title: Trends in use of antidepressants, lithium, and anticonvulsants in Kaiser Permanente-insured youths, 1994-2003.
abstract: In view of the current controversy regarding the use of antidepressants in children and adolescents, we examined trends from 1994 to 2003 in the use of antidepressants, lithium, and anticonvulsants by enrollees, aged 5-17 years, of Kaiser Permanente in Northern California. We found that the use of antidepressants more than doubled from 9.4 per 1000 enrollees to 21.3 per 1000. Most of this increase is associated with selective serotonin reuptake inhibitors (SSRIs), which increased from 4.6 to 14.5 per 1000. The use of tricyclic antidepressants (TCAs) decreased markedly, while the increase of other newer antidepressants rose from 1.3 to 6.5 per 1000. The use of anticonvulsants nearly doubled, from 3.5 to 6.9 per 1000, while lithium use was relatively stable at a rate of nearly 1 per 1000. Use of SSRIs, newer antidepressants, and anticonvulsants increased in boys as well as girls in each of three age groups: 5-9, 10-14, and 15-17 years. An increasing percentage of the antidepressant users had a diagnosis of depression, and an increasing percentage of anticonvulsant users had a diagnosis of bipolar disorder. Although the safety and efficacy of antidepressants in youths needs to be more firmly established, these findings may reflect progress in the diagnosis and treatment of mental illness.
authors.affiliation: Kaiser Permanente, Division of Research, Oakland, California 94612, USA. emh@dor.kaiser.org
authors.forename: Enid M
authors.initials: EM
authors.lastname: Hunkeler
authors.forename: Bruce
authors.initials: B
authors.lastname: Fireman
authors.forename: Janelle
authors.initials: J
authors.lastname: Lee
authors.forename: Robert
authors.initials: R
authors.lastname: Diamond
authors.forename: John
authors.initials: J
authors.lastname: Hamilton
authors.forename: Cheyenne X
authors.initials: CX
authors.lastname: He
authors.forename: Robin
authors.initials: R
authors.lastname: Dea
authors.forename: William Benjamin
authors.initials: WB
authors.lastname: Nowell
authors.forename: William A
authors.initials: WA
authors.lastname: Hargreaves
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002140:California; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data / Q000639:trends*; D008094:Lithium / Q000627:therapeutic use*; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D000927:Anticonvulsants; D000928:Antidepressive Agents; D008094:Lithium