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Case 2: From anxious to activated: selective serotonin reuptake inhibitor (SSRI)-related activation

Published online by Cambridge University Press:  09 February 2024

Jeffrey R. Strawn  and
Stephen M. Stahl
Jeffrey R. Strawn
Affiliation:
University of Cincinnati, Ohio
Stephen M. Stahl
Affiliation:
University of California, San Diego
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Summary

Which of the following represents an evidence-based intervention for a child with SSRI-related activation?

Type
Chapter
Information
Case Studies: Stahl's Essential Psychopharmacology
Children and Adolescents
 , pp. 17 - 34
Publisher: Cambridge University Press
Print publication year: 2023

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References

Aldrich, S. L., Poweleit, E. A., Prows, C. A., et al. Influence of CYP2C19 metabolizer status on escitalopram/citalopram tolerability and response in youth with anxiety and depressive disorders. Front Pharmacol 2019; 10: 99. https://doi.org/10.3389/fphar.2019.00099Google Scholar
Barnes, N. M., Sharp, T. A review of central 5-HT receptors and their function. Neuropharmacology 1999; 38: 1083–152. https://doi.org/10.1016/s0028-3908(99)00010-6Google Scholar
Dobson, E. T., Bloch, M. H., Strawn, J. R. Efficacy and tolerability of pharmacotherapy in pediatric anxiety disorders: a network meta-analysis. J Clin Psychiatry 2019; 80: 17r12064. https://doi.org/10.4088/JCP.17r12064Google Scholar
Goldstein, J. A. Clinical relevance of genetic polymorphisms in the human CYP2C subfamily. Br J Clin Pharmacol 2001; 52: 349–55. https://doi.org/10.1046/j.0306-5251.2001.01499.xGoogle Scholar
Guile, J. M. Sertraline-induced behavioral activation during the treatment of an adolescent with major depression. J Child Adolesc Psychopharmacol 1996; 6: 281–85. https://doi.org/10.1089/cap.1996.6.281Google Scholar
Hicks, J. K., Bishop, J. R., Sangkuhl, K., et al. Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2D6 and CYP2C19 genotypes and dosing of selective serotonin reuptake inhibitors. Clin Pharmacol Ther 2015; 98: 127–34. https://doi.org/10.1002/cpt.147Google Scholar
King, R. A., Riddle, M. A., Chappell, P. B., et al. Emergence of self-destructive phenomena in children and adolescents during fluoxetine treatment. J Am Acad Child Adolesc Psychiatry 1991; 30: 179–86. https://doi.org/10.1097/00004583-199103000-00003Google Scholar
Kruesi, M. J., Rapoport, J. L., Hamburger, S., et al. Cerebrospinal fluid monoamine metabolites, aggression, and impulsivity in disruptive behavior disorders of children and adolescents. Arch Gen Psychiatry 1990; 47: 419–26. https://doi.org/10.1001/archpsyc.1990.01810170019003Google Scholar
Locher, C., Koechlin, H., Zion, S. R., et al. Efficacy and safety of selective serotonin reuptake inhibitors, serotonin–norepinephrine reuptake inhibitors, and placebo in common psychiatric disorders among children and adolescents: a systematic review and meta-analysis. JAMA Psychiatry 2017; 74: 1011–20. https://doi.org/10.1001/jamapsychiatry.2017.2432Google Scholar
Luft, M. J., Lamy, M., DelBello, M. P., McNamara, R. K., Strawn, J. R. Antidepressant-induced activation in children and adolescents: risk, recognition and management. Curr Probl Pediatr Adolesc Health Care 2018; 48: 50–62. https://doi.org/10.1016/j.cppeds.2017.12.001CrossRefGoogle Scholar
Mills, J. A., Strawn, J. R. Antidepressant tolerability in pediatric anxiety and obsessive-compulsive disorders: a Bayesian hierarchical modeling meta-analysis. J Am Acad Child Adolesc Psychiatry 2020; 59: 1240–51. https://doi.org/10.1016/j.jaac.2019.10.013Google Scholar
