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Article: Effects of the committee on safety of medicines advice on antidepressant prescribing to children and adolescents in the UK

TitleEffects of the committee on safety of medicines advice on antidepressant prescribing to children and adolescents in the UK
Authors
KeywordsChemicals And Cas Registry Numbers
Issue Date2005
PublisherAdis International Ltd. The Journal's web site is located at http://drugsafety.adisonline.com/
Citation
Drug Safety, 2005, v. 28 n. 12, p. 1151-1157 How to Cite?
AbstractBackground: Psychotropic medication prescribing for children and adolescents rose significantly between 2000 and 2002, including antidepressant prescribing. In 2003, the Committee on Safety of Medicines (CSM) advised against using venlafaxine or any selective serotonin receptor inhibitor (SSRI), with the exception of fluoxetine, for childhood and adolescent depression. The aim of this study was to compare the prevalence and incidence of children and adolescents who were prescribed antidepressants in UK primary care, before and after the CSM advice on antidepressant prescribing. We also compared paediatric antidepressant prescribing trends from Mediplus data with national antidepressant prescribing trends in England from the Prescription Pricing Authority (PPA). Methods: The Disease Analyzer-Mediplus database contains anonymised primary care records for about 3 million patients. Eligible patients were aged ≤18 years and received ≥1 antidepressant prescription between 2000 and 2004. Antidepressants were grouped according to the CSM advice and the British National Formulary. Prevalence and incidence were calculated. The prevalences of 2000, 2002 and 2004 were compared using a Chi-squared test. PPA data on antidepressant prescribing rates were compared with paediatric antidepressant prescribing rates from Mediplus. Results: 5718 children and adolescents received a total of 25 542 prescriptions between 2000 and 2004. The median number of prescriptions per patient was two (interquartile range 1-5). Common indications included depression and anxiety. Antidepressant prevalence increased from 2000 to 2002 (from 5.4 to 6.6 patients per 1000 people), with a rise in the number of patients prescribed venlafaxine and SSRIs. However, between 2002 and 2004 there was a decrease in antidepressant prevalence (from 6.6 to 5.7 per 1000). The prevalence of CSM-contraindicated antidepressants (citalopram, escitalopram, fluvoxamine, paroxetine, sertraline and venlafaxine) declined by a third (from 3.1 to 2.0 per 1000), but there was no change in fluoxetine prevalence (from 2.1 to 2.3 per 1000). The number of patients prescribed tricyclic antidepressants dropped marginally (from 2.0 to 1.7 per 1000). Incidences followed the same trends as the prevalences, but there was a 48% reduction in the incidence of CSM-contraindicated antidepressants between 2002 and 2004. National antidepressant prescribing trends increased; paediatric prescribing trends were similar to national trends between 2000 and 2003; however, there was a 27% reduction in the paediatric prescribing rate of CSM-contraindicated antidepressants between 2002 and 2004. Conclusion: Since 2003, fewer children and adolescents have been prescribed antidepressants in primary care. However, fluoxetine and non-SSRI antidepressant prevalences have not risen, implying that they are not prescribed as alternative treatments. This study shows that the CSM advice has had a significant effect in reversing the rising prevalence of antidepressant prescribing to children and adolescents in primary care. © 2005 Adis Data Information BV. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/132880
ISSN
2015 Impact Factor: 3.206
2015 SCImago Journal Rankings: 1.359
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorMurray, MLen_HK
dc.contributor.authorThompson, Men_HK
dc.contributor.authorSantosh, PJen_HK
dc.contributor.authorWong, ICKen_HK
dc.date.accessioned2011-04-04T07:57:45Z-
dc.date.available2011-04-04T07:57:45Z-
dc.date.issued2005en_HK
dc.identifier.citationDrug Safety, 2005, v. 28 n. 12, p. 1151-1157en_HK
dc.identifier.issn0114-5916en_HK
dc.identifier.urihttp://hdl.handle.net/10722/132880-
