Antidepressant Management in the Context of Suicidal Ideation

 This is a case vignette created to exemplify a complex clinical problem and does not refer to any specific patient.This column aims to discuss practical approaches to everyday issues in pediatric pharmacotherapy. The cases and discussions specifically target aspects of clinical care related to psychopharmacology for which we do not have adequate applicable controlled trials. Given the need to address symptoms in youths with complex, severe, and comorbid disorders, recommendations are likely to be off-label from the perspective of the U.S. Food and Drug Administration. We fully appreciate that for virtually all disorders, medication is only one aspect of comprehensive care. This column focuses primarily on psychopharmacologic management. Although it is important that clinicians address psychosocial issues in the evaluation and treatment of their patients, such discussion is beyond the specific scope of this feature. These are not meant to be practice guidelines, but rather examples of thought processes that may go into pharmacotherapy decision making.Disclosure: Dr. Emslie receives research support from Eli Lilly, Organon, and Forest Laboratories; is a consultant for Eli Lilly, GlaxoSmithKline, Forest, Wyeth-Ayerst, and Pfizer; and is on the speakers' bureau of McNeil. Dr. E. Weller has been a consultant for or participated in studies supported by AstraZeneca, Johnson & Johnson, Jazz, and Otsuka. Dr. Kratochvil receives grant support from Eli Lilly, McNeil, Shire, Abbott, and Cephalon; is a consultant for Eli Lilly, Cephalon, Organon, AstraZeneca, Abbott, and Pfizer and a member of the Eli Lilly speakers' bureau; and has received study drug for an NIMH-funded study from Eli Lilly. The other authors have no financial relationships to disclose.

PII: S0890-8567(09)61942-0

doi: 10.1097/chi.0b013e3180ca7cc5

© 2007 The American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.