Vol 33(12):961-1056
When should GPs prescribe SSRIs for adolescent depression?
Leanne Rowe, MBBS, DipRACOG, FRACGP, FAICD, is a general practitioner, Bannockburn, Victoria, Senior Lecturer, Department of General Practice, University of Melbourne, and Chair, The Royal Australian College of General Practitioners (Victoria).
Bruce Tonge, MD, DPM, MRCPsych, FRANZCP, CertChildPsych, is Professor and Head, Monash University Department of Psychological Medicine and Centre for Developmental Psychiatry, Victoria.
Glenn Melvin, BSc, GradDipEdPsych, MPsych, PhD, is a psychologist, and Research Fellow, Monash University Centre for Developmental Psychiatry and Psychology, Victoria.
BACKGROUND Depression is a common disorder, increasing in prevalence in all ages. Research on the effective treatment of adolescent depression is lacking. Concern is growing about the recent increase in general practitioner prescribing of antidepressants and reports that selective serotonin reuptake inhibitors (SSRIs) may precipitate suicidal behaviour in adolescents.
OBJECTIVE This article discusses the importance of recognising and treating adolescent depression, methodological issues in research and recommendations for SSRI prescribing by Australian GPs.
DISCUSSION The lack of access to the mental health services and harmful effects of untreated adolescent depression are a cause for concern. On the balance of current information, the only SSRI Australian GPs may prescribe for the treatment of depression in adolescents is fluoxetine, and then only where cognitive behavioural therapy has failed or the depression is life threatening. The key to successful antidepressant drug treatment in adolescents is frequent review to monitor response, compliance and side effects.
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