E-drug: Antidepressants for children banned in the UK (cont'd)
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Depression in children is not easy to diagnose and to treat. It is a
typical manifestation of 'nature and nurture'. Crucial in the whole
matter is the ability of the child to communicate about it in verbal
and non-verbal terms. I don't think many parents and family
physicians are nowadays in optimal condition to manage this very
well. Therefore I see this as a particular area for a child
psychiatrist. The comprehensive diagnosis and treatment might
demand teamwork with a psychologist and behavourial specialists.
Our son has a familiar treat of vital depression which manifested
itself in his pre-puberty phase. Because both parents are
physicians and the family history provided strong indications we
gained quick access to specialist help. Right now he is on drug
therapy with dipiperon drops and ritalin tablets. This together with
supportive behavioural therapy for him and parents. You cannot
imagine how he has changed in the course of the last 2 years,
particularly after adding ritalin. I am convinced that this cannot be
solely explained by placebo. The best evidence for this I derive
from the objective observation of his teacher on the change in his
ability to concentrate in the class: in the 1st week after starting the
combination therapy he could draw himself out of his normal
preoccupations and organize his work as never before. Earlier
psychotherapy didn't have this effect and the only actual change
was adding ritalin to the dipiperon. The point I want to make is that
this all occurred in the context of guidance and supervision by a
specialist! Child depression, particularly in the beginning, needs to
be handled by a specialist.
Harry van Schooten, MD, MPH
The Netherlands
e-mail: H.vSchooten@inter.nl.net
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