title: Patterns of antidepressant use in Quebec children and adolescents: trends and predictors.
abstract: Antidepressants are highly prescribed in youth although most products have not been approved for use in this population. Furthermore, regulatory warnings have led to changes in antidepressant use that might have differed across various countries. Our study aimed at determining factors associated with antidepressant prescribing practices and at assessing trends in use from 1997 to 2005 in Quebec youth.A retrospective cohort study was conducted through claims databases of the Quebec public health care program (RAMQ). The study included 5094 children (age 2-14) and 11,121 adolescents (age 15-19) who were incident users of antidepressant between 1997 and 2005. The characteristics of users and prescribers were the main independent variables.Tricyclics were the most frequently dispensed products among children (50.9%) and selective serotonin reuptake inhibitors among adolescents (58.8%). Selection of an antidepressant class was associated with patient characteristics and with prescriber specialty. The number of antidepressant users increased from 1997 until 2001 then decreased thereafter.The selection of an antidepressant class was associated with clinical and non-clinical characteristics. Although antidepressant use decreased after regulatory warnings, there appears to be a care gap between the evidence generated by efficacy studies and the products prescribed in a real-life setting.
authors.affiliation: Center for Clinical Epidemiology and Community Studies, SMBD Jewish General Hospital, Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.
authors.forename: Marie
authors.initials: M
authors.lastname: Tournier
authors.forename: Brian
authors.initials: B
authors.lastname: Greenfield
authors.forename: Guillaume
authors.initials: G
authors.lastname: Galbaud du Fort
authors.forename: Thierry
authors.initials: T
authors.lastname: Ducruet
authors.forename: Julie Magno
authors.initials: JM
authors.lastname: Zito
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Cloutier
authors.forename: Yola
authors.initials: Y
authors.lastname: Moride
mesh_terms: D000293:Adolescent; D000367:Age Factors; D000928:Antidepressive Agents / Q000145:classification / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003863:Depression / Q000188:drug therapy* / Q000453:epidemiology; D004363:Drug Utilization / Q000706:statistics & numerical data* / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D055553:Prescription Drugs / Q000627:therapeutic use; D011792:Quebec / Q000453:epidemiology; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D055553:Prescription Drugs