Critical review of tricyclic antidepressant use in children and adolescents

Abstract

Objective: To provide a critical review of the role of tricyclic antidepressant (TCA) medications in children and adolescents.

Method: Multiple resources including a Medline search (1966-1998) were used.

Results: There were few double-blind, placebo-controlled studies of TCAs, and even fewer with positive results. Also, potentially serious cardiovascular side effects have been described.

Conclusions: The future therapeutic role of TCAs for children and adolescents needs to be seriously weighed against lethality of overdose, the unresolved issue of possible sudden unexplained death, and the availability of safer and easier to monitor medications. Ongoing future research on heart rate variability and epidemiology of psychotropic medication-related deaths will address developmental aspects of TCA use.