Tricyclic drugs for depression in children and adolescents
Background There is a need to identify effective and safe treatments for depression in children and adolescents. While tricyclic drugs are effective in treating depression in adults, individual studies involving children and adolescents have been equivocal. Prescribing of tricyclic drugs for depress...
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| Veröffentlicht in: | Cochrane database of systematic reviews 2013-06, Vol.2013 (6), p.CD002317 |
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| creator | Hazell, Philip Mirzaie, Mohsen Hazell, Philip |
| description | Background
There is a need to identify effective and safe treatments for depression in children and adolescents. While tricyclic drugs are effective in treating depression in adults, individual studies involving children and adolescents have been equivocal. Prescribing of tricyclic drugs for depression in children and adolescents is now uncommon, but an accurate estimate of their efficacy is helpful as a comparator for other drug treatments for depression in this age group. This is an update of a Cochrane review first published in 2000 and updated in 2002, 2006 and 2010.
Objectives
To assess the effects of tricyclic drugs compared with placebo for depression in children and adolescents and to determine whether there are differential responses to tricyclic drugs between child and adolescent patient populations.
Search methods
We conducted a search of the Cochrane Depression, Anxiety and Neurosis Review Group's Specialised Register (CCDANCTR) (to 12 April 2013), which includes relevant randomised controlled trials from the following bibliographic databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (all years), EMBASE (1974‐), MEDLINE (1950‐) and PsycINFO (1967‐). The bibliographies of previously published reviews and papers describing original research were cross‐checked. We contacted authors of relevant s in conference proceedings of the American Academy of Child and Adolescent Psychiatry, and we handsearched the Journal of the American Academy of Child and Adolescent Psychiatry (1978 to 1999).
Selection criteria
Randomised controlled trials comparing the efficacy of orally administered tricyclic drugs with placebo in depressed people aged 6 to 18 years.
Data collection and analysis
One of two review authors selected the trials, assessed their quality, and extracted trial and outcome data. A second review author assessed quality and checked accuracy of extracted data. Most studies reported multiple outcome measures including depression scales and clinical global impression scales. For each study, we took the best available depression measure as the index measure of depression outcome. We established predetermined criteria to assist in the ranking of measures. Where study authors reported categorical outcomes, we calculated individual and pooled risk ratios for non‐improvement in treated compared with control subjects. For continuous outcomes, we calculated pooled effect sizes as the number of standard deviations by which the change in de |
| doi_str_mv | 10.1002/14651858.CD002317.pub2 |
| format | Article |
| fullrecord | <record><control><sourceid>wiley_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7093893</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>CD002317.pub2</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4732-1c873cec58047db5b0f91f13938964ca9ae02c8bb42d09b6acedb5664c00e75e3</originalsourceid><addsrcrecordid>eNqFkMtOwzAURC0EoqXwC1V-IMWPJI5ZIEF5SpXYlLXlXN-0Rmlc2RTUvydRaQVsWNnWzJyRh5AxoxNGKb9kWZGzMi8n07vuKZicrDcVPyLDXkh75fjHfUDOYnyjVBSKy1My4EKWVDI1JFfz4GALjYPEhs0iJrUPicV1wBidbxPXJrB0jQ3YJqa1ibG-wQjYvsdzclKbJuLF9zkirw_38-lTOnt5fJ7ezFLIpOApg1IKQMhLmklb5RWtFauZUKJURQZGGaQcyqrKuKWqKgxg5yo6iVKUOYoRud5xux-u0PbdwTR6HdzKhK32xunfSuuWeuE_tKR9h-gAxQ4AwccYsD5kGdX9mnq_pt6v2RN5Fxz_bD7E9vN1htud4dM1uNXgYRlMi_9w_7R8AXvBhqs</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Tricyclic drugs for depression in children and adolescents</title><source>MEDLINE</source><source>Cochrane Library</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Hazell, Philip ; Mirzaie, Mohsen ; Hazell, Philip</creator><creatorcontrib>Hazell, Philip ; Mirzaie, Mohsen ; Hazell, Philip</creatorcontrib><description>Background
There is a need to identify effective and safe treatments for depression in children and adolescents. While tricyclic drugs are effective in treating depression in adults, individual studies involving children and adolescents have been equivocal. Prescribing of tricyclic drugs for depression in children and adolescents is now uncommon, but an accurate estimate of their efficacy is helpful as a comparator for other drug treatments for depression in this age group. This is an update of a Cochrane review first published in 2000 and updated in 2002, 2006 and 2010.
Objectives
To assess the effects of tricyclic drugs compared with placebo for depression in children and adolescents and to determine whether there are differential responses to tricyclic drugs between child and adolescent patient populations.
