Journal of the American Academy of Child and Adolescent Psychiatry
March 7, 2025
Colette Kosik-Gonzalez, Dong-Jing Fu, Li Nancy Chen et al.
14 citations
In a phase 2b trial, adolescents aged 12 to 17 with major depressive disorder at imminent risk for suicide received either esketamine nasal spray (28, 56, or 84 mg) or a psychoactive placebo (oral midazolam) twice weekly for four weeks, alongside standard care including hospitalization, an antidepressant, and psychotherapy. Pooled esketamine doses (56 and 84 mg) reduced depressive symptoms more than midazolam at 24 hours after the first dose, though individual doses did not reach statistical significance. Suicidality severity improved across all groups. Common side effects included dizziness, nausea, and dissociation.
Journal of the American Academy of Child and Adolescent Psychiatry
December 1, 2024
Jessica K Jeffrey, Marc J Weintraub, Charles S Grob
12 citations
A significant proportion of adolescents continue to experience impairing psychiatric symptoms even after receiving existing mental health services. The authors propose that the benefit-to-risk calculation supports trialing classic serotonergic psychedelics (e.g., psilocybin) and empathogenic compounds (e.g., MDMA) in combination with psychotherapy among select adolescents aged 16 to 17 years. They specifically recommend testing these treatments in adolescents with treatment-resistant psychiatric disorders or disorders that align with the current adult evidence base, such as those with FDA breakthrough designation for psilocybin in major depressive disorder or MDMA in posttraumatic stress disorder.
Journal of the American Academy of Child and Adolescent Psychiatry
December 19, 2024
Paul E Croarkin, Isabella Sutherland, Ming-Fen Ho
1 citation
A commentary responds to an earlier article advocating for clinical trials of psychedelic-assisted therapy in adolescents aged 16 to 17. The authors agree that rigorous studies of compounds like psilocybin, LSD, and MDMA in this age group are warranted, as adolescents are likely already using these substances therapeutically. They offer additional considerations to foster further dialogue and advocacy in the field.
Journal of the American Academy of Child and Adolescent Psychiatry
March 17, 2026
Yunjia Liu, Qiang Wang
Adolescent major depressive disorder is a leading cause of disability and a major risk factor for suicide. For 30% to 50% of patients who do not achieve remission after multiple treatments, consequences are substantial. Selective serotonin-reuptake inhibitors, though first-line, often take weeks to work and many adolescents do not respond, leaving a critical treatment gap. Esketamine, an NMDA receptor antagonist, may provide faster relief than conventional antidepressants, including as a monotherapy for treatment-resistant depression, but its neural mechanisms in the developing brain are not fully understood. Understanding these mechanisms is needed to guide clinical use and targeted prevention.