Multinational Study Shows Increase in Youth Antidepressant Use

International research team, including the School of Pharmacy’s Dr. Julie Zito, publishes new study examining antidepressant prescription rates for individuals ages 0-19 years.

By Malissa Carroll
March 10, 2016

A study published by an international research team in the journal European Neuropsychopharmacology shows rising rates of antidepressant use among children and adolescents ages 0-19 years.  Julie Zito, BSPharm, PhD, professor in the Department of Pharmaceutical Health Services Research (PHSR) at the University of Maryland School of Pharmacy, collaborated on the study, which featured data from five Western countries,  namely,  Denmark, Germany, the Netherlands, the United Kingdom, and the United States, and is the first multinational comparison of antidepressant use trends among  children and adolescents conducted in recent years.

“The safety of antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), for the treatment of depression in children and adolescents has been the subject of much discussion in recent years,” says Zito.

In 2004, the Food and Drug Administration (FDA) issued a boxed warning for SSRIs and other antidepressants. The warning indicated that children and adolescents who used these medications were at an increased risk for suicidal behaviors. Two years after the warning was issued, researchers noted a substantial decrease in the use of antidepressants among this population. However, it was unclear whether the decrease had persisted over time. The goal of this study was to provide important information on how antidepressant use in children and adolescents has evolved over recent years in different countries.

Zito and nine other researchers led by Christian Bachmann, MD, DrPH, visiting researcher in the Department of Child and Adolescent Psychiatry and the Institute of Psychiatry, Psychology, and Neuroscience at King’s College London, came together to design a new study to assess recent trends in antidepressant use among children and adolescents across five different countries. Using information collected from large health care databases in each country, the team compared the prevalence of use for SSRIs and tricyclic antidepressants (TCAs) from 2012 to data from 2005. They uncovered significant increases in antidepressant use across all countries studied over the seven year period.

“In all of the countries that we examined, we found that the use of antidepressants among children and adolescents has increased in recent years,” says Zito.

Across the study years, antidepressant prevalence of use was greater in U.S. youth than European youth. For example, U.S. youth had 50 percent greater use than U.K. youth. However, the greatest increases occurred in Denmark, Germany, and the U.K.

“Despite the sudden drop in antidepressant use in children and adolescents following the FDA boxed warning in the U.S., antidepressant use has rebounded here in the U.S. and increased substantially in other Western countries,” says Zito. “Without further study of diagnosis, treatment-emergent changes in safety, and functional outcomes (e.g., academic performance and social relationships), the pediatric antidepressant story is not complete.”

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