SSRI treatment for under-18s
============================

* E. Jane Garland

Mark Voysey has summarized the challenge facing physicians who treat depressed children. Two additional and more detailed critiques of the published and unpublished evidence1,2 are now available, and these reports underscore the fact that our evidence base has been distorted by selective publication and interpretation of data. However, as Voysey points out, a practical approach is required, and this may include judicious prescription of medication in individual cases, particularly in the presence of anxiety disorders, with appropriate monitoring.3 However, evidence-based psychological treatments such as cognitive behavioural therapy and interpersonal therapy4 need to be made more available. 

**E. Jane Garland** Clinical Professor, Psychiatry University of British Columbia Vancouver, BC

## Footnotes

*   *Competing interests:* Dr. Garland has received research funding from Pfizer and GlaxoSmithKline. A current CIHR-funded study has requested supplemental funding from Lundbeck.

## References

1.  1. Jureidini JN, Doecke CJ, Mansfield PR, Haby MM, Menkes DB, Tonkin AL. Efficacy and safety of antidepressants for children and adolescents. BMJ 2004;328:879-83.
    
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2.  2. Whittingdon CJ, Kendall T, Fonagy P, Cottrell D, Cotgrove A, Boddington E. Selective serotonin reuptake inhibitors in childhood depression: systematic review of published versus unpublished data. Lancet 2004;363:1335, 1341-5.
    
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3.  3. Garland EJ. Facing the evidence: antidepressant treatment in children and adolescents [editorial]. CMAJ 2004;170(4):489-91.
    
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4.  4. Lewinsohn PM, Clarke GN. Psychosocial treatments for adolescent depression. Clin Psychol Rev 1999; 19:329-42.
    
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