Sequenced treatment alternatives to relieve adolescent depression: A pragmatic clinical trial - PubMed
3 hours ago
- #Adolescent Depression
- #Fluoxetine
- #Sequential Treatment
- Adolescent major depressive disorder (MDD) is a widespread mental health condition with suboptimal treatment outcomes.
- The study compared fluoxetine monotherapy versus fluoxetine combined with cognitive-behavioral therapy (CBT) as initial treatments for adolescent MDD.
- Nonresponders to initial treatment were randomized to switch to sertraline, vortioxetine, or duloxetine, or augment fluoxetine with aripiprazole, olanzapine, or lithium.
- No significant differences were found between treatment strategies in primary outcomes or adverse events.
- Olanzapine augmentation showed greater improvement in sleep quality compared to duloxetine switching.
- Aripiprazole augmentation enhanced quality of life compared to duloxetine switching.
- Fluoxetine combined with CBT showed no significant advantage over fluoxetine monotherapy.
- All step 2 strategies were feasible and acceptable, supporting the sequential treatment pathway for adolescent MDD.
- Limitations include small sample size and lack of control and blinding.