Increase in non-evidence based use of antidepressants in children is cause for concern

doi:10.1136/bmj.328.7441.711-c

BMJ 2004;328:711-712 (20 March), doi:10.1136/bmj.328.7441.711-c

Letter

Increase in non-evidence based use of antidepressants in children is cause for concern

The first 150 words of the full text of this article appear below.

EDITOR—The use of antidepressants in children is increasing,although the evidence for the effectiveness and safety of pharmacologicaltreatment of depressive disorder in children and adolescentsis scant¹ and widely debated²—particularly for selectiveserotonin reuptake inhibitors (SSRIs).^3
4

We used the ARNO database (http://sanita.cineca.it/public/arno/arnoeng.htm)to analyse drug prescriptions written during 2002 to 568 770Italian patients under 18. A total of 1600 young people (2.8per 1000) received at least one antidepressant, 1200 of theman SSRI and 297 a tricyclic antidepressant. Two thirds of prescriptions(8284/11 369) were for adolescents (age 14-17), mostly girls(4583/5872; rate 10.6 per 1000 v 5.9 per 1000 for boys).

These prescribing rates are lower than those reported for theUnited States (1-2%) and the Netherlands (4.4 per 1000), butnevertheless about 28 000 youths are exposed to treatment withantidepressants, 21 000 of them receiving SSRIs. We found a. . . [Full text of this article]

Antonio Clavenna, senior research fellow

clavenna@marionegri.it

Maurizio Bonati, head

Laboratory for Mother and Child Health, Mario Negri Institute for Pharmacological Research, 20157 Milan, Italy

Elisa Rossi, statistician, Marisa De Rosa, senior researcher

Interuniversity Consortium, Bologna, Italy