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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adolescent, Age Factors, Antidepressive Agents, Second-Generation, Child, Depressive Disorder, Major, Double-Blind Method, Female, Fluoxetine, Follow-Up Studies, Humans, Male, Multicenter Studies as Topic, Personality Assessment, Randomized Controlled Trials as Topic, Treatment Outcome.
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Do children and adolescents have differential response rates in placebo-controlled trials of fluoxetine? Context: Recent acute efficacy trials of antidepressants in youth have suggested that high placebo-response rates in children (<12 years of age) indicate that children may be more responsive to non-specific treatment interventions. Yet, these studies generally have not presented age-specific outcome data. The objective of this study was to compare the efficacy outcomes for children (<12 years of age) and adolescents (>or = 12 years of age) using the combined data from two previously published double-blind, placebo-controlled trials of fluoxetine. Children (<12 years of age) and adolescents (>or = 12 years of age) with major depressive disorder were randomized to fluoxetine or placebo for 8-9 weeks of treatment. Outcome was assessed using the Children's Depression Rating Scale-Revised (CDRS-R) and Clinical Global Impressions scale. Random regression of the CDRS-R showed a treatment group by age group interaction (F(1,338)=4.10, P=.044), indicating that the treatment effect was significantly more pronounced in children than adolescents. Within children, response at exit to fluoxetine was significantly better than placebo (56.9% vs 33.3%; P=.009). Adolescent response rates at exit were not significantly different between the groups (51.1% vs 38.6%; P=.128). Remission rates were low for both groups.
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In the combined fluoxetine trials, drug-placebo difference was greater in children compared with adolescents. Contrary to expectations, the placebo-response rate was lower in the children than the adolescents.