Newer-generation antidepressants in children and adolescents with major depressive disorder

There were no data to inform the comparison of greatest interest: what effect do antidepressants have on resolution of a diagnosis of major depressive disorder? Findings for secondary outcomes suggest that most newer antidepressants may be associated with small and unimportant reductions in depression symptoms compared with placebo, which raises the question of whether they should be used at all.

Depressive disorder is heterogeneous, so the effects of newer-generation antidepressants in young people may be variable.

There is evidence to support a greater range of newer-generation formulations than fluoxetine for first‐line prescribing to children, including sertraline, escitalopram and duloxetine.

It remains critical to ensure there is close monitoring of suicide‐related outcomes (combined suicidal ideation and suicide attempt) in those treated with newer-generation antidepressants, given findings that many are associated with at least slightly greater odds of these outcomes.