Magazine article Clinical Psychiatry News

Antidepressant Use in American Youth on Rise. (900,000 Children Aged 2-19 Years)

Magazine article Clinical Psychiatry News

Antidepressant Use in American Youth on Rise. (900,000 Children Aged 2-19 Years)

Article excerpt

American youth are being treated with antidepressants in ever-increasing numbers, reported Julie Magno Zito, Ph.D., of the University of Maryland, Baltimore, and her colleagues.

The underlying diagnosis appears to differ based on whether the child is seen in a psychiatric or primary care setting, the researchers observed in a study of community patterns of antidepressant treatment in children.

The period between 1988 and 1994 saw a three- to fivefold increase in the overall prevalence of antidepressant treatment among 900,000 youths aged 2-19 years in two geographically distinct Medicaid populations and a group-model HMO. Data for the study were obtained from medical service utilization records and antidepressant prescription claims for youths enrolled in Midwestern and Mid-Atlantic Medicaid programs, as well as a group-model HMO in the Northwest (Pediatrics 109[5]:721-27, 2002).

A retrospective review of the treatment data also showed that antidepressant use in children who were seen in psychiatric settings tended to be associated with a diagnosis of depression, while youths being treated in primary care settings were more likely to receive antidepressants for attention-deficit hyperactivity disorder (ADHD).

The study considered three subclasses of antidepressants: tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and "other" antidepressants, which included trazodone, bupropion, maprotiline, and venlafaxine. In 1988, TCAs were the most commonly used antidepressant subclass across the study population. By 1994, the prevalence of SSRI use nearly equaled that of the TCAs, but TCA use still represented the majority of the total antidepressant use across the three health care sites.

The overall surge in antidepressant use can be attributed in part to the rapidly expanding use of SSRIs prescribed mainly for depression and anxiety, the investigators noted. …

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