Newman-Tancredi, A., Kleven, M. S. Comparative pharmacology of antipsychotics possessing combined dopamine D2 and serotonin 5-HT1A receptor properties. Psychopharmacology (Berl) 2011; 216: 451–73. https://doi.org/10.1007/s00213-011-2247-yGoogle Scholar
Placidi, G. P. A., Oquendo, M. A., Malone, K. M., et al. Aggressivity, suicide attempts, and depression: relationship to cerebrospinal fluid monoamine metabolite levels. Biol Psychiatry 2001; 50: 783–91. https://doi.org/10.1016/s0006-3223(01)01170-2Google Scholar
Poweleit, E. A., Mizuno, T., Taylor, Z. L., et al. A Population Pharmacokinetic Analysis of Escitalopram and the Effect of CYP2C19 on Clearance in Children and Adolescents. Annual Meeting of the American Society for Clinical Pharmacology & Therapeutics, Atlanta GA, March 22–24, 2023. Alexandria, VA: American Society for Clinical Pharmacology & Therapeutics, 2023.Google Scholar
Ramsey, L. B., Brown, J. T., Vear, S. I., Bishop, J. R., Van Driest, S. L. Gene-based dose optimization in children. Annu Rev Pharmacol Toxicol 2020; 60: 311–31. https://doi.org/10.1146/annurev-pharmtox-010919-023459Google Scholar
Reinblatt, S. P., DosReis, S., Walkup, J. T., Riddle, M. A. Activation adverse events induced by the selective serotonin reuptake inhibitor fluvoxamine in children and adolescents. J Child Adolesc Psychopharmacol 2009; 19: 119–26. https://doi.org/10.1089/cap.2008.040Google Scholar
Riddle, M. A., King, R. A., Hardin, M. T., et al. Behavioral side effects of fluoxetine in children and adolescents. J Child Adolesc Psychopharmacol 1990; 1: 193–8. https://doi.org/10.1089/cap.1990.1.193Google Scholar
Scott, S. A., Sangkuhl, K., Stein, C. M., et al. Clinical Pharmacogenetics Implementation Consortium guidelines for CYP2C19 genotype and clopidogrel therapy: 2013 update. Clin Pharmacol Ther 2013; 94: 317–23. https://doi.org/10.1038/clpt.2013.105Google Scholar
Strawn, J. R., Welge, J. A., Wehry, A. M., Keeshin, B., Rynn, M. A. Efficacy and tolerability of antidepressants in pediatric anxiety disorders: a systematic review and meta-analysis. Depress Anxiety 2015; 32: 149–57. https://doi.org/10.1002/da.22329Google Scholar
Strawn, J. R., Compton, S. N., Robertson, B., et al. Extended release guanfacine in pediatric anxiety disorders: a pilot, randomized, placebo-controlled trial. J Child Adolesc Psychopharmacol 2017; 27: 29–37. https://doi.org/10.1089/cap.2016.0132Google Scholar
Strawn, J. R., Mills, J. A., Sauley, B. A., Welge, J. A. The impact of antidepressant dose and class on treatment response in pediatric anxiety disorders: a meta-analysis. J Am Acad Child Adolesc Psychiatry 2018; 57: 235–44.e2. https://doi.org/10.1016/j.jaac.2018.01.015Google Scholar
Strawn, J. R., Poweleit, E. A., Ramsey, L. B. CYP2C19-guided escitalopram and sertraline dosing in pediatric patients: a pharmacokinetic modeling study. J Child Adolesc Psychopharmacol 2019; 29: 340–47. https://doi.org/10.1089/cap.2018.0160Google Scholar
Strawn, J. R., Mills, J. A., Schroeder, H., et al. Escitalopram in adolescents with generalized anxiety disorder: a double-blind, randomized, placebo-controlled study. J Clin Psychiatry 2020; 81: 20m13396. https://doi.org/10.4088/JCP.20m13396Google Scholar
Strawn, J. R., Lu, L., Peris, T. S., Levine, A., Walkup, J. T. Research review: pediatric anxiety disorders – what have we learnt in the last 10 years? J Child Psychol Psychiatry 2021; 62: 114–39. https://doi.org/10.1111/jcpp.13262CrossRefGoogle ScholarPubMed
Wilens, T. E., Biederman, J., Kwon, A., et al. A systematic chart review of the nature of psychiatric adverse events in children and adolescents treated with selective serotonin reuptake inhibitors. J Child Adolesc Psychopharmacol 2003; 13: 143–52. https://doi.org/10.1089/104454603322163862CrossRefGoogle ScholarPubMed

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