing. Theoretically, children may metabolize medications more quickly due to their proportionally larger liver mass.

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Table Reference Number
TABLE 47–1. Formulations and dosing for selective serotonin reuptake inhibitors
Table Reference Number
TABLE 47–2. U.S. Food and Drug Administration (FDA) indications for selective serotonin reuptake inhibitors
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TABLE 47–3. Pediatric randomized controlled trials for selective serotonin reuptake inhibitors
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TABLE 47–4. Pharmacodynamics and pharmacokinetics of selective serotonin reuptake inhibitors
Table Reference Number
TABLE 47–5. U.S. Food and Drug Administration (FDA) indications for atypical antidepressants
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TABLE 47–6. Formulations and dosing for atypical antidepressants
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TABLE 47–7. Pharmacodynamics and pharmacokinetics of atypical antidepressants
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TABLE 47–8. Pediatric randomized controlled trials for atypical antidepressantsa
Table Reference Number
TABLE 47–9. Pharmacodynamics and pharmacokinetics of tricyclic antidepressants

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