title: Prescribing Pattern of Antidepressants in Children and Adolescents: Findings from the Research on Asia Psychotropic Prescription Pattern.
abstract: OBJECTIVE
  Pharmacotherapy of depression in children and adolescents is complex. In the absence of research into the efficacy and safety of antidepressants in this group of patients, their off-label prescription is common. This paper aimed to illustrate the prescription pattern of antidepressants in children and adolescents from major psychiatric centres in Asia.
  
  
  METHODS
  The Research on Asia Psychotropic Prescription Pattern on Antidepressants worked collaboratively in 2013 to study the prescription pattern of antidepressants in Asia using a unified research protocol and questionnaire. Forty psychiatric centres from 10 Asian countries / regions participated and 2321 antidepressant prescriptions were analysed.
  
  
  RESULTS
  A total of 4.7% antidepressant prescriptions were for children and adolescents. Fluoxetine, sertraline, and escitalopram were the most common antidepressants prescribed for children and adolescents. Almost one-third (30.3%) of prescriptions were for diagnoses other than depressive and anxiety disorders. There was less antidepressant polypharmacy and concomitant use of benzodiazepine, but more concomitant use of antipsychotics in children and adolescents compared with adults.
  
  
  CONCLUSIONS
  Off-label use of antidepressants in children and adolescents was reported by 40 Asian psychiatric institutions that participated in the study. In-service education and regulatory mechanisms should be reinforced to ensure efficacy and safety of antidepressants in children and adolescents.
authors.affiliation: Department of Psychiatry & Mental Health, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia.
authors.forename: K Y
authors.initials: KY
authors.lastname: Chee
authors.affiliation: Department of Psychiatry, King George's Medical University, Chowk, Lucknow, India.
authors.forename: A
authors.initials: A
authors.lastname: Tripathi
authors.affiliation: Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: A
authors.initials: A
authors.lastname: Avasthi
authors.affiliation: Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital-Kaohsiung Medical Center and School of Medicine, Chang Gung University, Taiwan.
authors.forename: M Y
authors.initials: MY
authors.lastname: Chong
authors.affiliation: Faculty of Health Sciences, University of Macao, Macao SAR, PR China.
authors.forename: Y T
authors.initials: YT
authors.lastname: Xiang
authors.affiliation: Institute of Mental Health, Buangkok View, Buangkok Green Medical Park, Singapore.
authors.forename: K
authors.initials: K
authors.lastname: Sim
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kanba
authors.affiliation: Department of Psychiatric Epidemiology, Shanghai Mental Health Center, Shanghai, PR China.
authors.forename: Y L
authors.initials: YL
authors.lastname: He
authors.affiliation: Department of Psychiatry, College of Medicine, Korea University, Seoul, South Korea.
authors.forename: M S
authors.initials: MS
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, PR China.
authors.forename: H F K
authors.initials: HF
authors.lastname: Chiu
authors.affiliation: Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan.
authors.forename: S Y
authors.initials: SY
authors.lastname: Yang
authors.affiliation: Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Kuga
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.
authors.forename: P
authors.initials: P
authors.lastname: Udomratn
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia.
authors.forename: A J
authors.initials: AJ
authors.lastname: Tanra
authors.affiliation: Dr Soetomo Hospital-Faculty of Medicine, Airlangga University, Jawa Timur, Indonesia.
authors.forename: M M
authors.initials: MM
authors.lastname: Maramis
authors.affiliation: Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
authors.forename: S
authors.initials: S
authors.lastname: Grover
authors.affiliation: Department of Psychological Medicine, National University Hospital, Singapore.
authors.forename: R
authors.initials: R
authors.lastname: Mahendran
authors.affiliation: Department of Psychiatry, Pushpagiri Medical College, Thiruvalla, India.
authors.forename: R A
authors.initials: RA
authors.lastname: Kallivayalil
authors.affiliation: Department of Psychiatry, TMU-Wan Fang Medical Center and School of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: W W
authors.initials: WW
authors.lastname: Shen
authors.affiliation: Department of Psychiatry, Kobe University, Kobe, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Shinfuku
authors.affiliation: Department of Pharmacology, National University of Singapore, Singapore.
authors.forename: C H
authors.initials: CH
authors.lastname: Tan
authors.affiliation: Association for the Improvement of Mental Health Programmes, Geneva, Switzerland.
authors.forename: N
authors.initials: N
authors.lastname: Sartorius
mesh_terms: D000293:Adolescent; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy*; D001208:Asia; D002648:Child; D003866:Depressive Disorder / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*
chemical_list: D000928:Antidepressive Agents
keywords: Adolescent; Antidepressive agents; Child; Ethnopsychology