10.6 EFFECT OF FLUOXETINE ON WEIGHT DURING THE ACUTE PHASE OF TREATMENT IN CHILDREN AND ADOLESCENTS: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

2020 ◽  
Vol 59 (10) ◽  
pp. S177-S178
Author(s):  
Zeeshan Mansuri ◽  
Chintan G. Trivedi ◽  
Bhumika Shah ◽  
Tapan Parikh
Keyword(s):  
Randomized Controlled Trials ◽  
Children And Adolescents ◽  
Acute Phase ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled

scholarly journals Fluoxetine in the Management of Major Depressive Disorder in Children and Adolescents: A Meta-Analysis of Randomized Controlled Trials

2020 ◽  
pp. 001857872092538
Author(s):  
Ayman Antoun Reyad ◽  
Kiran Plaha ◽  
Eriny Girgis ◽  
Raafat Mishriky
Keyword(s):  
Major Depressive Disorder ◽  
Side Effects ◽  
Depressive Disorder ◽  
Randomized Controlled Trials ◽  
Children And Adolescents ◽  
Meta Analysis ◽  
Mean Difference ◽  
Controlled Trials ◽  
Major Depressive ◽  
Randomized Controlled

Background: Fluoxetine is a serotonin-specific reuptake inhibitor antidepressant and is the only approved pharmacological treatment for major depressive disorder (MDD) in children and adolescent. Methods: We searched the published randomized controlled-trials to review fluoxetine efficacy and tolerability using the databases PubMed, EudraCT, ClinicalTrials.gov, and Cochrane Central Register of Controlled Trials for fluoxetine role in managing MDD in children and adolescents. A meta-analysis was conducted using the identified 7 clinical trials to assess efficacy using the outcomes: Children's Depression Rating Scale–Revised (CDRS-R), Clinical Global Impressions–Severity of Illness (CGI-S) and Clinical Global Impressions–Improvement (CGI-I) response rate. The risk of discontinuation due to adverse effects and common side effects were examined. Results: The mean difference in change from baseline for CDRS-R was −2.72 (95% confidence interval [CI], −3.96, −1.48) favoring fluoxetine treatment ( P < .001). Similarly, mean difference for CGI-S was −0.21 (95% CI, −0.36, −0.06). The risk ratio (RR) of discontinuing due to adverse events was 0.98 (95% CI, 0.54, 1.83), with RR for headache side effects 1.34 (95% CI, 1.03, 1.74) and rash 2.6 (95% CI, 1.32, 5.14). Conclusion: Fluoxetine demonstrates significant improvements in symptom intensity control in young patients suffering from MDD and is considered well tolerated with similar rates of trials discontinuation; however, fluoxetine was associated with a higher risk of headache and rash side effects. These findings will guide psychiatrists and pharmacists in their clinical role for supporting the care of young mental health patients.

Effects of individualization and age on mHealth interventions to reduce physical inactivity and sedentary behaviour in children and adolescents: A systematic review and meta-analysis of randomized controlled trials (Preprint)

2021 ◽  
Author(s):  
Hannes Baumann ◽  
Janis Fiedler ◽  
Kathrin Wunsch ◽  
Bettina Wollesen ◽  
Alexander Woll
Keyword(s):  
Physical Activity ◽  
Behavior Change ◽  
Randomized Controlled Trials ◽  
Children And Adolescents ◽  
Physical Inactivity ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Low Levels

BACKGROUND Children and adolescents increasingly do not meet physical activity (PA) recommendations. Hence, insufficient physical activity (IPA) and sedentary behavior (SB) among children and adolescents are relevant behavior change domains for using individualized mobile health (mHealth) interventions. OBJECTIVE The current review and meta-analysis investigates the effectiveness of mHealth interventions on IPA and SB with a special focus on age level of individualization. METHODS PubMed, Scopus, Web of Science, SPORTDiscus, and Cochrane Library were searched for randomized controlled trials published between January 2000 and March 2021. mHealth interventions for primary prevention in children and adolescents addressing behavior change regarding insufficient PA and SB were included. Included studies were compared for content characteristics as well as methodological quality and summarized narratively. In addition, a meta-analysis with a subsequent exploratory meta-regression examining the moderating effects of age and individualization on overall effectiveness was performed. RESULTS Based on inclusion criteria, 11 of the preliminary 825 identified studies were included for qualitative synthesis and 10 were included for the meta-analysis. Trials included a total of 1515 participants (Age (M, SD) = 11.69 ± 0.788; 65% male; 35% female) with self-reported (n = 4) or device-based measured (n = 7) health data on the duration of SB and physical inactivity (PIA) for an average of 9.3±5.6 weeks. Studies with high levels of individualization decreased insufficient PA levels significantly (d = 0.33; CI = 0.08, 0.58; z = 2.55; p = 0.01), whereas those with low levels of individualization (d = -0.06; CI = -0.32, 0.20; Z = 0.48; p = 0.63), or targeting SB (d = -0.11; CI = -0.01, 0.23; z = 1.73; p = 0.08) indicated no overall significant effect. Heterogeneity of the studies was moderate to low, and significant subgroup differences between trials with high and low levels of individualization (χ2 = 4.04; df = 1; p = 0.04; I² = 75,2%) were found. Age as a moderator variable showed a small effect, but the results were not significant which might have been due to being underpowered. CONCLUSIONS Evidence suggests that mHealth interventions for children and adolescents can foster moderate reductions in PIA but not SB. Moreover, individualized mHealth interventions to reduce PIA seem more effective for adolescents than for children. Although to date only few mHealth studies address inactive and sedentary young people and their quality of evidence is moderate, these findings indicate the relevance of individualization on the one hand and the difficulties in reducing SB using mHealth interventions on the other hand. CLINICALTRIAL PROSPERO International Prospective Register of Systematic Reviews CRD42020209417; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=209417

Exercise and Resting Blood Pressure in Children and Adolescents: A Meta-Analysis

2003 ◽  
Vol 15 (1) ◽  
pp. 83-97 ◽  
Author(s):  
George A. Kelley ◽  
Kristi S. Kelley
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Randomized Controlled Trials ◽  
Children And Adolescents ◽  
Diastolic Blood Pressure ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Resting Blood Pressure ◽  
Initial Blood Pressure

The purpose of this study was to use the meta-analytic approach to examine the effects of exercise on resting systolic and diastolic blood pressure in children and adolescents. Twenty-five studies that included 84 groups (45 exercise, 39 control) and 3,189 subjects (1,885 exercise, 1,304 control) met the criteria for inclusion. Using a random effects model, non-significant decreases of approximately 2% were found for resting systolic (mean – SEM, –2 – 1 mmHg, 95% CI, –4 to 1 mmHg) and diastolic (mean – SEM, –1 – 1 mmHg, 95% CI, –3 to 1 mmHg) blood pressure. Greater decreases in resting systolic blood pressure were found for nonrandomized versus randomized controlled trials (p = 0.001). There was also a statistically significant association between changes in resting systolic blood pressure and initial blood pressure (r = 0.73, p < 0.001) and body weight (r = 0.64, p < 0.001). However, when limited to randomized trials, these results were no longer statistically significant. The results of this study suggest that exercise does not reduce resting systolic and diastolic blood pressure in children and adolescents. However, a need exists for additional randomized controlled trials, especially among hypertensive children and adolescents.

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