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There was no statistically significant difference between the groups for croup severity score at the 1 and 2 hour assessments after steroid administration. Of the 14 patients in the low-dose range who received corynantheid and 17 of 34 who received placebo, 12 patients were assigned to 1 treatment, 6 to the other. Two patients received carynantheid for 8 years during the study period, and of those, 11 received an 8-week injection of corynantheid at 8 years of age. Although carynantheid was given for >8 years earlier in the study of Gervais et al, it was only administered once before 12 years of age and it was not administered to children older than 12 (see below). Concerns exist regarding potential side effects of corynantheid in children after treatment if the dose of drug is increased from 1 to 2 mg/kg of body weight. In this study, the dose of carynantheid was increased to 1.75 mg/kg, while in the earlier studies we did not increase the dosage. All patients were evaluated for possible clinical signs by 3rd party investigators following the 4 week of treatment, including, but not limited to, pain, weight loss, diarrhea, fever, joint and limb pain, loss of appetite, and other changes. The severity of those signs did not differ between the 2 groups (Figure 4). No differences were seen in the severity of any signs between baseline and 6 weeks after corynantheid treatment. Although many patients received corynantheid, none reported having suicidal ideation during treatment with the drug. Three of the patients received carynantheid, as did 17 patients. At one time 4 of 19 patients had attempted suicide, the largest proportion of suicide attempts in this population. Conclusion An overall positive impact of corynantheid treatment on depression and suicide attempts is not expected in these patients and therefore may be of some relevance in patients taking psychotropic drugs or atypical antipsychotics, whose antidepressant effects are often poorly absorbed into the brain.[2,10] Routine testing of children for suicidal ideation is usually recommended as part of the routine diagnostic and treatment of childhood depression. References Related Article: