Out of the black box: Treatment of resistant depression in adolescents and the antidepressant controversy

  • Karen Dineen Wagner
  • , Joan Rosenbaum Asarnow
  • , Benedetto Vitiello
  • , Gregory Clarke
  • , Martin Keller
  • , Graham J. Emslie
  • , Neal Ryan
  • , Giovanna Porta
  • , Satish Iyengar
  • , Louise Ritz
  • , Jamie Zelanzny
  • , Matthew Onorato
  • , David Brent

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Objective: The purpose of this article is to describe the effects of the pediatric antidepressant controversy on the Treatment of Serotonin-Selective Reuptake Inhibitor (SSRI) Resistant Depression in Adolescents (TORDIA) trial. Method: Adolescents, ages 12-18 years, with SSRI resistant depression were randomized to one of four treatments for a 12 week trial: Switch to different SSRI, switch to an alternate antidepressant (venlafaxine), switch to an alternate SSRI plus cognitive behavior therapy (CBT), or switch to venlafaxine plus CBT. Results: The health advisories and "black box" warnings regarding suicidality and antidepressants in adolescents occurred during the course of the TORDIA trial. Revisions to the protocol, multiple-consent form changes, and re-consenting of patients were necessary. Recruitment of participants was adversely affected. Conclusion: Despite a cascade of unforeseen events that delayed the completion of the study, the TORDIA trial resulted in clinically important information about treatment-resistant depression in adolescents.

Original languageEnglish (US)
Pages (from-to)5-10
Number of pages6
JournalJournal of Child and Adolescent Psychopharmacology
Volume22
Issue number1
DOIs
StatePublished - Feb 1 2012

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health
  • Pharmacology (medical)

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