title: Trends and patterns of antidepressant use in children and adolescents from five western countries, 2005-2012.
abstract: Following the FDA black box warning in 2004, substantial reductions in antidepressant (ATD) use were observed within 2 years in children and adolescents in several countries. However, whether these reductions were sustained is not known. The objective of this study was to assess more recent trends in ATD use in youth (0-19 years) for the calendar years 2005/6-2012 using data extracted from regional or national databases of Denmark, Germany, the Netherlands, the United Kingdom (UK), and the United States (US). In a repeated cross-sectional design, the annual prevalence of ATD use was calculated and stratified by age, sex, and according to subclass and specific drug. Across the years, the prevalence of ATD use increased from 1.3% to 1.6% in the US data (+26.1%); 0.7% to 1.1% in the UK data (+54.4%); 0.6% to 1.0% in Denmark data (+60.5%); 0.5% to 0.6% in the Netherlands data (+17.6%); and 0.3% to 0.5% in Germany data (+49.2%). The relative growth was greatest for 15-19 year olds in Denmark, Germany and UK cohorts, and for 10-14 year olds in Netherlands and US cohorts. While SSRIs were the most commonly used ATDs, particularly in Denmark (81.8% of all ATDs), Germany and the UK still displayed notable proportions of tricyclic antidepressant use (23.0% and 19.5%, respectively). Despite the sudden decline in ATD use in the wake of government warnings, this trend did not persist, and by contrast, in recent years, ATD use in children and adolescents has increased substantially in youth cohorts from five Western countries.
authors.affiliation: Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom. Electronic address: chrstn.bchmnn@gmail.com.
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Bachmann
authors.affiliation: Institute of Public Health, Clinical Pharmacology, Faculty of Health Sciences, University of Southern Denmark, Denmark.
authors.forename: Lise
authors.initials: L
authors.lastname: Aagaard
authors.affiliation: Department of Pharmaceutical Health Services Research, University of Maryland, Baltimore, MD, USA.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Burcu
authors.affiliation: Division of Health Economics, Health Policy and Health Services Research, Centre for Social Policy Research, University of Bremen, Germany.
authors.forename: Gerd
authors.initials: G
authors.lastname: Glaeske
authors.affiliation: Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Luuk J
authors.initials: LJ
authors.lastname: Kalverdijk
authors.affiliation: Department of Primary Care and Population Health, University College London Medical School, London, United Kingdom.
authors.forename: Irene
authors.initials: I
authors.lastname: Petersen
authors.affiliation: Department of Pharmacoepidemiology and Pharmacoeconomics, University Centre of Pharmacy, University Groningen, The Netherlands.
authors.forename: Catharina C M
authors.initials: CC
authors.lastname: Schuiling-Veninga
authors.affiliation: Department of Primary Care and Population Health, University College London Medical School, London, United Kingdom; Population, Policy and Practice, University College London Institute of Child Health, London, United Kingdom.
authors.forename: Linda
authors.initials: L
authors.lastname: Wijlaars
authors.affiliation: Department of Pharmaceutical Health Services Research, University of Maryland, Baltimore, MD, USA; Department of Psychiatry, University of Maryland, Baltimore, MD, USA.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Zito
authors.affiliation: Department of Health Services Research, Carl von Ossietzky University Oldenburg, Germany.
authors.forename: Falk
authors.initials: F
authors.lastname: Hoffmann
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D003863:Depression / Q000188:drug therapy* / Q000453:epidemiology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents
keywords: Adolescent; Antidepressant agents; Black box warning; Child; Multinational; Prevalence trends