title: Off-label prescribing patterns of antidepressants in children and adolescents.
abstract: OBJECTIVE
  To understand the extent of off-label prescribing among pediatrics, the study assesses the prescribing patterns of antidepressants in ambulatory settings.
  
  
  METHODS
  A cross-sectional analysis was conducted using the National Ambulatory Medical Care Survey from 2000 to 2006. The prevalence of off-label prescribing of antidepressants was estimated, and predictive factors were evaluated.
  
  
  METHODS
  Children and adolescents aged 6-18 years to private physicians' offices.
  
  
  METHODS
  Prevalence of antidepressant prescriptions including FDA and non-FDA-approved indications, types of antidepressants prescribed, and factors associated with off-label prescribing.
  
  
  RESULTS
  Our study population made 18 646 visits to private physicians' offices, representing about 667 million weighted visits during the study period. The mean age of the patients was 12.2 years (SD = 3.7), and majority of the visits were made by White people (73.1%). Of all visits, 3.7% (95%CI: 3.2%-4.2%) were associated with antidepressants. The most prevalent form of antidepressants prescribed were selective serotonin reuptake inhibitors (63.7%). Only 9.2% of the visits were associated with FDA-approved indications. Visits made to pediatricians (adjusted OR = 2.4; 95%CI: 1.1-5.1), family physicians, and other offices (adjusted OR = 1.9; 95%CI: 1.2-3.1) were more likely to be associated with off-label prescribing as compared with visits to a psychiatrist's office.
  
  
  CONCLUSIONS
  The study observed a very high prevalence of off-label antidepressant prescribing patterns among children and adolescents in US ambulatory care settings. Coordinated efforts should be placed to evaluate the potential reasons and ramifications of antidepressant off-label prescribing to guard patients' safety.
authors.affiliation: Department of Clinical and Administrative Pharmacy Sciences, School of Pharmacy, Center for Minority Health Services Research, Howard University, Washington, DC 20059‐0001, USA. eunlee@howard.edu
authors.forename: Euni
authors.initials: E
authors.lastname: Lee
authors.forename: Anna R
authors.initials: AR
authors.lastname: Teschemaker
authors.forename: Rosemary
authors.initials: R
authors.lastname: Johann-Liang
authors.forename: Gina
authors.initials: G
authors.lastname: Bazemore
authors.forename: Martin
authors.initials: M
authors.lastname: Yoon
authors.forename: Kye-Sik
authors.initials: KS
authors.lastname: Shim
authors.forename: Marlon
authors.initials: M
authors.lastname: Daniel
authors.forename: Jerome
authors.initials: J
authors.lastname: Pittman
authors.forename: Anthony K
authors.initials: AK
authors.lastname: Wutoh
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002648:Child; D003430:Cross-Sectional Studies; D017277:Drug Approval; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D056687:Off-Label Use / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D000928:Antidepressive Agents