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Worrying rise in use of antidepressants in children

Letter: Increase in non-evidence based use of antidepressants in children is cause for concern BMJ Volume 328, pp 711-2


The use of antidepressant drugs in children is increasing, although evidence for their effectiveness and safety in children and adolescents is scant and widely debated, particularly for selective serotonin reuptake inhibitors (SSRIs) argue researchers in a letter to this week's BMJ.

They analysed drug prescriptions written during 2002 to over 500,000 Italian patients under 18. A total of 1600 young people (2.8 per 1000) received at least one antidepressant, 1200 of them an SSRI. Two thirds of prescriptions were for adolescents (age 14-17), mostly girls.

These prescribing rates are lower than those reported for the United States (1-2%) and the Netherlands (4.4 per 1000), but nevertheless about 28,000 youths are exposed to treatment with antidepressants, 21,000 of them receiving SSRIs, say the authors.

They also found a 4.5-fold increase in the rate of prescriptions for SSRIs between 2000 and 2002.

Apart from sertaline for obsessive compulsive disorder, all the SSRIs prescribed are unlicensed for children. The occurrence of depressive syndrome and obsessive compulsive disorder in children must be determined, along with their therapeutic needs.

Appropriate, independently funded studies should also be planned to guarantee effective and safe evidence based therapeutic approaches for children, adolescents, and their families, they conclude.


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