Depression treatment during outpatient visits by U.S. children and adolescents

Ma, Jun; Lee, Ky-Van; Stafford, Randall S.

doi:10.1016/j.jadohealth.2005.07.012

Cited by 56 publications

(35 citation statements)

References 21 publications

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“…In the 1980s and 1990s, the introduction of SSRI-class antidepressants led to a substantial increase in depression treatment in children and adolescents (18,19,20). Because depression is an under-treated disease (21) with the potential for long term negative consequences, these increases were viewed at the time by many as important reductions in unmet need.…”

Section: Resultsmentioning

confidence: 99%

Antidepressants and Suicide Risk: How Did Specific Information in FDA Safety Warnings Affect Treatment Patterns?

Busch

Frank

Leslie³

et al. 2010

Psychiatric Services

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Objective-From June 2003 through October 2004, the Food and Drug Administration (FDA) released five safety warnings related to antidepressant use and increased suicide risk in children. While researchers have documented a decline in antidepressant use in children over this time period, less is known about whether specific safety information conveyed in individual warnings was reflected in treatment patterns. (2001)(2002)(2003)(2004)(2005) for a national sample of privately insured children were used to construct treatment episodes (N=23,529). For each new episode of major depressive disorder, it was determined whether children's treatment followed specific recommendations included in warnings released by the FDA. Treatment recommendations pertained to the use of the antidepressants paroxetine and fluoxetine and to patient monitoring. Treatment patterns were expected to change as the nature of risk information conveyed by the FDA changed over time. Methods-Thomson Marketscan claims dataResults-The timing of FDA recommendations was associated with trends in the use of paroxetine and fluoxetine by children with major depressive disorder newly initiating antidepressant treatment. However, no evidence of increases in outpatient visits (i.e., monitoring) among depressed children initiating antidepressants was found.Conclusions-Release of specific risk and benefit information by the FDA was associated with changes in prescribing, but not outpatient follow-up. These results suggest the FDA plays an important role in communicating information to the public and providers, but while public health safety warnings were associated with changes in some practice patterns, not all recommendations conveyed in warnings were followed.

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Section: Resultsmentioning

confidence: 99%

Antidepressants and Suicide Risk: How Did Specific Information in FDA Safety Warnings Affect Treatment Patterns?

Busch

Frank

Leslie³

et al. 2010

Psychiatric Services

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“…Thus, the numbers of children and adolescents diagnosed and treated for MDD (Ma et al 2005 ;Skaer et al 2009), ADHD (Robison et al 2002 ;Olfson et al 2003b) and paediatric BD (Blader and Carlson, 2007 ;Moreno et al 2007) have increased substantially in the last few decades, whereas the number of pharmacological studies performed in paediatric patients remains low as compared with adults (American Academy of Children and Adolescent Psychiatry, 2009). This fact may be related to the well-known difficulties of conducting clinical trials in paediatric patients (Caldwell et al 2004) and means that clinical choices must often be based on inadequate information or results from adult studies, even if there seems to be a failure to publish negative findings and risks might be underestimated (Safer et al 2003).…”

Section: Increase In the Use Of Polypharmacy Involving Antidepressantsmentioning

confidence: 99%

Polypharmacy with antidepressants in children and adolescents

Díaz‐Caneja

Espliego

Parellada

et al. 2012

Int. J. Neuropsychopharm.

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The aim of this study was to review current epidemiological data on the use of antidepressants in co-prescription with other psychotropic drugs in children and adolescents, as well as available efficacy and safety information. A Medline search from inception until February 2012 was performed to identify epidemiological and clinical studies, reviews and reports containing potentially relevant information on polypharmacy with antidepressants in young people. There has been an increase in polypharmacy in children and adolescents involving antidepressants in recent years. Antidepressants have become one of the drug classes most frequently prescribed in combination and are commonly co-prescribed with stimulants and antipsychotics. Most information regarding efficacy and safety of polypharmacy patterns was provided by case series and open-label studies. Efficacy studies gave some support for the use of a combination of antidepressants and antipsychotics in the management of refractory obsessive-compulsive disorder and some residual symptoms in major depressive disorder. Even less empirical support was found for a combination of stimulants and antidepressants in co-morbid attention deficit hyperactivity disorder and mood or anxiety disorders. Adverse events were similar to those found with individual medication groups, with severe adverse events mostly reported by individual case reports. The use of polypharmacy with antidepressants has become a regular practice in clinical settings. Although there is still little efficacy and safety information, preliminary evidence points to the potential clinical usefulness of some polypharmacy patterns. Further research on patients with co-morbidities or more severe conditions is needed, in order to improve knowledge of this issue.

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“…This is despite limited published data supporting their safety and efficacy in this population (Moreno et al 2007). Recent controversy has centered on the possible association between use of selective serotonin reuptake inhibitors (SSRIs) and suicidal ideation and suicidal behavior among children and adolescents.…”

Section: Introductionmentioning

confidence: 99%