Out of the black box: treatment of resistant depression in adolescents and the antidepressant controversy
Karen Dineen Wagner, Joan Rosenbaum Asarnow, Benedetto Vitiello, Gregory Clarke, Martin Keller, Graham J Emslie, Neal Ryan, Giovanna Porta, Satish Iyengar, Louise Ritz, Jamie Zelanzny, Matthew Onorato, David Brent, Karen Dineen Wagner, Joan Rosenbaum Asarnow, Benedetto Vitiello, Gregory Clarke, Martin Keller, Graham J Emslie, Neal Ryan, Giovanna Porta, Satish Iyengar, Louise Ritz, Jamie Zelanzny, Matthew Onorato, David Brent
Abstract
Objective: The purpose of this article is to describe the effects of the pediatric antidepressant controversy on the Treatment of Serotonin-Selective Reuptake Inhibitor (SSRI) Resistant Depression in Adolescents (TORDIA) trial.
Method: Adolescents, ages 12-18 years, with SSRI resistant depression were randomized to one of four treatments for a 12 week trial: Switch to different SSRI, switch to an alternate antidepressant (venlafaxine), switch to an alternate SSRI plus cognitive behavior therapy (CBT), or switch to venlafaxine plus CBT.
Results: The health advisories and "black box" warnings regarding suicidality and antidepressants in adolescents occurred during the course of the TORDIA trial. Revisions to the protocol, multiple-consent form changes, and re-consenting of patients were necessary. Recruitment of participants was adversely affected.
Conclusion: Despite a cascade of unforeseen events that delayed the completion of the study, the TORDIA trial resulted in clinically important information about treatment-resistant depression in adolescents.
Trial registration: ClinicalTrials.gov NCT00018902.
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Source: PubMed