Predicting Desipramine Levels in Children and Adolescents: A Naturalistic Clinical Study

Efficacy of antidepressants in juvenile depression: meta-analysis

“…adult mood disorders. 60,63,70–73 The average 60% drug response rate in juvenile depressed patients (Tables DS1, DS2) was similar to that reported in depressed adults, 46,53,55 suggesting that neither the major developmental changes in drug disposition 74,75 nor possible changes in pharmacodynamics are involved in the limited superiority of antidepressants to placebo in juvenile depression.…”

“…70,71,78 Even though median baseline depression severity scores were at the mid-range of scale scores (averaging 50%; Table DS2), suggesting substantial illness severity, sampling of young patients with depression may include a high proportion of relatively mildly ill patients, who have most probably never received in-patient treatment, and who are more likely to improve spontaneously with or without additional effects of placebo treatment. 79 Importantly, prepubertal children with depression may differ biologically from adolescents or adults, 66,74,80 and it remains unclear whether depression in prepubertal children is a substantially different disorder from that found in adolescents or adults, perhaps including developmental differences in either the pharmacodynamics of antidepressants or in their clinical effects. 66,81 The current data preclude adequate assessment of potential developmental effects owing to the paucity of studies of children considered separately.…”

Sudden Death Related to Selected Tricyclic Antidepressants in Children

“…[1] It is well known that 7 to 10% of Caucasians have abnormalities in these isoenzymes which result in decreased rates of degradation and substantially higher blood concentrations at the same mg/kg dose, and that there is considerable variability in the serum TCA concentration between children at the same dose of a TCA. [1,61] However, it is not known whether any of the patients in these case reports had any evidence of isoenzyme abnormality.…”

Absence of Effect of Stimulants on the Pharmacokinetics of Desipramine in Children

“…33 In addition, our estimations of desipramine pharmacokinetic parameters are similar to those in adults. 2,9,12,27,48,54,55 These results suggest that developmental factors may have little impact on the desipramine-stimulant interaction.…”

“…with psychostimulants to treat attention-deficit hyperactivity disorder (ADHD) in children and adolescents. [2][3][4][5][6][7][8][9][10] The addition of TCAs to the regimen is not entirely surprising considering that at least 30% of these children do not adequately respond to, or are unable to tolerate, psychostimulants. 8,[11][12][13] Although the reasons for this inadequate response to stimulants are unclear, studies documented that ADHD is frequently comorbid with conditions that may not be responsive to stimulants, such as mood and anxiety disorders.…”