Letters Section Editor: Robert M. Golub, MD, Senior Editor.
To the Editor: In their meta-analysis of trials of antidepressants in children and adolescents, Dr Bridge and colleagues1 reported that drug class was not a significant moderator of efficacy for major depression. However, their binary classification of drugs as SSRIs or non-SSRIs failed to account for heterogeneity within the SSRI class. As the authors note, the long half-life of fluoxetine distinguishes it from other SSRIs.2 Clinical differences among SSRIs have been attributed to their heterogeneous pharmacology.3 A systematic review of trials of SSRIs for pediatric depression concluded that fluoxetine has a more favorable risk-benefit profile than other SSRIs.4
Edwards JL, Kirk KK, Midha CK. Benefits and Harms of Pediatric Antidepressant Medications. JAMA. 2007;298(6):626-627. doi:10.1001/jama.298.6.626-b