Search methods
We conducted a search of the Cochrane Depression, Anxiety and Neurosis Review Group's Specialised Register (CCDANCTR) (to 12 April 2013), which includes relevant randomised controlled trials from the following bibliographic databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (all years), EMBASE (1974‐), MEDLINE (1950‐) and PsycINFO (1967‐). The bibliographies of previously published reviews and papers describing original research were cross‐checked. We contacted authors of relevant s in conference proceedings of the American Academy of Child and Adolescent Psychiatry, and we handsearched the Journal of the American Academy of Child and Adolescent Psychiatry (1978 to 1999).
Selection criteria
Randomised controlled trials comparing the efficacy of orally administered tricyclic drugs with placebo in depressed people aged 6 to 18 years.
Data collection and analysis
One of two review authors selected the trials, assessed their quality, and extracted trial and outcome data. A second review author assessed quality and checked accuracy of extracted data. Most studies reported multiple outcome measures including depression scales and clinical global impression scales. For each study, we took the best available depression measure as the index measure of depression outcome. We established predetermined criteria to assist in the ranking of measures. Where study authors reported categorical outcomes, we calculated individual and pooled risk ratios for non‐improvement in treated compared with control subjects. For continuous outcomes, we calculated pooled effect sizes as the number of standard deviations by which the change in depression scores for the treatment group exceeded those for the control group.
Main results
Fourteen trials (590 participants) were included. No overall difference was found for the primary outcome of response to treatment compared with placebo (risk ratio (RR) 1.07, 95% confidence interval (CI) 0.91 to 1.26; 9 trials, N = 454). There was a small reduction in depression symptoms (standardised mean difference (SMD) ‐0.32, 95% CI ‐0.59 to ‐0.04; 13 trials, N = 533), but the evidence was of low quality. Subgroup analyses suggested a small reduction in depression symptoms among adolescents (SMD ‐0.45, 95% CI ‐0.83 to ‐0.007), and negligible change among children (SMD 0.15, 95% CI ‐0.34 to 0.64). Treatment with a tricyclic antidepressant caused more vertigo (RR 2.76, 95% CI 1.73 to 4.43; 5 trials, N = 324), orthostatic hypotension (RR 4.86, 95% CI 1.69 to 13.97; 5 trials, N = 324), tremor (RR 5.43, 95% CI 1.64 to 17.98; 4 trials, N = 308) and dry mouth (RR 3.35, 95% CI 1.98 to 5.64; 5 trials, N = 324) than did placebo, but no differences were found for other possible adverse effects. Wide CIs and the probability of selective reporting mean that there was very low‐quality evidence for adverse events.
There was heterogeneity across the studies in the age of participants, treatment setting, tricyclic drug administered and outcome measures. Statistical heterogeneity was identified for reduction in depressive symptoms, but not for rates of remission or response. As such, the findings from analyses of pooled data should be interpreted with caution.
We judged none of these trials to be at low risk of bias, with limited information about many aspects of risk of bias, high dropout rates, and issues regarding measurement instruments and the clinical usefulness of outcomes, which were often variously defined across trials.
Authors' conclusions
Data suggest tricyclic drugs are not useful in treating depression in children. There is marginal evidence to support the use of tricyclic drugs in the treatment of depression in adolescents.</description><identifier>ISSN: 1465-1858</identifier><identifier>EISSN: 1465-1858</identifier><identifier>EISSN: 1469-493X</identifier><identifier>DOI: 10.1002/14651858.CD002317.pub2</identifier><identifier>PMID: 23780719</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Administration, Oral ; Adolescent ; Age Factors ; Antidepressants ; Antidepressive Agents, Tricyclic ; Antidepressive Agents, Tricyclic - adverse effects ; Antidepressive Agents, Tricyclic - therapeutic use ; Child ; Child & Adolescent ; Child health ; Condition ; Confidence Intervals ; Depression ; Depression - drug therapy ; Depressive disorder ; Depressive disorder, major ; Depressive disorders & major depression ; Exclusively child and/or adolescent poopulation ; Humans ; Intervention ; Medicine General & Introductory Medical Sciences ; Mental health ; Mood disorders ; Odds Ratio ; Outcome Assessment, Health Care ; Population ; Randomized Controlled Trials as Topic ; TCAs</subject><ispartof>Cochrane database of systematic reviews, 2013-06, Vol.2013 (6), p.CD002317</ispartof><rights>Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4732-1c873cec58047db5b0f91f13938964ca9ae02c8bb42d09b6acedb5664c00e75e3</citedby><cites>FETCH-LOGICAL-c4732-1c873cec58047db5b0f91f13938964ca9ae02c8bb42d09b6acedb5664c00e75e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23780719$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hazell, Philip</creatorcontrib><creatorcontrib>Mirzaie, Mohsen</creatorcontrib><creatorcontrib>Hazell, Philip</creatorcontrib><title>Tricyclic drugs for depression in children and adolescents</title><title>Cochrane database of systematic reviews</title><addtitle>Cochrane Database Syst Rev</addtitle><description>Background
There is a need to identify effective and safe treatments for depression in children and adolescents. While tricyclic drugs are effective in treating depression in adults, individual studies involving children and adolescents have been equivocal. Prescribing of tricyclic drugs for depression in children and adolescents is now uncommon, but an accurate estimate of their efficacy is helpful as a comparator for other drug treatments for depression in this age group. This is an update of a Cochrane review first published in 2000 and updated in 2002, 2006 and 2010.
