Use of SSRIs among Danish children: a nationwide study

Abstract

Our objective was to describe the use of selective serotonin reuptake inhibitors (SSRIs) in the entire Danish population of children and adolescents from 1995 to 2011. Data on filled SSRIs were obtained for all children in Denmark aged 5-17 during 1995-2011. The amount and type of SSRIs filled were calculated as well as incidence rates and prevalence proportions. Furthermore, we looked at concurrent use of other psychotropic drug treatment duration. A total of 23,547 children aged 5-17 used SSRIs during the study period, most commonly sertraline followed by citalopram. Overall, the incidence rate increased from 0.57 per 1,000 person years in 1997 to 3.30 in 2010 and fell to 2.55 in 2011, while the prevalence proportion rose from 0.1 per 1,000 children at the end of 1995 to 3.3 at the end of 2011. However, these findings were driven entirely by an increase among adolescents (12-17 years), where the prevalence proportion rose from 0.11 and 0.36 to 4.64 and 8.52 per 1,000 boys and girls, respectively. A significant proportion of SSRI users used other psychotropic drugs concurrently, most notably antipsychotics (12-28 %) and psychostimulants (10-33 %). About 50 % of adolescents and 40 % of children discontinued treatment within 12 months of initiation. We found a marked increase in the use of SSRI drugs among adolescents in Denmark between 1995 and 2011. Whether this increase reflects a true increase in disorder occurrence, an increase in diagnostic intensity or more aggressive treatment remains uncertain.

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 .…”

“…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 .…”

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

“…Treatment guidelines for pediatric depression, OCD, and anxiety disorders emphasize that drug‐therapy should always be given in combination with psychosocial interventions and non‐pharmacological treatment, and with a close monitoring of beneficial and harmful effects . In recent years, a trend of increasing use of ADs among children and adolescents has been observed in the USA, Canada, and European countries . However, large differences in prescribing prevalence of AD drugs exist between countries, with the highest use of ADs in the USA .…”

Poor guideline adherence in the initiation of antidepressant treatment in children and adolescents in the Netherlands: choice of antidepressant and dose

“…Such a trend was also found in countries like the UK [13], but only to a slight extent or not at all in other countries, such as Canada [27] or Denmark [28]. The decrease in antidepressant initiation in young people was likely related to media coverage of the potential for treatment-emergent suicidality with antidepressant treatment [15], but this effect appears to have been transient.…”