dc.description.abstractBackground: Psychotropic medication prescribing for children and adolescents rose significantly between 2000 and 2002, including antidepressant prescribing. In 2003, the Committee on Safety of Medicines (CSM) advised against using venlafaxine or any selective serotonin receptor inhibitor (SSRI), with the exception of fluoxetine, for childhood and adolescent depression. The aim of this study was to compare the prevalence and incidence of children and adolescents who were prescribed antidepressants in UK primary care, before and after the CSM advice on antidepressant prescribing. We also compared paediatric antidepressant prescribing trends from Mediplus data with national antidepressant prescribing trends in England from the Prescription Pricing Authority (PPA). Methods: The Disease Analyzer-Mediplus database contains anonymised primary care records for about 3 million patients. Eligible patients were aged ≤18 years and received ≥1 antidepressant prescription between 2000 and 2004. Antidepressants were grouped according to the CSM advice and the British National Formulary. Prevalence and incidence were calculated. The prevalences of 2000, 2002 and 2004 were compared using a Chi-squared test. PPA data on antidepressant prescribing rates were compared with paediatric antidepressant prescribing rates from Mediplus. Results: 5718 children and adolescents received a total of 25 542 prescriptions between 2000 and 2004. The median number of prescriptions per patient was two (interquartile range 1-5). Common indications included depression and anxiety. Antidepressant prevalence increased from 2000 to 2002 (from 5.4 to 6.6 patients per 1000 people), with a rise in the number of patients prescribed venlafaxine and SSRIs. However, between 2002 and 2004 there was a decrease in antidepressant prevalence (from 6.6 to 5.7 per 1000). The prevalence of CSM-contraindicated antidepressants (citalopram, escitalopram, fluvoxamine, paroxetine, sertraline and venlafaxine) declined by a third (from 3.1 to 2.0 per 1000), but there was no change in fluoxetine prevalence (from 2.1 to 2.3 per 1000). The number of patients prescribed tricyclic antidepressants dropped marginally (from 2.0 to 1.7 per 1000). Incidences followed the same trends as the prevalences, but there was a 48% reduction in the incidence of CSM-contraindicated antidepressants between 2002 and 2004. National antidepressant prescribing trends increased; paediatric prescribing trends were similar to national trends between 2000 and 2003; however, there was a 27% reduction in the paediatric prescribing rate of CSM-contraindicated antidepressants between 2002 and 2004. Conclusion: Since 2003, fewer children and adolescents have been prescribed antidepressants in primary care. However, fluoxetine and non-SSRI antidepressant prevalences have not risen, implying that they are not prescribed as alternative treatments. This study shows that the CSM advice has had a significant effect in reversing the rising prevalence of antidepressant prescribing to children and adolescents in primary care. © 2005 Adis Data Information BV. All rights reserved.en_HK
dc.languageengen_US
dc.publisherAdis International Ltd. The Journal's web site is located at http://drugsafety.adisonline.com/en_HK
dc.relation.ispartofDrug Safetyen_HK
dc.subjectChemicals And Cas Registry Numbersen_US
dc.titleEffects of the committee on safety of medicines advice on antidepressant prescribing to children and adolescents in the UKen_HK
dc.typeArticleen_HK
dc.identifier.emailWong, ICK: wongick@hku.hken_HK
dc.identifier.authorityWong, ICK=rp01480en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.2165/00002018-200528120-00009en_HK
dc.identifier.pmid16329717-
dc.identifier.scopuseid_2-s2.0-28844509678en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-28844509678&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume28en_HK
dc.identifier.issue12en_HK
dc.identifier.spage1151en_HK
dc.identifier.epage1157en_HK
dc.identifier.isiWOS:000234705000008-
dc.publisher.placeNew Zealanden_HK
dc.identifier.scopusauthoridMurray, ML=7403583537en_HK
dc.identifier.scopusauthoridThompson, M=7404621943en_HK
dc.identifier.scopusauthoridSantosh, PJ=6701465826en_HK
dc.identifier.scopusauthoridWong, ICK=7102513915en_HK

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