Pharmacotherapy for Pediatric Major Depression

Pediatric major depressive disorder (MDD) is a prevalent, chronic, and serious illness that causes short-term and life-long impairment in multiple areas of development and functioning of children and adolescents. The prevalence rates of pediatric MDD are estimated at 2.8% for children and 5.6% for adolescents, based on a recent meta-analysis of 26 studies, with a lifetime prevalence rate of 25%. The response (significant reduction of depressive symptoms) rate to a first antidepressant in randomized-controlled trials (RCTs) of children and adolescents with MDD is about 50% to 60%. About 40% to 50% of adolescents who failed one antidepressant responded to a second antidepressant. As in adult MDD, MDD in children and adolescents has high relapse rates (return of symptoms within the same episode) and recurrence (new episode).