Objectives
To assess the effects of tricyclic drugs compared with placebo for depression in children and adolescents and to determine whether there are differential responses to tricyclic drugs between child and adolescent patient populations.
Search methods
We conducted a search of the Cochrane Depression, Anxiety and Neurosis Review Group's Specialised Register (CCDANCTR) (to 12 April 2013), which includes relevant randomised controlled trials from the following bibliographic databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (all years), EMBASE (1974‐), MEDLINE (1950‐) and PsycINFO (1967‐). The bibliographies of previously published reviews and papers describing original research were cross‐checked. We contacted authors of relevant s in conference proceedings of the American Academy of Child and Adolescent Psychiatry, and we handsearched the Journal of the American Academy of Child and Adolescent Psychiatry (1978 to 1999).
Selection criteria
Randomised controlled trials comparing the efficacy of orally administered tricyclic drugs with placebo in depressed people aged 6 to 18 years.
Data collection and analysis
One of two review authors selected the trials, assessed their quality, and extracted trial and outcome data. A second review author assessed quality and checked accuracy of extracted data. Most studies reported multiple outcome measures including depression scales and clinical global impression scales. For each study, we took the best available depression measure as the index measure of depression outcome. We established predetermined criteria to assist in the ranking of measures. Where study authors reported categorical outcomes, we calculated individual and pooled risk ratios for non‐improvement in treated compared with control subjects. For continuous outcomes, we calculated pooled effect sizes as the number of standard deviations by which the change in depression scores for the treatment group exceeded those for the control group.
Main results
Fourteen trials (590 participants) were included. No overall difference was found for the primary outcome of response to treatment compared with placebo (risk ratio (RR) 1.07, 95% confidence interval (CI) 0.91 to 1.26; 9 trials, N = 454). There was a small reduction in depression symptoms (standardised mean difference (SMD) ‐0.32, 95% CI ‐0.59 to ‐0.04; 13 trials, N = 533), but the evidence was of low quality. Subgroup analyses suggested a small reduction in depression symptoms among adolescents (SMD ‐0.45, 95% CI ‐0.83 to ‐0.007), and negligible change among children (SMD 0.15, 95% CI ‐0.34 to 0.64). Treatment with a tricyclic antidepressant caused more vertigo (RR 2.76, 95% CI 1.73 to 4.43; 5 trials, N = 324), orthostatic hypotension (RR 4.86, 95% CI 1.69 to 13.97; 5 trials, N = 324), tremor (RR 5.43, 95% CI 1.64 to 17.98; 4 trials, N = 308) and dry mouth (RR 3.35, 95% CI 1.98 to 5.64; 5 trials, N = 324) than did placebo, but no differences were found for other possible adverse effects. Wide CIs and the probability of selective reporting mean that there was very low‐quality evidence for adverse events.
There was heterogeneity across the studies in the age of participants, treatment setting, tricyclic drug administered and outcome measures. Statistical heterogeneity was identified for reduction in depressive symptoms, but not for rates of remission or response. As such, the findings from analyses of pooled data should be interpreted with caution.
We judged none of these trials to be at low risk of bias, with limited information about many aspects of risk of bias, high dropout rates, and issues regarding measurement instruments and the clinical usefulness of outcomes, which were often variously defined across trials.
