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Review
. 2014 Feb;59(2):89-97.
doi: 10.1177/070674371405900204.

Long-term trend in pediatric antidepressant use, 1983-2007: a population-based study

Xiangfei Meng, Carl D'Arcy, Raymond Tempier
Review

Long-term trend in pediatric antidepressant use, 1983-2007: a population-based study

Xiangfei Meng et al. Can J Psychiatry. 2014 Feb.

Abstract
in English, French

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.

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Figures

Figure 1a
Figure 1a
The rate of ADs dispensed to children and adolescents aged 0 to 19 by sex, Saskatchewan, 1983 to 2007
Figure 1b
Figure 1b
The rate of ADs dispensed by age groups standardized to the total of 9 years in Saskatchewan covered youth population, 1983 to 2007
Figure 2a
Figure 2a
The rate of ADs dispensed to male children and adolescents aged 0 to 19 by age, Saskatchewan, 1983 to 2007
Figure 2b
Figure 2b
The rate of ADs dispensed to female children and adolescents aged 0 to 19 by age, Saskatchewan, 1983 to 2007
Figure 3
Figure 3
The rate of ADs dispensed to children and adolescents aged 0 to 19 by medical specialty, Saskatchewan, 1983 to 2007
Figure 4
Figure 4
The rate of dispensed ADs to children and adolescents by subclass, Saskatchewan, 1983 to 2007
Figure 5
Figure 5
The percentage of pediatric patients who were dispensed different numbers of ADs, Saskatchewan, 1983 to 2007
See this image and copyright information in PMC

References

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