Magazine article Clinical Psychiatry News

Antidepressant Use Soars for Preschool Girls, Boys: Prescriptions for 1998-2002 Examined

Magazine article Clinical Psychiatry News

Antidepressant Use Soars for Preschool Girls, Boys: Prescriptions for 1998-2002 Examined

Article excerpt

Antidepressant use doubled among preschool girls and increased by 64% among preschool boys between 1998 and 2002, based on a national sample of prescriptions for commercially insured children.

Overall antidepressant use in children aged 18 years and younger in the United States jumped by 49%--from 160 prescriptions per 10,000 children (1.6%) in 1998 to 240 prescriptions per 10,000 children (2.4%) in 2002.

The total growth in use was higher among girls (68%) than boys (48%), said Thomas Delate, Ph.D., and his colleagues at Express Scripts Inc., a pharmacy benefit management company based in St. Louis. Express Scripts supplied prescription information for the years 1998-2002 from databases that were created for research purposes. The company also funded the study.

The population-based, retrospective study examined the prevalence of ambulatory prescription antidepressant use in children who were commercially insured (Psychiatric Services 55[4]:387-91, 2004). In the samples of more than 300,000 children aged 18 years and younger for each year studied, the number of children using antidepressants increased from 5,880 in 1998 to 9,013 in 2004.

Preschool girls accounted for 0.08% of the overall sample in 1998 and 0.16% in 2002, while preschool boys accounted for 0.14% of the overall sample in 1998 and 0.23% in 2002.

In addition, the use of antidepressants was higher among younger boys and older girls over the 4 years studied, and the prevalence of use increased with successively older age groups.

The findings come against the backdrop of increased scrutiny of antidepressants by the Food and Drug Administration. In March, the agency called for stronger warning labels on 10 antidepressants. (See related editorial on p. 23.)

Few antidepressants have been FDA-approved for use in children, but off-label use appears to be rising and gaining acceptance, the researchers said. Among the possible factors behind this trend are increasing rates of depression in successive age groups, growing awareness of and screening for depression by pediatricians, increasing extrapolation of safe and successful adult treatments to the needs of children, and increasing reliance on pharmacotherapy by physicians as health insurance coverage for mental health services, such as psychotherapy, declines.

In a teleconference earlier this spring, Dr. Russell Katz, director of the FDA's Division of Neuropharmacological Drug Products, said the FDA has requested that the manufacturers of fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), escitalopram (Lexapro), bupropion (Wellbutrin), venlafaxine (Effexor), nefazodone (Serzone), and mirtazapine (Remeron) place revised warnings on these products that include the potential for worsening depressive symptoms, suicidal thoughts, and manic episodes in bipolar patients. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed


An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.