Prescription For Kids' Depression

Study Says Zoloft Is Effective In Treating Adolescents' Depression

(CBS)  There is new evidence that the anti-depressant Zoloft is effective for kids and adolescents who suffer from moderate to severe depression.

Dr. Richard Friedman, psychiatrist and director of the psychopharmacology clinic at Weill Medical College of Cornell University, stopped by The Early Show to offer insight into the largest published study to test Selective Serotonin Reuptake Inhibitors (SSRI) antidepressants on children.

The Zoloft study consisted of children aged six to 17 years old who had been suffering from diagnosed clinical depression of at least moderate severity for at least six weeks. Researchers found that 69 percent of kids who took the drug improved significantly, compared with 59 percent of those who took a placebo. The researchers concluded that the study is both statistically and clinically significant, and that the medication was effective.

Friedman says the study is good news, even though the treatment effect in the study is rather small. He suggests more studies of Zoloft and the other SSRI drugs are needed to further determine how effective and when they are effective in children.

He also says there is no reason to think that data from one particular SSRI such as Paxil or Prozac will not be similar for the other drugs in the class. The study is also important in adding to the limited data about the effects SSRIs on children. There is a lot more data on anti-depressants for adults.

Childhood depression can be just as debilitating and potentially life-threatening as adult depression, according to Friedman, and it's important to identify it and treat it by any means possible. Since the drugs have proven themselves effective in adults, they are increasingly prescribed for childhood depression.

Usually a doctor will try other means besides medication if the depression is milder. But, Friedman says for severe cases, the SSRIs are a useful weapon in the fight against childhood depression. Depression can manifest itself as young as five or six years old.

The latest study comes two months after warnings from England that the SSRI antidepressant Paxil should not be prescribed for children because it increased suicidal thoughts and behavior in children and adolescents. Some experts have theorized that Paxil might cause self-destructive behavior from agitation or manic episodes produced by the drug.

The FDA recommended in June that doctors refrain from treating children with Paxil while the agency reviewed the issue.

But, Friedman says, if Zoloft study results continue to show a benefit, and similar results show up for the other SSRIs, their use will continue to benefit depressed children.

No public data have linked Zoloft with suicide in children or adolescents, and the new study found similar rates of suicidal behavior in those who took the drug and those who took a placebo. Friedman says that the warnings about Paxil should be taken very seriously, because there is no reason to think other drugs in its class such as Zoloft would not have similar effects.

But, he says, for the severely depressed child, these drugs should definitely be prescribed, because they can potentially save lives. Suicidal thoughts and suicide are a common symptom of depression, and it can be difficult to determine whether the drug or the underlying depression is causing the suicidal tendencies. Some experts believe it is better to prescribe, keep close tabs on the patient and alter the treatment course accordingly rather than deny treatment and put a patient at risk.

Results on SSRIs on children across the board are not uniform, and there are differing views amongst scientists on the subject. Some psychiatrists point out that other studies have not found large differences in effectiveness between the drugs and placebos.

Some, however, suggest that children may be more likely to respond to any type of mental health intervention, and that it is not an easy task to differentiate the role of the drug and the role of talk therapy or other interventions.