title: Trends in youth antidepressant dispensing and refill limits, 2000 through 2009.
abstract: BACKGROUND
  Antidepressant (AD) dispensing for depression in youth declined in the years following the 2003-04 Food and Drug Administration actions regarding increased risk of suicidal behavior.
  
  
  OBJECTIVE
  To extend observation of youth AD dispensing and associated characteristics through 2009 to determine if AD dispensing continues to decline, has stabilized, or has rebounded.
  
  
  METHODS
  Retrospective time series design.
  
  
  METHODS
  Youth (n=57,782) ages 10 to 17 inclusive.
  
  
  RESULTS
  Both new (incident) and refill AD dispensing continued to decline through 2009, with no sign of leveling off. However, among youth who started AD treatment the cumulative supply of AD medication remained consistent across the pre- and postperiods, suggesting that cumulative treatment episode duration has not been degraded--possibly as a function of greater days supply with each new refill in the postperiod. Prescribers dramatically curtailed preauthorized refills in the postwarning period.
  
  
  CONCLUSIONS
  Declines in AD dispensing to depressed youth may not reflect less intensive treatment for those youth who persist beyond the initial dispense. Lower rates of preauthorized refills may have been an attempt by prescribers to encourage return visits to evaluate response and adverse consequences.
authors.affiliation: Kaiser Permanente Center for Health Research (CHR), Portland, Oregon 97227, USA. greg.clarke@kpchr.org
authors.forename: Greg
authors.initials: G
authors.lastname: Clarke
authors.forename: John
authors.initials: J
authors.lastname: Dickerson
authors.forename: Christina M
authors.initials: CM
authors.lastname: Gullion
authors.forename: Lynn L
authors.initials: LL
authors.lastname: DeBar
mesh_terms: D000293:Adolescent; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D003866:Depressive Disorder / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States; D014486:United States Food and Drug Administration; D000092864:Suicide Prevention
chemical_list: D000928:Antidepressive Agents