Objective: Studies on the pharmacotherapy of adolescent major depression are limited but suggest that the illness is often resistant to drug treatment. We aim to report the use of lithium augmentation of venlafaxine in two teenagers with major depression.
Clinical picture: Two 16–year-olds with major depression are described. Treatment: In both patients, the treatment involved trials of a selective serotonin re-uptake inhibitor, venlafaxine, and psychotherapy preceded lithium augmentation of venlafaxine. The trial of venlafaxine alone had been short in one patient. Outcome: Combining lithium and venlafaxine was rapidly followed by marked improvement in mood and function.
Conclusions: Augmentation of antidepressants should be considered in young depressed patients who fail to respond to adequate trials of new antidepressants alone.
National Health and Medical Research Council.Depression in young people: clinical practice guidelines. Canberra: Australian Government Publishing Service, 1997.
2.
BurkeKCBurkeJDRegierDARaeDSAge of onset of selected mental disorders in five community populations. Archives of General Psychiatry1990; 47:511–518.
3.
KandelDBDaviesM.Adult sequelae of adolescent depressive symptoms. Archives of General Psychiatry1986; 43:255–262.
4.
HazellPO'ConnellDHeathcoteDRobertsonJHenryD.A meta-analysis of the efficacy of the tricyclics in the treatment of child and adolescent depression. British Medical Journal1995; 310:897–901.
5.
RyanNDPuig-AntichJRabinovichHMAOIs in adolescent major depression unresponsive to tricyclic antidepressants. Journal of the American Academy of Child and Adolescent Psychiatry1988; 27:755–758.
6.
ShermanC.Prozac for kids: landmark study affirms drug's use. Clinical Psychiatry News1995; 23:1.
7.
EmslieGJRushALWeinbergWAA double-blind, randomised, placebo-controlled trial of fluoxetine in children and adolescents. Archives of General Psychiatry1997; 54:1031–1037.
8.
SimeonJGDinicolaVFFergusonHBCoppingW.Adolescent depression: a placebo controlled fluoxetine treatment study and follow-up. Progress in Neuropsychopharmacological Biological Psychiatry1990; 14:791–795.
9.
MandokiMWTapiaMRTapiaMASumnerGSParkerJLVenlafaxine in the treatment of children and adolescents with major depression. Psychopharmacology Bulletin1997; 33:149–154.
10.
RyanNDMeyerVDachilleSMazzieDPuig-AntichJ.Lithium antidepressant augmentation in TCA-refractory depression in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry1988; 27:371–376.
11.
StroberMFreemanRRigaliJSchmidtSDiamondR.The pharmacotherapy of depressive illness in adolescence: effects of lithium augmentation in nonresponders to imipramine. Journal of the American Academy of Child and Adolescent Psychiatry1992; 31:16–20.
12.
SchweitzerITuckwellVJohnsonG.A review of the use of augmentation therapy for the treatment of resistant depression: implications for the clinician. Australian and New Zealand Journal of Psychiatry1997; 31:340–352.
13.
TroySMPharmacokinetic interaction between multiple-dose venlafaxine and single-dose lithium. Journal of Clinical Pharmacology1996; 36:175–181.
