Antidepressant drug use among adolescents during 2004–2013: a population‐based register linkage study

Abstract

ObjectiveTo study trends in use of antidepressants (ADs) by adolescents, and psychiatric morbidity and use of other psychotropic drugs as a measure of psychiatric comorbidity.MethodsOne‐year prevalence of AD drug use was analyzed for 13‐ to 17‐year‐old Norwegians during 2004–2013. Use of other psychotropic drugs and specialist healthcare services was analyzed for incident AD users in 2012, using linked data from the Norwegian Prescription Database and the Norwegian Patient Register.ResultsThe 1‐year prevalence of AD drug use increased from 6.4/1000 to 9.1/1000 during 2004–2013, with the steepest increase from 2010, particularly among girls. The highest prevalence was found in 17‐year‐old girls (17.8/1000 in 2010, 27.5/1000 in 2013). Of incident AD drug users in 2012, 84.4% had been in contact with specialist health care. As the first drug, 78.4% were prescribed a selective serotonin reuptake inhibitor. The most common types of other psychotropic drugs were melatonin (24.6%), antipsychotic drugs (13.2%), stimulants (8.8%), and anxiolytics (6.0%).ConclusionsUse of ADs among adolescents has increased over the last 3–4 years, particularly among 16‐ to 17‐year‐old girls. A total of 85% of incident users had been in contact with specialist health care, which may indicate that drug‐therapy is used by adolescents with more severe symptoms.

Increase in diagnosis of depressive disorders contributes to the increase in antidepressant use in adolescents

“…Only a weak increase was observed in boys. This is in line with previous studies that have separately studied either diagnosed or self‐reported depression or prescription of ADs .…”

“…Increased use of ADs after the dip in 2004–7 could thus indicate a return to a more normal situation . A previous study from Norway , however, showed that the increase in use of ADs did not only return to the 2004 level (around 2010), but increased further. The current study shows that the increase in AD use in 2010–2013 was paralleled by a similar increase in incident depressive disorders.…”

“…Recent studies have shown an increasing use of antidepressants (ADs) among adolescents in European countries and in the USA . In Norway, we have also seen a pronounced increase in the use of ADs between 2009 and 2016, particularly among 16‐ to 17‐year‐old girls . Data from The Norwegian Prescription Database (NorPD) has demonstrated that 1.1% of all 17‐year‐old boys and 3.0% of all 17‐year‐old girls filled a prescription for an AD in Norway in 2016 .…”

Utilization of Stimulants and Atomoxetine for Attention‐Deficit/Hyperactivity Disorder among 5.4 Million Children Using Population‐Based Longitudinal Data

“…Future studies should investigate the appropriateness of this treatment. Two other studies on use of antidepressants in the general adolescent population show that adolescent girls are more likely to receive antidepressants than adolescent boys . Higher exposure to antidepressants in girls medicated with ADHD drugs may support earlier findings that girls tend to have a more inattentive type of ADHD .…”

Clinical correlates of augmentation/combination treatment strategies in major depressive disorder

“…Moreover, some SGAs received the official approval for this indication by regulatory authorities as augmenting agents of antidepressants (e.g., quetiapine XR in the USA and Europe, aripiprazole in the USA, and olanzapine in combination with fluoxetine in the USA). Accordingly, pharmacoepidemiological surveys consistently revealed a substantial increase in augmentation/combination treatment strategies in general and SGA prescriptions in particular in MDD over the last decades .…”