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Abstract
There is a broad consensus that children and adolescents can, and do, become depressed. However that consensus falls apart when it comes to treatment. Antidepressants are considered dangerous by some and essential by others. To add to that, selective publication of drug company data has undermined confidence in the available evidence—even the authors of clinical guidelines seem confused. Which is why the TADS (Treatment for Adolescents with Depression Study) findings are so important (see Evid Based Ment Health 2007;10:100–2): here they report on outcomes for fluoxetine, CBT or the two combined after 36 weeks of treatment (Arch Gen Psychiatry 2007;64:1132–44). All three interventions were effective but fluoxetine (with or without CBT) got the quicker response. Notably, adding CBT seemed to ameliorate the suicidal thinking associated with fluoxetine. So combined treatment may be best, but given the absence of a therapist in every clinic fluoxetine can, and should, be used.

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