Your search should have produced at least 21 references (more will have been added since I made this demo). Clicking on the title of an article in PsycINFO takes you to summary information for that article. The summary will include information about the authors, the source (journal or book), and an abstract, which is a 150- to 250-word summary of the article. You can use the titles and the abstracts to decide whether to pursue an article or ignore it. Instead of looking at the references you got, look just at the ones below for now.
Based on the titles and abstracts, which one(s) appear useful or not useful?
1. Pharmacotherapy of Depressed Children and Adolescents: Current Issues and Potential Directions. Vasa, Roma A.; Carlino, Anthony R.; Pine, Daniel S.; Biological Psychiatry, Vol 59(11), Jun 2006. pp. 1021-1028. [Original Journal Article]
Abstract: The recent deliberations by the U.S. Food and Drug Administration (FDA) regarding the relationship between antidepressants and suicidality in children have incited debates about the safety of these medications for the treatment of pediatric depression. In light of these events, this review discusses four issues pertaining to pharmacotherapy for pediatric depression. First, we summarize pertinent data from randomized controlled trials of antidepressants for pediatric depression. These data provide strong support for fluoxetine and modest support for the other antidepressants. Second, we examine the outcome of the FDA meta-analysis of the data on antidepressant-induced suicidality, with specific emphasis on the methodological limitations of this analysis. Third, we consider the collective implications of the antidepressant efficacy and suicidality data on clinical practice. Specifically, we present several compelling arguments that justify the continued use of antidepressants for pediatric depression, despite the inherent limitations of these medications. Finally, we review several pathophysiological factors that might provide insights into treatment response and impact the design of future pharmacotherapy studies of depression. These factors relate to diagnostic heterogeneity, developmental consistency, and psychobiology. Potentially novel pharmacotherapies are also discussed.
CheckIt is focused only on children and adolescents, but the abstract mentions fluoxetine specifically. This looks like it would provide some good background information, but you should look for another article to go beyond the child/adolescent population. I would give this an 8/10.
2. Bipolar depression: Issues in diagnosis and treatment. Thase, Michael E.; Harvard Review of Psychiatry, Vol 13(5), Sep-Oct 2005. pp. 257-271. [Original Journal Article]
Abstract: Although bipolar affective disorder is defined by the history of manic or hypomanic episodes, depression is arguably a more important facet of the illness. Depressive episodes, on average, are more numerous and last longer than manic or hypomanic episodes, and most suicides occur during these periods. Misdiagnosis of major depressive disorder delays initiation of appropriate therapy, further worsening prognosis. Distinguishing features of bipolar depression include earlier age of onset, a family history of bipolar disorder, presence of psychotic or reverse neurovegetative features, and antidepressant-induced switching. Bipolar I depressions should initially be treated with a mood stabilizer (carbamazapine, divalproex, lamotrigine, lithium, or an atypical antipsychotic); antidepressant monotherapy is contraindicated. More severe or “breakthrough” episodes often require a concomitant antidepressant, such as bupropion or a selective serotonin reuptake inhibitor (SSRI). The first treatment specifically approved for bipolar depression is a combination of the SSRI fluoxetine and the atypical antipsychotic olanzapine. For refractory depressive episodes, venlafaxine, the monoamine oxidase inhibitor tranylcypromine, and ECT are most widely recommended. The optimal duration of maintenance antidepressant therapy has not been established empirically and, until better evidence-based guidelines are established, should be determined on a case-by-case basis.
CheckNot specific enough. Might mention fluoxetine, but the focus of this article is clearly bipolar mood disorder. I’d give this a 1/10.
3. Selective Serotonin Reuptake Inhibitors in adolescent suicide. Giner, Lucas; Nichols, C. Matthew; Carballo, Juan J.; In: Suicidal behavior in adolescence: An international perspective. Merrick, Joav; Zalsman, Gil; London, England: Freund Publishing House, 2005. pp. 81-93. [Original Chapter]
Abstract: The controversy surrounding Selective Serotonin Reuptake Inhibitors (SSRIs) and suicidality dates back to the early 1990’s, as the first agent reported to be associated with suicidality was fluoxetine. In 2003, the British Medicines and Healthcare Products Regulatory Agency (MHRA) warned about possible risk of suicidality in children and adolescents treated with paroxetine for Major Depressive Disorder (MDD). This warning was soon extended to all the SSRIs as well as venlafaxine and mirtazapine. Similarly, the United States Food and Drug Administration (FDA) issued a “black box warning” for these medications in 2004. We review the history of the debate concerning this warning and its clinical implications, and review the latest contributions to the literature.
CheckBingo. You should definitely get this one. 10/10.
4. Fluoxetine and suicide: A meta-analysis of controlled trials of treatment for depression. Beasley, Charles M.; Dornseif, Bruce E.; Bosomworth, Janet C.; International Clinical Psychopharmacology, Vol 6(Suppl 6), Jun 1992. pp. 35-57. [Journal Article]
Abstract: Conducted a meta-analysis of data from 17 double-blind clinical controlled trials in patients with major depressive disorder comparing fluoxetine (n = 1,765) with a tricyclic antidepressant (n = 731) or placebo (n = 569), or both. Multiple data sources were searched to identify patients with suicidal acts. Suicidal ideation was assessed with Item 3 of the Hamilton Rating Scale for Depression, which systematically rates suicidality. Improvement was defined as a decrease from baseline at the last visit during the treatment. The pooled incidence of improvement of suicidal ideation was 72.2% for fluoxetine, 54.8% for placebo, and 69.8% for tricyclic antidepressants. Data do not show that fluoxetine is associated with an increased risk of suicidal acts or emergence of substantial suicidal thoughts among depressed patients.
CheckDing! Ding! Ding! We have a winner! Not only does this directly address the question we are after, but it is also a meta-analysis, which means that it systematically combines the results of many studies. Only downside is that it is older: 1992. It will not address more recent research. 9/10.
On the PsycINFO search screen, find the reference that matches the last article above (title beginning "Fluoxetine and suicide: A meta-analysis...") and click on it.