Antidepressant drugs prescription to children and adolescents increased 300% in the nineties

The rate at which antidepressant drugs are prescribed for the nation’s children and adolescents increased more than three fold between the early 1990s and 2001, according to a review of medical office survey data completed recently by researchers at Washington State University.

The newly reported findings – presented this week in New York to the American Psychiatric Association, and reported yesterday in the Wall Street Journal – also show that the rate at which children and adolescents are being diagnosed for depression has more than doubled during the same timeframe.

The diagnoses and prescriptions covered in the data relate primarily to teenaged patients, said David A. Sclar, Boeing Distinguished Professor of Health Policy and Administration, and lead researcher for the study. In contrast to the case with most adults, the data indicate antidepressant drug prescriptions for the young patients surveyed were written largely by psychiatrists, rather than pediatricians, family-care physicians, or other non-psychiatric doctors. 

The research was drawn from the results of the annual U.S. National Ambulatory Medical Care Survey and covered doctors’ office visits conducted from 1990 through 1993, 1994 through 1997, and 1998 through 2001, Sclar said.

The U.S. population-adjusted rate of doctor office visits documenting a diagnosis of depression among children and adolescents aged five to 18 years increased from 12.9 per thousand in 1990 through 1993, 31.1 per thousand in 1998 through 2001. For the same period, the number of prescriptions for antidepressant medications related specifically to the treatment of depression rose from 5.7 to 18.4 per thousand office visits, a 3.2 fold increase.

The number of antidepressant prescriptions written to treat all patients – including those experiencing anxiety and obsessive-compulsive disorder – rose to 42.6 per thousand office visits in 1998 through 2001, from 13.0 per thousand in 1990 through 1993.

Although doctors and medical researchers have been aware of a growing rate of diagnosis of depression and the prescription of antidepressants among the young, the WSU researchers’ work provides a rare quantitative assessment of that trend.

The findings come also on the heels of a recent warning by the Food and Drug Administration that both children taking antidepressants need to be monitored closely for the risk of suicide. There has also been increasing controversy in the U.S. and abroad over the types of medications that are safe and effective in the treatment of childhood depression.

According to the article yesterday in the Wall Street Journal, the American Academy of Child and Adolescent Psychiatry – which has challenged the use of older antidepressants in treating children – intends to call for greater access to as-yet unpublished pharamaceutical company studies related to the safety and effectiveness of antidepressant medications at a meeting of the American Medical Association in June. 

A professor of health policy and administration, Sclar is also the Boehringer Ingelheim Scholar in Pharmaceutical Economics, and director of the pharmacoeconomics and pharmacoepidemiology research unit at the WSU College of Pharmacy. His research focuses on pharmaceutical economics and health policy.

Co-authors on the study are, Tracy L. Skaer, professor of health policy and administration, and associate director of the pharmacoeconomics and pharmacoepidemiology research unit, and Linda M. Robison, research assistant professor of health policy and administration, and research coordinator of the pharmacoeconomics and pharmacoepidemiology research unit.

This research was supported by the pharmacoeconomics and pharmacoepidemiology research unit at the WSU College of Pharmacy, and by an independent investigator award to professor Skaer from the National Alliance for Research on Schizophrenia and Depression.