Source: J Indian Med Assoc  |  Posted 17 years ago

By Bruce Sylvester

NEW YORK, NY -- May 5, 2004 -- Over the past 12 years there has been a significant increase in the rate of children and adolescents in the U.S. who are diagnosed with depression and in rate of selective serotonin reuptake inhibitors (SSRIs) being prescribed for children with depression, researchers reported here on May 4th at the American Psychiatric Association Annual Meeting.

"We found that antidepressant use has grown among children aged 5 to 18 years old," said lead investigator Linda Robinson, MSPH, Research Coordinator, Pharmacoeconomics Division, Pharmacoepidemiology Unit, School of Pharmacy, Washington State University, Pullman, Washington.

"In 1998 the American Academy of Child and Adolescent Psychiatry suggested against the use of tricyclics in children," she said. "They suggested that SSRIs would be a better choice of drugs. We found that the use of tricyclics has decreased over the period 1990-2001 in children, and that there has been more than a doubling in the use of SSRIs among the children. This study breaks it out by type."

The investigators analyzed data from the National Ambulatory Medical Care Survey, which included the number and rate of office-based physician visits resulting in a diagnosis of depression and the prescriptions of antidepressants by type for the period 1990-2001. The researchers used the data to conduct a trend analysis, using three 4-year time intervals -- 1990-1993, 1994-1997, and 1998-2001.

They found that from 1990 to 2001, the population-adjusted rate of office visits leading to a diagnosis of depression increased 2.4-fold among children and adolescents, from 12.9 per 1,000 to 31.1 per 1,000. They also found that over the same period, children who received a prescription for an antidepressant increased from 44.4% to 59.3% and SSRI prescriptions increased from 20.7% to 39.7%. Tricyclic prescriptions antidepressant dropped from 21% to 2.7%.

"Recently and notably there has been some British research leading to concern about suicidality among children using SSRIs," Ms. Robinson added. "We haven't seen that problem here in U.S. research, but the issue is currently under review by the U.S. Food and Drug Administration."

The study was funded through a 2001 Independent Investigator Award from the National Alliance for Research on Schizophrenia and Depression.

[Presentation title: "Antidepressant Trends Among Children Diagnosed With Depression, 1990?2001." Abstract # NR485]