Tiie Role Of Neuroscience In Informed Consent For Antidepressants In Adolescents

Depression in adolescents shares many features with the disorder in adults, however, it also unique in a number of ways. Like many psychiatric disorders, there is a growing body of evidence that depression is a biologic disorder in both adults and adolescents. Scientific information currently available regarding the genetics and neuroscience of depression in adolescents may be important in establishing a basis for a decision to use antidepressant medication. Due to the complex nature of depressive illnesses, existing studies use scientifically complex designs and the results are not easy to convey to patients or their legal guardians who must make treatment related decisions. This paper reviews selected research on depression in adults and adolescents and summarizes findings in a way that may be helpful in communicating with families considering the use of antidepressant medications. Very strong evidence exists for an inherited susceptibility to depression that interacts with environmental stressors to produce depressive illness in adolescents. Neuroimag,ing, studies demonstrate small regional changes in volumes of specific brain regions in depression and larger functional differences in regional metabolism or neurotransmitter receptor densities. Modern endocrine studies continue to support historically observed abnormalities in reactivity of the hypothalamic -pituitary adrenal system in depressed individuals. Theories of antidepressant action that involve changes in regulation of monoamines are broadly supported by this literature which also helps to explain the delays in therapeutic response that are typical in antidepressant treatment.