The Prevalence of Stimulant and Antidepressant Use by Australian Children and Adolescents with Attention-Deficit/Hyperactivity Disorder and Major Depressive Disorder: A National Survey

By Sawyer, Michael G.; Reece, Christy E. et al. | Journal of Child and Adolescent Psychopharmacology, March 2017 | Go to article overview

The Prevalence of Stimulant and Antidepressant Use by Australian Children and Adolescents with Attention-Deficit/Hyperactivity Disorder and Major Depressive Disorder: A National Survey


Sawyer, Michael G., Reece, Christy E., Sawyer, Alyssa Cp, Johnson, Sarah, Lawrence, David, Zubrick, Stephen R., Journal of Child and Adolescent Psychopharmacology


[Author Affiliation]

Michael G. Sawyer. 1 School of Medicine, University of Adelaide, Adelaide, South Australia, Australia. 2 Research and Evaluation Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia.

Christy E. Reece. 1 School of Medicine, University of Adelaide, Adelaide, South Australia, Australia. 2 Research and Evaluation Unit, Women's and Children's Health Network, Adelaide, South Australia, Australia.

Alyssa C.P. Sawyer. 1 School of Medicine, University of Adelaide, Adelaide, South Australia, Australia. 3 School of Public Health, University of Adelaide, Adelaide, South Australia, Australia.

Sarah Johnson. 4 Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.

David Lawrence. 4 Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.

Stephen R. Zubrick. 4 Telethon Kids Institute, The University of Western Australia, Perth, Western Australia, Australia.

Funding: Young Minds Matter: The second Australian Child and Adolescent Survey of Mental Health and Wellbeing was funded by the Australian Government Department of Health.

Address correspondence to: Michael G. Sawyer, MBBS, PhD, Research and Evaluation Unit, Women's and Children's Hospital, 72 King William Road, North Adelaide 5006, South Australia, Australia, E-mail: michael.sawyer@adelaide.edu.au

Introduction

Although there is little evidence that the prevalence of child and adolescent mental disorders has changed during recent years, in many countries, prescribing of stimulant and antidepressant medications has greatly increased during this time (Hodgkins et al. 2011; Pringsheim et al. 2011; McCarthy et al. 2012; Zuvekas and Vitiello 2012; Karanges et al. 2014). For example, between 2009 and 2012 in Australia, there was a 26.7% increase in dispensing of stimulant medication for 3- to 9-year-olds and a 14.2% increase for 10- to 14-year-olds (Karanges et al. 2014). In the UK, prescribing of antidepressants among children and adolescents aged 18 years or younger increased 1.7-fold between 1992 and 2001, while prescribing of stimulant medication for 15- to 21-year-olds increased 6.23-fold between 1999 and 2006 (Murray et al. 2004; McCarthy et al. 2012). In the United States, from 1996 to 2008, stimulant use among 0- to 18-year-olds increased 3.4% annually, primarily due to a marked increase in use with adolescents (Zuvekas and Vitiello 2012). Over the same time, although the use of antidepressant medication declined somewhat following warnings about increased risk of suicidal behavior, subsequently, rates have started to rise again (Volkers et al. 2007; Wijlaars et al. 2012).

Information about the ways in which stimulant and antidepressant medications are being used to treat children in the general community is important for several reasons (for brevity, the term "children" will generally be used to refer to "children and adolescents" in this article). First, there is only limited evidence that antidepressant medications are effective when used to treat childhood depressive disorders (Hetrick et al. 2012). Second, while there is evidence that stimulant medications provide short-term benefits for attention-deficit/hyperactivity disorder (ADHD), evidence of longer term benefits is weaker (Thomas et al. 2013; Storebo et al. 2015). Third, both stimulant and antidepressant medications can cause important adverse side effects (Psychotropic Expert Group 2013; Taylor et al. 2015).

The percentages of children with ADHD and major depressive disorder (MDD) in the community treated with stimulant and antidepressant medications are unclear. In addition, there is little information about the number of children without these disorders who are being treated with these medications. These are significant omissions because accurate targeting of medications is important to ensure that all children with treatable disorders receive appropriate medications, while those without disorders are not exposed to inappropriate treatments and adverse side effects. …

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