[Use of antidepressants among children and adolescents--did the warnings lead to fewer prescriptions?].
BACKGROUND
Use of antidepressants (especially selective serotonin reuptake inhibitors (SSRIs) and venlafaxine) for treatment of children and adolescents with major depression, anxiety disorders or obsessive-compulsive disorders (OCD) has been discussed, because of marginal effects and an increased risk for suicidal thoughts and actions. The European and Norwegian health authorities issued a series of warnings and recommendations from the summer 2003 till the summer of 2005. The newly established Norwegian Prescription Database was used to investigate whether these warnings have had an effect.


METHODS
The number of SSRI users was compared monthly to the number of venlafaxine users in the period 2004 to 2006. Users below 18 of age were compared to those aged 18 or above. New users of SSRIs and venlafaxine in 2005 and 2006 were characterized according to age, gender and the medical specialty of the doctor giving the first prescription for the drugs.


RESULTS
The SSRIs/venlafaxine user proportion for those below 18 years of age was 17% lower in 2005 than in 2004. Among older users the number rose by 2%. Fluoxetin was the most frequently prescribed drug among young first time users. Non-specialist MDs prescribed most of the drugs.


CONCLUSIONS
Antidepressants are used less by children and adolescents in Norway than in many other countries, but the warnings against SSRIs and venlafaxine seem to have had an effect anyway. Also the official recommendation to use fluoxetine seems to have been followed.
Bramness
Jørgen G
JG
Avdeling for legemiddelepidemiologi, Divisjon for epidemiologi, Nasjonalt folkehelseinstitutt, Postboks 4404 Nydalen, 0403 Oslo. jorgen.bramness@fhi.no
Engeland
Anders
A
Furu
Kari
K
D000293:Adolescent; D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000008:administration & dosage* / Q000009:adverse effects; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D003511:Cyclohexanols / Q000008:administration & dosage* / Q000009:adverse effects; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends; D005260:Female; D005473:Fluoxetine / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008297:Male; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D000069470:Venlafaxine Hydrochloride
D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D003511:Cyclohexanols; D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride