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        Antidepressants in children and adolescents – changes in utilization after safety warnings
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        Antidepressants in children and adolescents – changes in utilization after safety warnings
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Background:

Antidepressants, in particular selective serotonin reuptake inhibitors (SSRIs), are one of the most commonly used classes of psychotropic drug in children and adolescents. In 2003, emerging evidence suggested that antidepressants may increase risk of suicidal behaviour in young people. This evidence was accompanied by national and international guidelines cautioning against use of many antidepressants in young people. This study aimed to assess whether these safety warnings have impacted upon antidepressant utilization rates.

Methods:

This study was based at a metropolitan health service incorporating children's and adult hospitals. Total service utilization of antidepressants was extracted from pharmacy software for the period January 2002 to December 2005. Monthly utilization rates were computed for adults and children's services as defined daily doses per occupied bed days. Changes in utilization over time were compared for children and adults.

Results:

There was a significant relationship between time and antidepressant utilization in children and adolescents, where antidepressant use decreased over time (R = 0.416, t = −3.11, P < 0.01). In contrast, there was a trend suggesting a minor increase in use of antidepressants over time in adults (R = 0.262, t = 1.84, P = 0.072). In children, there was a reduction in use of all SSRIs, except for fluoxetine, which exhibited a small increase in use.

Conclusions:

National and international warnings about safety of antidepressants in children and adolescent appear to have influenced utilization of these medications. Further research is required to determine optimal utilization rates.