 |
|
Imipramine in Prepubertal Major Depressive Disorders
Joaquim Puig-Antich, MD;
James M. Perel, PhD;
William Lupatkin, MD;
William J. Chambers, MD;
Mary Ann Tabrizi, RN;
Janet King, RN;
Raymond Goetz, PhD;
Mark Davies, MPH;
Richard L. Stiller, PhD
Arch Gen Psychiatry. 1987;44(1):81-89.
Abstract
• The potential effectiveness of imipramine hydrochloride (up to 5 mg/kg/d) was investigated in 53 prepubertal children suffering from major depressive disorder. Two complementary strategies were used simultaneously: (1) a five-week, doubleblind, placebo-controlled design (N = 38), and (2) a plasma level/clinical response study (N = 30). Fifteen of the 16 children randomly assigned to active drug in the first study also participated in the second. Subjects were assessed using the Schedule for Affective Disorders and Schizophrenia for School Age Children and diagnosed according to unmodified Research Diagnostic Criteria. Response rates in the doubleblind study were similar in both groups (imipramine, 56%; placebo, 68%). In the plasma level study, total maintenance plasma level (imipramine plus desipramine) was found to positively and linearly predict clinical response of the depressive syndrome (P<.003). No evidence of a curvilinear relationship was found. Depressive hallucinations during the episode negatively predicted clinical response (P<.05). Weight-corrected imipramine dosage did not predict either clinical response or plasma level in the individual subject. No predictors of response were found in the placebo group. These results suggest that the mean imipramine dosage was too low, and that future double-blind, placebo-controlled studies of imipramine in prepubertal major depression should include plasma level titration to above 150 ng/mL and an initial placebo washout period.
Author Affiliations
From the Department of Psychiatry, Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute, New York. Drs Puig-Antich, Perel, and Stiller are now with the University of Pittsburgh Medical School and Western Psychiatric Institute and Clinic, Pittsburgh.
Footnotes
Accepted for publication Sept 9, 1985.
Reprints not available.
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Efficacy of antidepressants in juvenile depression: meta-analysis
Tsapakis et al.
Br. J. Psychiatry 2008;193:10-17.
ABSTRACT
| FULL TEXT
Impersistence of depression in youth: implications for drug study design.
Malone et al.
J Clin Pharmacol 2006;46:1044-1051.
ABSTRACT
| FULL TEXT
Efficacy of Interpersonal Psychotherapy for Depressed Adolescents
Mufson et al.
Arch Gen Psychiatry 1999;56:573-579.
ABSTRACT
| FULL TEXT
Systematic review of efficacy of cognitive behaviour therapies in childhood and adolescent depressive disorder
Harrington et al.
BMJ 1998;316:1559-1563.
ABSTRACT
| FULL TEXT
A Double-blind, Randomized, Placebo-Controlled Trial of Fluoxetine in Children and Adolescents With Depression
Emslie et al.
Arch Gen Psychiatry 1997;54:1031-1037.
ABSTRACT
Efficacy of tricyclic drugs in treating child and adolescent depression: a meta-analysis
Hazell et al.
BMJ 1995;310:897-901.
ABSTRACT
| FULL TEXT
A Controlled Family History Study of Prepubertal Major Depressive Disorder
Puig-Antich et al.
Arch Gen Psychiatry 1989;46:406-418.
ABSTRACT
Use of Antidepressants in Bulimia
Walsh
CLIN PEDIATR 1989;28:127-128.
The Clinical Picture of Major Depression in Children and Adolescents
Ryan et al.
Arch Gen Psychiatry 1987;44:854-861.
ABSTRACT
|
