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(p. 355) Treatments for Pediatric Depression 

(p. 355) Treatments for Pediatric Depression
Chapter:
(p. 355) Treatments for Pediatric Depression
Author(s):

Carolina Biernacki

, Prerna Martin

, Pablo H. Goldberg

, and Moira A. Rynn

DOI:
10.1093/med:psych/9780199342211.003.0012
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date: 28 October 2020

Practice guidelines recommend psychosocial interventions for mild or brief cases of pediatric depression. In moderate to severe cases, medication treatment is recommended, with or without cognitive-behavioral therapy (CBT). Fluoxetine and escitalopram are the only antidepressants approved by the U.S. Food & Drug Administration for acute pediatric depression. Among psychosocial interventions, CBT and interpersonal psychotherapy for adolescents (IPT-A) have the largest evidence base for treatment of depressed youth. Combination treatment with CBT and antidepressant medication is superior to treatment with either modality alone. In treatment-resistant depression, a switch in antidepressant is more likely to yield a positive response when medication is used with CBT. Antidepressants should be used judiciously in youths as higher rates of adverse events have been demonstrated, and data from adult trials cannot be systematically extrapolated to youths. Further studies are needed to assess alternative medication and psychosocial treatments as well as factors predictive of treatment response.

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