Authors' conclusions
Data suggest tricyclic drugs are not useful in treating depression in children. There is marginal evidence to support the use of tricyclic drugs in the treatment of depression in adolescents.</description><subject>Administration, Oral</subject><subject>Adolescent</subject><subject>Age Factors</subject><subject>Antidepressants</subject><subject>Antidepressive Agents, Tricyclic</subject><subject>Antidepressive Agents, Tricyclic - adverse effects</subject><subject>Antidepressive Agents, Tricyclic - therapeutic use</subject><subject>Child</subject><subject>Child & Adolescent</subject><subject>Child health</subject><subject>Condition</subject><subject>Confidence Intervals</subject><subject>Depression</subject><subject>Depression - drug therapy</subject><subject>Depressive disorder</subject><subject>Depressive disorder, major</subject><subject>Depressive disorders & major depression</subject><subject>Exclusively child and/or adolescent poopulation</subject><subject>Humans</subject><subject>Intervention</subject><subject>Medicine General & Introductory Medical Sciences</subject><subject>Mental health</subject><subject>Mood disorders</subject><subject>Odds Ratio</subject><subject>Outcome Assessment, Health Care</subject><subject>Population</subject><subject>Randomized Controlled Trials as Topic</subject><subject>TCAs</subject><issn>1465-1858</issn><issn>1465-1858</issn><issn>1469-493X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>RWY</sourceid><sourceid>EIF</sourceid><recordid>eNqFkMtOwzAURC0EoqXwC1V-IMWPJI5ZIEF5SpXYlLXlXN-0Rmlc2RTUvydRaQVsWNnWzJyRh5AxoxNGKb9kWZGzMi8n07vuKZicrDcVPyLDXkh75fjHfUDOYnyjVBSKy1My4EKWVDI1JFfz4GALjYPEhs0iJrUPicV1wBidbxPXJrB0jQ3YJqa1ibG-wQjYvsdzclKbJuLF9zkirw_38-lTOnt5fJ7ezFLIpOApg1IKQMhLmklb5RWtFauZUKJURQZGGaQcyqrKuKWqKgxg5yo6iVKUOYoRud5xux-u0PbdwTR6HdzKhK32xunfSuuWeuE_tKR9h-gAxQ4AwccYsD5kGdX9mnq_pt6v2RN5Fxz_bD7E9vN1htud4dM1uNXgYRlMi_9w_7R8AXvBhqs</recordid><startdate>20130618</startdate><enddate>20130618</enddate><creator>Hazell, Philip</creator><creator>Mirzaie, Mohsen</creator><creator>Hazell, Philip</creator><general>John Wiley & Sons, Ltd</general><scope>7PX</scope><scope>RWY</scope><scope>ZYTZH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>20130618</creationdate><title>Tricyclic drugs for depression in children and adolescents</title><author>Hazell, Philip ; Mirzaie, Mohsen ; Hazell, Philip</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4732-1c873cec58047db5b0f91f13938964ca9ae02c8bb42d09b6acedb5664c00e75e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Administration, Oral</topic><topic>Adolescent</topic><topic>Age Factors</topic><topic>Antidepressants</topic><topic>Antidepressive Agents, Tricyclic</topic><topic>Antidepressive Agents, Tricyclic - adverse effects</topic><topic>Antidepressive Agents, Tricyclic - therapeutic use</topic><topic>Child</topic><topic>Child & Adolescent</topic><topic>Child health</topic><topic>Condition</topic><topic>Confidence Intervals</topic><topic>Depression</topic><topic>Depression - drug therapy</topic><topic>Depressive disorder</topic><topic>Depressive disorder, major</topic><topic>Depressive disorders & major depression</topic><topic>Exclusively child and/or adolescent poopulation</topic><topic>Humans</topic><topic>Intervention</topic><topic>Medicine General & Introductory Medical Sciences</topic><topic>Mental health</topic><topic>Mood disorders</topic><topic>Odds Ratio</topic><topic>Outcome Assessment, Health Care</topic><topic>Population</topic><topic>Randomized Controlled Trials as Topic</topic><topic>TCAs</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hazell, Philip</creatorcontrib><creatorcontrib>Mirzaie, Mohsen</creatorcontrib><creatorcontrib>Hazell, Philip</creatorcontrib><collection>Wiley-Blackwell Cochrane Library</collection><collection>Cochrane Library</collection><collection>Cochrane Library (Open Aceess)</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cochrane database of systematic reviews</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hazell, Philip</au><au>Mirzaie, Mohsen</au><au>Hazell, Philip</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Tricyclic drugs for depression in children and adolescents</atitle><jtitle>Cochrane database of systematic reviews</jtitle><addtitle>Cochrane Database Syst Rev</addtitle><date>2013-06-18</date><risdate>2013</risdate><volume>2013</volume><issue>6</issue><spage>CD002317</spage><pages>CD002317-</pages><issn>1465-1858</issn><eissn>1465-1858</eissn><eissn>1469-493X</eissn><abstract>Background
There is a need to identify effective and safe treatments for depression in children and adolescents. While tricyclic drugs are effective in treating depression in adults, individual studies involving children and adolescents have been equivocal. Prescribing of tricyclic drugs for depression in children and adolescents is now uncommon, but an accurate estimate of their efficacy is helpful as a comparator for other drug treatments for depression in this age group. This is an update of a Cochrane review first published in 2000 and updated in 2002, 2006 and 2010.
