Impact of Regulatory Safety Warnings on the Use of Antidepressants among Children and Adolescents in Finland

Abstract

In contrast to many other countries, the use of antidepressants continued to increase among children and adolescents in Finland post October, 2003. While the rate of fluoxetine use increased, there was a decline in the rate at which all other SSRIs were used.

Treatment duration with selective serotonin reuptake inhibitors among children and adolescents in Finland: a nationwide register study

“…This increase has been partly due to the increased prescription of newer antidepressants, although SSRIs remain the most widely used. Unlike in many other countries, overall prescribing of SSRIs did not decline in Finland following the safety warnings and health advisories issued in 2003 [12]. The fundamental reimbursement system for antidepressants has not changed since our study was conducted.…”

“…There is a high concordance between self-reported psychotropic use and psychotropic use among adolescents recorded in a national prescription register [25]. Finnish Prescription Register has been used previously to study nationwide psychotropic drug use [12,24,26,27]. All drugs in the register are coded using the Anatomical Therapeutic Chemical (ATC) classification system that is recommended by the World Health Organization [28].…”

“…In a US Medicaid population, 51% of 5-to 17-year-olds used <80% of their prescribed antidepressants, with higher rates of adherence in the first 3 months being associated with younger age, nonHispanic white ethnicity, use of other psychotropic drugs, optimal provider contact, and adequate antidepressant dose [11]. In Finland, 31% of children and adolescents aged <20 years who received a reimbursed SSRI from 1999 to 2005 received only one prescription [12]. Among people <26 years in Finland in 2007, 26% of males and 21% overall collected only one antidepressant prescription [6].…”

Medication adherence: a review of pharmacy education, research, practice and policy in Finland

“…The remaining papers investigated compliance or adherence in relation to medications for glaucoma63, diabetes62,64-68, juvenile rheumatoid arthritis62,69, and asthma 21,62. Seven papers assessed compliance or adherence to health treatment regimens (including medication compliance and adherence) among children and adolescents 56,57,59,62,64,65,69…”

“…Four papers used the National Prescription Register as the only data source 38-40,59. Two papers combined data from the National Prescription Register with data obtained from the National Hospital Discharge Register and/or Cause of Death Register 47,50.…”