The Relevance of Pharmacokinetic Studies in Designing Efficacy Trials in Juvenile Major Depression

Findling, Robert L.; McNamara, Nora; Stansbrey, Robert J.; Feeny, Norah C.; Young, Christopher; Peric, Franco V.; Youngstrom, Eric A.

doi:10.1089/cap.2006.16.131

Cited by 61 publications

(38 citation statements)

References 31 publications

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“…Even less is known about pharmacokinetic response in other minority groups (Sramek and Pi 1996). However, as noted in a recent review of the literature (Findling et al 2006), even the existing information is being underutilized. Most randomized, placebo-controlled trials to date do not utilize the dosing strategies suggested by pharmacokinetic data.…”

Section: S Department Of Health and Human Services 2001; Freedenthanmentioning

confidence: 99%

Treatment of Culturally Diverse Children and Adolescents with Depression

Stewart

Simmons²,

Habibpour

2012

Journal of Child and Adolescent Psychopharmacology

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This article is written for the practitioners treating depression in ethnic minority youth. It will review the context in which services are delivered to these youth: Researchers have recognized persistent ethnic differences in terms of utilization of services and unmet need. Furthermore, when ethnic minority youth do receive pediatric mental health care, the services that they receive may differ from those given to White patients. The reasons for these discrepancies have been examined in numerous studies, and have included contextual variables (economics, availability, and accessibility of services), patient variables (differences in prevalence or manifestation of the disorder, cultural beliefs and attitudes, preferential use of alternative or informal services, health literacy, and adherence), and provider variables (referral bias and patient-provider communication). Information about the differences between White and minority youth in the pharmacodynamics and pharmacokinetics of the antidepressant response is still limited. There are significant challenges for developing evidence-based guidelines that inform practice with these youth, hinging on both the underrepresentation of ethnic minority groups in clinical trials, and the great variability in biological and cultural characteristics of individuals in ethnic minority categories. Awareness on the part of the practitioner of the cultural variables that influence help-seeking and ongoing utilization of mental health services may aid in the engagement, effective treatment, and retention of ethnic minority children and adolescents with depression. However, given the great heterogeneity that exists within any cultural grouping, clinicians will need to integrate information about cultural patterns with that obtained from the individual patient and family to inform optimal practices for each patient. This article is written to enhance awareness on the part of the practitioner as to the variables that influence psychiatric care for depression in culturally diverse youth. The mental health needs of minority youth are not well served: They are treated less frequently, and when they are treated, the services they receive are less frequently adequate. The reasons that have been proposed for the disparities in their care, particularly with regard to diagnosis and treatment for depression, will be reviewed. They include contextual factors (such as economics, insurance, and other variables affecting the availability of services) patient and family factors (such as prevalence, symptom presentation, and values and beliefs that influence whether patients are referred to and avail themselves of services), and provider factors (such as referral bias and patient-provider communication, which affect whether patients engage and stay in treatment). The implications for the practitioner treating ethnic minority youth with depression will be discussed. Culture, as used in this article, refers to the common values, beliefs, and social behaviors of individuals with a shared heritage. S...

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Section: S Department Of Health and Human Services 2001; Freedenthanmentioning

confidence: 99%

Treatment of Culturally Diverse Children and Adolescents with Depression

Stewart

Simmons²,

Habibpour

2012

Journal of Child and Adolescent Psychopharmacology

View full text Add to dashboard Cite

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“…[91] Dosages have ranged from 0.24 mg kg day in a 5-year-old [90] to 15-45 mg day in children 7 years of age and older. [92] Commonly reported adverse effects attributed to mirtazapine included tiredness, dizziness, and increased appetite. Antidepressant use in children and adolescents has been associated with an increased risk of suicidal behaviour or ideation, although the benefit risk ratio of these agents is controversial.…”

Section: Mirtazapinementioning

confidence: 99%

Optimizing Emetic Control in Children Receiving Antineoplastic Therapy

Dupuis

Nathan

2010

Pediatric Drugs

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Existing guidelines for the prevention of antineoplastic chemotherapy-induced nausea and vomiting (CINV) in children are constrained by the lack of robust evidence. Current guidelines recommend the use of a serotonin 5-HT(3) receptor antagonist plus a corticosteroid to prevent acute CINV. Consequently, antiemetic agents that are recommended for use in adult cancer patients do not appear in the current pediatric guidelines. In addition, there is no information to guide the selection of alternative antiemetic agents for children who either cannot receive the recommended agents or who do not respond adequately to the treatment. Possible barriers to adherence to the pediatric antiemetic selection guidelines that are currently available are discussed, and published pediatric experience with antiemetic agents recommended in the current adult antiemetic selection guidelines (dolasetron, tropisetron, palonosetron, aprepitant) is summarized in this review. The use of novel and emerging antiemetic therapeutic interventions {metopimazine, diphenhydramine (Benadryl)-lorazepam (Avitan)-dexamethasone (Decadron) [BAD], nabilone, acupuncture, midazolam, olanzapine, mirtazapine, gabapentin, droperidol} in children are explored.

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“…However, fluoxetine trials showed equal efficacy in children and in adolescents [26]. The superiority of fluoxetine over other agents in the treatment of prepubertal depression may be explained by the pharmacokinetic properties of paroxetine, sertraline, citalopram, and venlafaxine [86]. For most SSRIs, the half-life in children is much lower than it is in adolescents [86,87], yet the dosing recommendations parallel those for adults.…”

Section: Predictors Of Treatment Outcomementioning

confidence: 99%

“…The superiority of fluoxetine over other agents in the treatment of prepubertal depression may be explained by the pharmacokinetic properties of paroxetine, sertraline, citalopram, and venlafaxine [86]. For most SSRIs, the half-life in children is much lower than it is in adolescents [86,87], yet the dosing recommendations parallel those for adults. There is some evidence that inadequate exposure to antidepressants can lead to a lower response rate and --conversely --that increasing exposure by increasing the dose of antidepressant can improve the response rate [88].…”

Section: Predictors Of Treatment Outcomementioning

confidence: 99%