Fluoxetine versus placebo in preventing relapse of major depression in children and adolescents

Graham J. Emslie, Beth D. Kennard, Taryn L. Mayes, Jeanne Nightingale-Teresi, Thomas Carmody, Carroll W. Hughes, A. John Rush, Rongrong Tao, Jeanne W. Rintelmann

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Abstract

Objective: The authors compared fluoxetine and placebo in continuation treatment to prevent relapse of major depressive disorder in children and adolescents. Method: After a detailed evaluation, children and adolescents 7-18 years of age with major depressive disorder were treated openly with fluoxetine. Those who had an adequate response after 12 weeks, as indicated by a Clinical Global Impression improvement score of 1 or 2 and a decrease of at least 50% in Children's Depression Rating Scale - Revised score, were randomly assigned to receive fluoxetine or placebo for an additional 6 months. The primary outcome measures were relapse and time to relapse. Relapse was defined as either a score of 40 or higher on the Children's Depression Rating Scale with a history of 2 weeks of clinical deterioration, or clinical deterioration as judged by the clinician. Additional analyses were conducted with relapse defined only as a score of 40 or higher on the Children's Depression Rating Scale. Results: Of 168 participants enrolled in acute fluoxetine treatment, 102 were randomly assigned to continuation treatment with fluoxetine (N=50) or placebo (N=52). Of these, 21 participants (42.0%) in the fluoxetine group relapsed, compared with 36 (69.2%) in the placebo group, a significant difference. Similarly, under the stricter definition of relapse, fewer participants in the fluoxetine group relapsed (N=11; 22.0%) than in the placebo group (N=25; 48.1%). Time to relapse was significantly shorter in the placebo group. Conclusions: Continuation treatment with fluoxetine was superior to placebo in preventing relapse and in increasing time to relapse in children and adolescents with major depression.

Original languageEnglish (US)
Pages (from-to)459-467
Number of pages9
JournalAmerican Journal of Psychiatry
Volume165
Issue number4
DOIs
StatePublished - Apr 2008

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Fluoxetine
Placebos
Depression
Recurrence
Major Depressive Disorder
Therapeutics
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Fluoxetine versus placebo in preventing relapse of major depression in children and adolescents. / Emslie, Graham J.; Kennard, Beth D.; Mayes, Taryn L.; Nightingale-Teresi, Jeanne; Carmody, Thomas; Hughes, Carroll W.; Rush, A. John; Tao, Rongrong; Rintelmann, Jeanne W.

In: American Journal of Psychiatry, Vol. 165, No. 4, 04.2008, p. 459-467.

Research output: Contribution to journalArticle

Emslie, Graham J. ; Kennard, Beth D. ; Mayes, Taryn L. ; Nightingale-Teresi, Jeanne ; Carmody, Thomas ; Hughes, Carroll W. ; Rush, A. John ; Tao, Rongrong ; Rintelmann, Jeanne W. / Fluoxetine versus placebo in preventing relapse of major depression in children and adolescents. In: American Journal of Psychiatry. 2008 ; Vol. 165, No. 4. pp. 459-467.
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