Impact of regulatory safety warnings on the use of antidepressants among children and adolescents in Finland.
OBJECTIVE
The aim of this study was to analyze changes in the prevalence and incidence of antidepressant use among children and adolescents in Finland post October, 2003.


METHODS
The sample comprised all children and adolescents in Finland aged < or =19.0 years (n = 27,676) who collected one or more reimbursed prescriptions for an antidepressant in noninstitutional and nonhospital settings between January, 1998, and December, 2005. Time-series models were used to compare antidepressant use 60 months before and 24 months after the health advisory issued by the Food and Drug Administration (FDA) in October, 2003.


RESULTS
The annual prevalence (users/1,000 youths) of antidepressant use increased from 5.24 in 2002 to 5.93 in 2005. There was an increase in the monthly incidence (users = 1,000 youths) of selective serotonin reuptake inhibitors (SSRIs) use (+0.02498), fluoxetine use (+0.00691), and sertraline use (+0.00727) post October, 2003. When considering preadvisory trends in antidepressant use, only fluoxetine use was higher than the predicted post October 2003, use (<0.001). The use of all other SSRIs was significantly lower than predicted.


CONCLUSIONS
In contrast to many other countries, the use of antidepressants continued to increase among children and adolescents in Finland post October, 2003. While the rate of fluoxetine use increased, there was a decline in the rate at which all other SSRIs were used.
Foulon
Veerle
V
Research Centre for Pharmaceutical Care and Pharmacoeconomics, Faculty of Pharmacy, Katholieke Universiteit Leuven, Belgium.
Svala
Anni
A
Koskinen
Hanna
H
Chen
Timothy F
TF
Saastamoinen
Leena K
LK
Bell
J Simon
JS
D000293:Adolescent; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004348:Drug Labeling; D004363:Drug Utilization / Q000706:statistics & numerical data / Q000639:trends; D004335:Drug and Narcotic Control; D005260:Female; D005387:Finland; D006801:Humans; D015994:Incidence; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends; D015995:Prevalence
D000928:Antidepressive Agents