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. 2025 Jan-Dec:16:21501319251347906.
doi: 10.1177/21501319251347906. Epub 2025 Jun 17.

Patterns of Antidepressant and Antianxiety Medication Prescriptions in Pediatric Primary Care in the U.S

Laura M Prichett  1   2 , Andrea S Young  1 , Ellie Wu  1 , Robert H Yolken  1 , Emily G Severance  1 , Juleisa Badio  1 , Meilin Zheng  1 , Tina Kumra  1
Affiliations

Patterns of Antidepressant and Antianxiety Medication Prescriptions in Pediatric Primary Care in the U.S

Laura M Prichett et al. J Prim Care Community Health. 2025 Jan-Dec.

Abstract

Background: Shortages of pediatric mental health (MH) specialty providers have left pediatric primary care providers (PPCP) to care for the influx of youth with MH needs. This study examined trends in prescription of antidepressants and antianxiety medication in pediatric primary care clinics from 2015 to 2023.

Methods: Annual rates of prescription of antidepressant and/or antianxiety medication orders were calculated by race/ethnicity, sex, and practice type. Adjusted mean differences (AMD) were calculated and compared for the beginning and end of the study period.

Results: Prescription orders for antianxiety and/or antidepressant medications increased between 2015 and 2023 across all patients but was greatest among Hispanic youth (AMD = 50.9, 95% CI = 15.3-86.4) and among females irrespective of race (AMD = 29.3, 95% CI = 16.8-41.7). Despite these increases, non-Hispanic White youth were more likely to receive prescriptions than Hispanic and non-Hispanic Asian or Black youth across time periods. Family practices (treating adults and children) had the highest rates of prescription across time periods.

Conclusions: While prescription rates for antidepressant and antianxiety medications have increased overall, treatment gaps between White and ethnoracially minoritized pediatric patients have persisted. Differences in prescribing patterns between practice environments suggest PPCPs may be more comfortable prescribing MH medications in family practices relative to pediatric practices.

Keywords: adolescent; anxiety; depression; disparities; medication; pediatrics; primary care; suicide.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Overall trend in antianxiety/antidepressant prescriptions, from 2015 to 2023, patients ages 12 to 20 years, n = 36 967.
Figure 2.
Figure 2.
Trend in antianxiety/antidepressant prescriptions by sex, from 2015 to 2023, patients ages 12 to 20 years, n = 36 967.
Figure 3.
Figure 3.
Trend in antianxiety/antidepressant prescriptions by practice type, from 2015 to 2023, patients ages 12 to 20 years, n = 36 967.
Figure 4.
Figure 4.
Trend in antianxiety/antidepressant prescriptions by race/sex subgroup from 2015 to 2023, patients ages 12 to 20 years: (a) White and Black males and females, (b) White and Hispanic males and females, and (c) White and Asian males and females.
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