ABSTRACT
Phases of Treatment and Response ................................................................. 573 Specifi c Antidepressants............................................................................. 573
Tricyclic Antidepressants (TCAs) .......................................................... 573 Selective Serotonin Reuptake Inhibitors (SSRIs) .................................. 574 SSRIs Side Effects ................................................................................... 575 SSRIs and the Risk of Suicidal Behavior ............................................... 576 Serotonin and Norepinephrine Reuptake
Inhibitors (SNRIs) ............................................................................... 577 Monoamine Oxidase (MAOA) Inhibitors .............................................. 577 Other Antidepressants ............................................................................ 577
Other Biological Therapies ......................................................................... 578 Electro Convulsive Therapy (ECT) ......................................................... 578 Transcranial Magnetic Stimulation (TMS) ........................................... 578 Sleep Deprivation .................................................................................... 578
Treatment Algorithm and Recommendations ........................................... 579 Treatment for Specifi c Types of Depression ............................................... 581
Psychotic Depression .............................................................................. 581 Atypical Depression ................................................................................ 581 Seasonal Depression ............................................................................... 581 Bipolar Depression .................................................................................. 581
Treatment of Resistant Depression ............................................................. 581 Treatment of Comorbidities ........................................................................ 582
Future Directions ............................................................................................. 582 Note ................................................................................................................... 583 References ........................................................................................................ 583
Epidemiological studies estimate prevalence rates of major depression disorder (MDD) to be as high as 1-2.5% among prepubertal children (with no gender difference), while in adolescence, rates climb to 3-8% (with female predominance of 2:1) (Goodyer, 1999). The prevalence of this disorder in late adolescence is very close to that of adults (Lewinsohn, Rohde, & Seeley, 1998). Signifi cant morbidity and mortality are likely. Adolescent-onset depression has a marked increased risk of recurring later in life relative to
adult-onset depressive disorder, and the same is true for suicide (Weissman et al., 1999). Most depressive episodes in adolescents recur within 5 years of onset (Birmaher et al., 1996b), a rate that may surpass recurrence rates of adult-onset depression (Emslie, Mayes, & Ruberu, 2005). One study reported a 40% recurrence rate in adolescents within 1 year (Emslie et al., 1998).
