This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on Web of Science (2)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Psychiatry  • Depression  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Wagner and colleagues¹ presented the results of 2 randomized controlled trials suggesting that sertraline is effective for treating MDD in children and adolescents. I believe the authors' statement that their findings are "clinically as well as statistically relevant" is premature.

First, it is unclear why 2 separate trials (introducing additional variability), rather than 1 larger trial, were conducted. Second, the rationale for the a priori decision to define response as a 40% decrease in depressive symptoms, rather than the more commonly used 50% decrease in symptoms, is unclear. This seems to create a bias for a favorable result for sertraline. Third, the authors used the last-observation-carried-forward method rather than a more conservative analysis considering noncompleters as nonresponders. Nonetheless, sertraline barely achieved a statistically significant improvement over placebo. It is unlikely that statistically significant results would have been observed with a more conservative analysis and a higher . . . [Full Text of this Article]

David Price, MD
Colorado Permanente Medical Group
Denver

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Efficacy of Sertraline in the Treatment of Children and Adolescents With Major Depressive Disorder
Maju Mathews, Manu Mathews, and Joanne Mathews
JAMA. 2004;291(1):40.
EXTRACT | FULL TEXT  

Efficacy of Sertraline in the Treatment of Children and Adolescents With Major Depressive Disorder
Glen I. Spielmans
JAMA. 2004;291(1):41.
EXTRACT | FULL TEXT  

Efficacy of Sertraline in the Treatment of Children and Adolescents With Major Depressive Disorder
Antal E. Solyom
JAMA. 2004;291(1):41-42.
EXTRACT | FULL TEXT  

Efficacy of Sertraline in the Treatment of Children and Adolescents With Major Depressive Disorder—Reply
Karen D. Wagner, Christopher J. Wohlberg, and Ruoyong Yang
JAMA. 2004;291(1):42.
EXTRACT | FULL TEXT  

Efficacy of Sertraline in the Treatment of Children and Adolescents With Major Depressive Disorder: Two Randomized Controlled Trials
Karen Dineen Wagner, Paul Ambrosini, Moira Rynn, Christopher Wohlberg, Ruoyong Yang, Michael S. Greenbaum, Ann Childress, Craig Donnelly, and Deborah Deas
JAMA. 2003;290(8):1033-1041.
ABSTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Sertraline and Depression in Children
Garland
JAMA 2004;291:1561-1561.
FULL TEXT