Efficacy and side effects of antidepressant and mood stabilizer psychotropic drugs in children and adolescents

Aim: Aim of this study is to retrospectively evaluate the effectiveness and side effects of antidepressant and mood stabilizer drug treatment initiated for children and adolescents between the ages of 6 and 18 in a child and adolescent psychiatry clinic. Method: A retrospective review of the files of children and adolescents who were referred to our child and adolescent psychiatry clinic within one year was conducted. Totally 98 patients were initiated on antidepressants, while 24 were initiated on mood stabilizers. To assess drug effectiveness; at 0., 3. and 6. months; CGI, CDI, SCARED, CY-BOCS, NSESSS, SABAMAS, EAT-40 and YMRS scales were used, to assess drug side effects; at 3. and 6. months; UKU, SABAMAS, LISERS scales were used. Moreover, laboratory and anthropological findings at the 0th, 3rd and 6th months were evaluated. Results: The two most common diagnoses in patients having started antidepressants were anxiety disorder (93.9%) and MDD (75.5%). These two diagnoses were comorbid at a rate of 69%. Of the antidepressants used, 60.2% (n=59) were sertraline, 20.4% (n=20) were fluoxetine, 12.2% (n=12) were escitalopram, and 7.16% (n=7) were citalopram. In the treatment of MDD, monotherapy fluoxetine (p = 0.016) was more effective in the first three months, and with antipsychotic combination sertraline in six months (p=0.045) were found to be more effective. Among the SSRI side effects, behavioral activation was most common with fluoxetine (36.36%) and apathy was the most prevalent with sertraline (28.5%). ADHD (58.3%) was found to be the most frequently encountered comorbidity in bipolar disorder patients using mood stabilizers, 54.2% (n=13) of the cases use lithium and 45.8% (n=11) use valproate. Mood stabilizers were used together with antipsychotics in the treatment. The efficacy of treatment with lithium and valproate groups did not differ significantly. Combinations of the lithium or valproate with antipsychotics have produced similar side effects. The incidence of tremor, decreased salivation, and polyuria/polydipsia was found to be higher in the lithium group. Conclusion: In reducing the severity of the disease symptoms, antidepressants were found to be effective in depression and anxiety disorders, while mood stabilizers were found to be effective in bipolar disorder. Monotherapy with antidepressants constitutes an effective and safe preference for children and adolescents. It has been observed that there is a risk of many side effects when using antidepressants or mood stabilizers together with antipsychotics, therefore regular monitoring of side effects is essential. Keywords: Antidepressant, fluoxetine, lithium, sertraline, valproate.