Objectives
To assess the effects of tricyclic drugs compared with placebo for depression in children and adolescents and to determine whether there are differential responses to tricyclic drugs between child and adolescent patient populations.
Search methods
We conducted a search of the Cochrane Depression, Anxiety and Neurosis Review Group's Specialised Register (CCDANCTR) (to 12 April 2013), which includes relevant randomised controlled trials from the following bibliographic databases: the Cochrane Central Register of Controlled Trials (CENTRAL) (all years), EMBASE (1974‐), MEDLINE (1950‐) and PsycINFO (1967‐). The bibliographies of previously published reviews and papers describing original research were cross‐checked. We contacted authors of relevant s in conference proceedings of the American Academy of Child and Adolescent Psychiatry, and we handsearched the Journal of the American Academy of Child and Adolescent Psychiatry (1978 to 1999).
Selection criteria
Randomised controlled trials comparing the efficacy of orally administered tricyclic drugs with placebo in depressed people aged 6 to 18 years.
Data collection and analysis
One of two review authors selected the trials, assessed their quality, and extracted trial and outcome data. A second review author assessed quality and checked accuracy of extracted data. Most studies reported multiple outcome measures including depression scales and clinical global impression scales. For each study, we took the best available depression measure as the index measure of depression outcome. We established predetermined criteria to assist in the ranking of measures. Where study authors reported categorical outcomes, we calculated individual and pooled risk ratios for non‐improvement in treated compared with control subjects. For continuous outcomes, we calculated pooled effect sizes as the number of standard deviations by which the change in depression scores for the treatment group exceeded those for the control group.
Main results
Fourteen trials (590 participants) were included. No overall difference was found for the primary outcome of response to treatment compared with placebo (risk ratio (RR) 1.07, 95% confidence interval (CI) 0.91 to 1.26; 9 trials, N = 454). There was a small reduction in depression symptoms (standardised mean difference (SMD) ‐0.32, 95% CI ‐0.59 to ‐0.04; 13 trials, N = 533), but the evidence was of low quality. Subgroup analyses suggested a small reduction in depression symptoms among adolescents (SMD ‐0.45, 95% CI ‐0.83 to ‐0.007), and negligible change among children (SMD 0.15, 95% CI ‐0.34 to 0.64). Treatment with a tricyclic antidepressant caused more vertigo (RR 2.76, 95% CI 1.73 to 4.43; 5 trials, N = 324), orthostatic hypotension (RR 4.86, 95% CI 1.69 to 13.97; 5 trials, N = 324), tremor (RR 5.43, 95% CI 1.64 to 17.98; 4 trials, N = 308) and dry mouth (RR 3.35, 95% CI 1.98 to 5.64; 5 trials, N = 324) than did placebo, but no differences were found for other possible adverse effects. Wide CIs and the probability of selective reporting mean that there was very low‐quality evidence for adverse events.
There was heterogeneity across the studies in the age of participants, treatment setting, tricyclic drug administered and outcome measures. Statistical heterogeneity was identified for reduction in depressive symptoms, but not for rates of remission or response. As such, the findings from analyses of pooled data should be interpreted with caution.
We judged none of these trials to be at low risk of bias, with limited information about many aspects of risk of bias, high dropout rates, and issues regarding measurement instruments and the clinical usefulness of outcomes, which were often variously defined across trials.
Authors' conclusions
Data suggest tricyclic drugs are not useful in treating depression in children. There is marginal evidence to support the use of tricyclic drugs in the treatment of depression in adolescents.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>23780719</pmid><doi>10.1002/14651858.CD002317.pub2</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Cochrane Library; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Administration, Oral Adolescent Age Factors Antidepressants Antidepressive Agents, Tricyclic Antidepressive Agents, Tricyclic - adverse effects Antidepressive Agents, Tricyclic - therapeutic use Child Child & Adolescent Child health Condition Confidence Intervals Depression Depression - drug therapy Depressive disorder Depressive disorder, major Depressive disorders & major depression Exclusively child and/or adolescent poopulation Humans Intervention Medicine General & Introductory Medical Sciences Mental health Mood disorders Odds Ratio Outcome Assessment, Health Care Population Randomized Controlled Trials as Topic TCAs |
| title | Tricyclic drugs for depression in children and adolescents |
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