Pharmacotherapy for Adolescent Depression¹

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, and Seeley, 1998). Signi? 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, and Ruberu, 2005). One study reported a 40% recurrence rate in adolescents within 1 year (Emslie et al., 1998).