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. 2007 Apr;97(4):750-4.
doi: 10.2105/AJPH.2006.087262. Epub 2007 Feb 28.

The effect of antidepressant warnings on prescribing trends in Ontario, Canada

Paul A Kurdyak  1 , David N Juurlink, Muhammad M Mamdani
Affiliations

The effect of antidepressant warnings on prescribing trends in Ontario, Canada

Paul A Kurdyak et al. Am J Public Health. 2007 Apr.

Abstract

Objectives: We studied whether 5 regulatory agency advisories concerning the possible increased risk of suicidal behavior during antidepressant therapy had an effect on antidepressant prescription trends in Ontario.

Methods: We conducted a population-based, time-series analysis of new monthly antidepressant prescriptions dispensed by the Ontario Drug Benefits program in 3 age groups (younger than 20 years, 20-65 years old, and older than 65 years) over a 7-year period (April 1998 to March 2005). The impact of five advisories about the possible risk of suicide during antidepressant therapy was also analyzed.

Results: The number of new prescriptions for selective serotonin reuptake inhibitors as a group did not change after any antidepressant warning in any age group. However, the rate of new paroxetine prescriptions in patients younger than 20 years declined by 54% immediately after the first warning for paroxetine was issued in the United Kingdom in June 2003. That same warning had no effect on new paroxetine prescriptions in the other age categories.

Conclusion: The warning about paroxetine use in depressed patients younger than 18 years that was issued in the United Kingdom led to a significant decrease in new paroxetine prescriptions for young patients in this country. By contrast, warnings in North America did not influence new antidepressant prescription rates in any patient group.

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Figures

FIGURE 1—
FIGURE 1—
New SSRI prescription rates among individuals younger than 20 years, 20–65 years, and older than 65 years: Ontario, Canada, 2001–2005. Note. Arrows indicate the dates of the 5 antidepressant warnings: June 10, 2003 (United Kingdom), October 27, 2003 (US Food and Drug Administration [FDA]); March 22, 2004 (FDA); June 3, 2004 (Health Canada); and October 15, 2004 (FDA).
FIGURE 2—
FIGURE 2—
New paroxetine prescription rates (per 10 000 individuals) for individuals younger than 20 years: Ontario, Canada, 2003–2004. Note. The time-series forecast predicts values for new paroxetine prescriptions after June 2003. Arrows indicate the dates of the 5 antidepressant warnings: June 10, 2003 (United Kingdom); October 27, 2003 (US Food and Drug Administration [FDA]); March 22, 2004 (FDA); June 3, 2004 (Health Canada); and October 15, 2004 (FDA).
FIGURE 3—
FIGURE 3—
New paroxetine prescription rates (per 10 000 individuals) for individuals aged 20–65 years and 66 years and older: Ontario, Canada, 2003–2004.
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References

    1. Teicher MH, Glod C, Cole JO. Emergence of intense suicidal preoccupation during fluoxetine treatment. Am J Psychiatry. 1990;147:207–210. - PubMed
    1. Khan A, Khan S, Kolts R, Brown WA. Suicide rates in clinical trials of SSRIs, other antidepressants, and placebo: analysis of FDA reports. Am J Psychiatry. 2003;160:790–792. - PubMed
    1. Jick H, Kaye JA, Jick SS. Antidepressants and the risk of suicidal behaviors. JAMA. 2004;292: 338–343. - PubMed
    1. Fergusson D, Doucette S, Glass KC, et al. Association between suicide attempts and selective serotonin reuptake inhibitors: systematic review of randomised controlled trials. BMJ. 2005;330:396–399. - PMC - PubMed
    1. Gibbons RD, Hur K, Bhaumik DK, Mann JJ. The relationship between antidepressant medication use and rate of suicide. Arch Gen Psychiatry. 2005;62: 165–172. - PubMed

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