CNS Spectrums

Review Articles

Are antidepressants effective in quality of life improvement among children and adolescents? A systematic review

Dejan Stevanovica1 c1, Ivana Tadica2 and Rajna Kneza3

a1 Department of Psychiatry, General Hospital Sombor, Sombor, Serbia

a2 Department of Social Pharmacy and Pharmacy Legislation, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia

a3 Department of Psychiatry, Rijeka University Hospital Centre, Rijeka, Croatia


There is some evidence indicating that psychotropic medications might lead to health-related quality of life (QOL) improvements among children and adolescents with psychiatric disorders. The aim of this systematic review is to assess evidence regarding whether antidepressant treatment improves QOL among children and adolescents with depressive or anxiety disorders. A comprehensive search resulted in 5 clinical trials to be included in this review: 4 trials with major depressive disorder (MDD) and 1 trial with social anxiety disorder (SAD). In one MDD trial, fluoxetine combined with cognitive behavior therapy (CBT) significantly improved QOL compared to fluoxetine or CBT alone (effect sizes were 0.53 and 0.69, respectively). In 2 combined trials, sertraline alone significantly improved QOL among adolescents with MDD (effect size was 0.29), but not among children with MDD. Essentially, it was observed that antidepressants in these trials had minor positive effects on QOL improvement, which were lower than their potential to improve depressive symptoms. Although fluoxetine with CBT or sertraline monotherapy were shown to have some potential to improve QOL, this systematic review found inconclusive evidence that antidepressant treatments improve QOL among children and adolescents with depressive or anxiety disorders. More research is required, considering that QOL is currently under-evaluated in clinical trials with antidepressants among children and adolescents and available trials have limited methodological quality when reporting QOL data.

(Received March 21 2013)

(Accepted July 29 2013)

(Online publication September 13 2013)

Key words

  • Anxiety disorders;
  • clinical trial;
  • depression;
  • efficacy;
  • quality of life


c1 Address for correspondence: Dejan Stevanovic, MD, Department of Psychiatry, General Hospital Sombor, Apatinski put 38, 25000 Sombor, Serbia. Email