Long-term trend in pediatric antidepressant use, 1983-2007: a population-based study
- PMID: 24881127
- PMCID: PMC4079232
- DOI: 10.1177/070674371405900204
Long-term trend in pediatric antidepressant use, 1983-2007: a population-based study
Abstract
Objective: Research is needed to clarify and improve our understanding of appropriateness and safety issues concerning antidepressant (AD) treatment. We explored the long-term trend in the dispensing of pediatric ADs using provincial, population-based data from Canada.
Methods: Data covering 22 ADs were drawn from the Saskatchewan Ministry of Health administrative data files in outpatient settings. The data were for 9 triennial years from 1983 to 2007, a 24-year period, for those aged 0 to 19 in the general population. Descriptive analyses were used.
Results: In 1983, 5.9 per 1000 population aged 0 to 19 were dispensed at least 1 AD; this decreased to 5.1 per 1000 population in 1989, and then increased to 15.4 per 1000 population in 2007, with a slower increase after 2004. Both sexes were dispensed more ADs from 1989 onwards, with females being the heavier users. The rate of AD use increased significantly with age, and this trend became more pronounced after 1998. Family physicians were the major prescribers and their prescriptions significantly increased from 1989 to 2004 and decreased in 2007. The use of selective serotonin reuptake inhibitors (SSRIs) was the major reason for the increase. The number of AD scripts per patient also increased.
Conclusions: The growth in the prevalence of AD use among children and youth was largely caused by the use of SSRIs. The possibility of safety issues induced by AD use among children and adolescents, and different patterns of medication practice, suggest continuing education is warranted.
Objectif :: La a recherche est nécessaire pour clarifier et améliorer notre compréhension des questions d’applicabilité et d’innocuité concernant le traitement aux antidépresseurs (AD). Nous avons exploré la tendance à long terme de la dispensation d’AD pédiatriques à l’aide des données provinciales d’une population du Canada.
Méthodes :: Des données sur 22 AD ont été extraites des fichiers de données administratives sur les services externes du ministère de la Santé de la Saskatchewan. Les données couraient sur 9 années triennales de 1983 à 2007, une période de 24 ans, pour les personnes de 0 à 19 ans de la population générale. Des analyses descriptives ont été utilisées.
Résultats :: En 1983, 5,9 par 1000 de population âgés de 0 à 19 ans se sont fait dispenser au moins 1 AD, ce qui a diminué à 5,1 par 1000 de population en 1989, puis qui a augmenté à 15,4 par 1000 de population en 2007, l’augmentation étant plus lente après 2004. Plus d’AD ont été dispensés aux deux sexes à compter de 1989 et après, les filles étant les plus grandes utilisatrices. Le taux d’utilisation des AD s’est accru significativement avec l’âge, et cette tendance est devenue plus marquée après 1998. Les médecins de famille étaient les principaux prescripteurs et leurs ordonnances ont augmenté significativement de 1989 à 2004 pour diminuer en 2007. L’utilisation des inhibiteurs spécifiques du recapture de la sérotonine (ISRS) constitue la principale raison de l’augmentation. Le nombre de prescriptions d’AD par patient a aussi augmenté.
Conclusions :: La croissance de la prévalence de l’utilisation d’AD chez les enfants et les adolescents a été largement causée par l’utilisation des ISRS. La possibilité de problèmes d’innocuité induits par l’utilisation d’AD chez les enfants et les adolescents, et différents modèles de pratique des médicaments suggèrent que la formation continue est justifiée.
Figures







Similar articles
-
What were the impacts of the Committee on Safety of Medicines warning and publication of the NICE guidelines on trends in child and adolescent antidepressant prescribing in primary care? A population based study.BMJ Open. 2019 Aug 7;9(8):e028201. doi: 10.1136/bmjopen-2018-028201. BMJ Open. 2019. PMID: 31391190 Free PMC article.
-
Outpatient treatment of children and adolescents with antidepressants in Croatia.Int J Psychiatry Clin Pract. 2012 Sep;16(3):214-22. doi: 10.3109/13651501.2011.640939. Epub 2011 Dec 5. Int J Psychiatry Clin Pract. 2012. PMID: 22136212
-
Trends in psychotropic use in Saskatchewan from 1983 to 2007.Can J Psychiatry. 2013 Jul;58(7):426-31. doi: 10.1177/070674371305800708. Can J Psychiatry. 2013. PMID: 23870725
-
Update on depression and antidepressant medications.Medsurg Nurs. 2006 Aug;15(4):241-6, 222. Medsurg Nurs. 2006. PMID: 16999187 Review. No abstract available.
-
Pharmacotherapy of early-onset depression. Update and new directions.Child Adolesc Psychiatr Clin N Am. 2000 Jan;9(1):135-57. Child Adolesc Psychiatr Clin N Am. 2000. PMID: 10674194 Review.
Cited by
-
Trends in psychiatric disorders prevalence and prescription patterns of children in Alberta, Canada.Soc Psychiatry Psychiatr Epidemiol. 2019 Dec;54(12):1565-1574. doi: 10.1007/s00127-019-01714-w. Epub 2019 May 25. Soc Psychiatry Psychiatr Epidemiol. 2019. PMID: 31129714
-
Prescription prevalence of psychotropic drugs in children and adolescents: an analysis of international data.Eur J Clin Pharmacol. 2019 Oct;75(10):1333-1346. doi: 10.1007/s00228-019-02711-3. Epub 2019 Jul 4. Eur J Clin Pharmacol. 2019. PMID: 31270564
-
Autophagy Induction and Accumulation of Phosphorylated Tau in the Hippocampus and Prefrontal Cortex of Adult C57BL/6 Mice Subjected to Adolescent Fluoxetine Treatment.J Alzheimers Dis. 2021;83(4):1691-1702. doi: 10.3233/JAD-210475. J Alzheimers Dis. 2021. PMID: 34420960 Free PMC article.
-
Time trends in symptoms of mental illness in children and adolescents in Canada.CMAJ. 2014 Dec 9;186(18):E672-8. doi: 10.1503/cmaj.140064. Epub 2014 Nov 3. CMAJ. 2014. PMID: 25367419 Free PMC article.
-
Poor guideline adherence in the initiation of antidepressant treatment in children and adolescents in the Netherlands: choice of antidepressant and dose.Eur Child Adolesc Psychiatry. 2016 Nov;25(11):1161-1170. doi: 10.1007/s00787-016-0836-3. Epub 2016 Mar 17. Eur Child Adolesc Psychiatry. 2016. PMID: 26988978 Free PMC article.
References
-
- Stahl SM. Selecting an antidepressant by using mechanism of action to enhance efficacy and avoid side effects. J Clin Psychiatry. 1998;59(Suppl 18):23–29. - PubMed
-
- Zito JM, Tobi H, de Jong-van den Berg LT, et al. Antidepressant prevalence for youths: a multi-national comparison. Pharmacoepidemiol Drug Saf. 2006;15(11):793–798. - PubMed
-
- Fegert JM, Kolch M, Zito JM, et al. Antidepressant use in children and adolescents in Germany. J Child Adolesc Psychopharmacol. 2006;16(1–2):197–206. - PubMed
-
- Middleton N, Gunnell D, Whitley E, et al. Secular trends in antidepressant prescribing in the UK, 1975–1998. J Public Health Med. 2001;23(4):262–267. - PubMed
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical