PHARMACOLOGICAL TREATMENT OF MAJOR DEPRESSIVE DISORDER IN CHILDREN AND ADOLESCENTS: THE PAROXETINE CONTROVERSY
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Keywords
paroxetine, major depressive disorder, social anxiety disorder
Abstract
Controversy has surrounded the use of the selective serotonin reuptake inhibitor (SSRI) paroxetine in children and adolescents under the age of 18 years. Pending further review, paroxetine treatment for major depressive disorder (MDD) should not be initiated in youth under the age of 18 years. However, in the event that a youth with MDD has responded to paroxetine with good symptom resolution, it would be unwise to discontinue the drug. When discontinuation of paroxetine is desired, it should be undertaken with gradual tapering to prevent the emergence of rebound anxiety. As the evidence for efficacy in social anxiety disorder outweighs the evidence for use in MDD it may be appropriate to use paroxetine for social anxiety disorder in this age group with careful monitoring for the presence of suicidal ideation
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