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Psychiatry

Which of the following medications has been shown to have little or no benefit in the treatment of moderate to severe depression in children and adolescents?

A. Fluoxetine

B. Citalopram

C. Nortriptyline

D. Sertraline

Answer: C

Tricyclic antidepressants such as nortriptyline have been shown to have little to no benefit in the treatment of depression in childhood and adolescence. Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine and sertraline are first-line treatment for children and adolescents with moderate to severe depression. The selective serotonin norepinephrine inhibitor (SNRI) citalopram is also first-line treatment for moderate to severe depression in pediatric patients.

Reference: Clark MS, Jansen KL, Cloy JL. Treatment of childhood and adolescent depression. Am Fam Physician. 2012;85(5):442-448. Pubmed ID: 22963063.

What is the estimated prevalence of depression in adolescents 13 to 18 years old?

A. Less than 2%

B. 5% to 10%

C. 15% to 20%

D. 25% to 30%

Answer: B

The estimated prevalence of depression in adolescents age 13 to 18 is approximately 5%. The estimated prevalence of depression in children younger than 13 is approximately 3%.

Reference: Clark MS, Jansen KL, Cloy JL. Treatment of childhood and adolescent depression. Am Fam Physician. 2012;85(5):442-448. Pubmed ID: 22963063.

After starting pharmacotherapy with an SSRI for an adolescent with depression, how often should this patient be seen in the office or contacted by phone during the titration period?

A. They do not need to be seen or called on a regular schedule.

B. They should be seen or called 3 times per week until remission is achieved.

C. They should be seen 1 and 2 weeks after starting the medication, then titration should occur every 3 to 4 weeks until remission occurs.

D. They should be seen every 3 months until remission occurs.

Answer: C

After initiating an adolescent on SSRIs, they should be seen or contacted by phone weekly for the first 2 weeks, then titration can occur every 3 to 4 weeks until remission occurs. Once remission has occurred, patients can be seen every 3 months. Once symptoms are stable, medication should be continued for 6 to 12 months. When considering ...

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