Antidepressant prescribing in Irish children:secular trends and international comparison in the context of a safety warning

TitleAntidepressant prescribing in Irish children:secular trends and international comparison in the context of a safety warning
Publication TypePublished Journal Article
2015
AuthorsO’Sullivan K, Boland F, Reulbach U, Motterlini N, Kelly D, Bennett K, Fahey T
JournalBMC Pediatrics
Volume15
Issue119
KeywordsAnti-depressants, children, Paediatric prescribing, Safety warning
Abstract

Background: In 2003, the Irish Medicines Board (IMB) warned against the treatment of childhood depression with
selective serotonin reuptake inhibitors (SSRIs) due to increased risk of suicide. This study examined the effect of this
warning on the prevalence of anti-depressants in Irish children and compared age and gender trends and
international comparisons of prescription rates.
Methods: A retrospective cohort study of the Irish Health Service Executive (HSE) pharmacy claims database for the
General Medical Services (GMS) scheme for dispensed medication. Data were obtained for 2002–2011 for those
aged ≤15 years. Prevalence of anti-depressants per 1000 eligible population, along with 95 % confidence intervals,
were calculated. A negative binomial regression analysis was used to investigate trends and compare rates across
years, sex and age groups (0–4, 5–11, 12–15 years). International prescribing data were retrieved from the literature.
Results: The prevalence of anti-depressants decreased from 4.74/1000 population (95 % CI: 4.47-5.01) in 2002 to
2.61/1000 population (95 % CI: 2.43-2.80) in 2008. SSRI rates decreased from 2002 to 2008. Prescription rates for
contra-indicated SSRIs paroxetine, sertraline and citralopram decreased significantly from 2002 to 2005, and, apart
from paroxetine, only small fluctuations were seen from 2005 onwards. Fluoxetine was the most frequently
prescribed anti-depressant and rates increased between 2002 and 2011. Anti-depressant rates were higher for
younger boys and older girls. The Irish prevalence was lower than the US, similar to the U.K. and higher than
Germany and Denmark.
Conclusions: The direction and timing of these trends suggest that medical practitioners followed the IMB advice.

URLhttp://www.biomedcentral.com/content/pdf/s12887-015-0436-2.pdf
DOI10.1186/s12887-015-0436-2