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Unlicensed and off label drug use for paediatric patients

BMJ 1998; 317 doi: (Published 18 July 1998) Cite this as: BMJ 1998;317:204

General practitioners prescribe SSRIs to children off label

  1. Richard M Martin, Clinical research fellow.,
  2. Lynda V Wilton, Honorary visiting lecturer.,
  3. Ronald D Mann, Senior professorial fellow. (,
  4. Paul Steventon, Chairman,
  5. Sean R Hilton, Professor.
  1. Drug Safety Research Unit, Southampton SO31 1AA
  2. Faculty of Medicine, Health and Biological Sciences, University of Southampton, Southampton SO16 7PX
  3. Doctors Independent Network, Ewell, Surrey KT17 1TF
  4. Division of General Practice and Primary Care, St George's Hospital Medical School, London SW17 0RE
  5. Academic Division of Child Health, Derbyshire Children's Hospital, Derby DE22 3NE

    EDITOR—Turner et al highlight the fact that children admitted to hospital are often prescribed unlicensed drugs and drugs given outside the terms of their product licence (off label).1 The appropriateness of such prescribing is uncertain, and a high rate of adverse drug reactions has been observed in children prescribed such drugs.2 The problem is not limited to hospitals. General practitioners may be asked to prescribe unlicensed or off label drugs by specialists or may consider initiating such treatment themselves. Little information exists on the extent of such prescribing in primary care.

    We examined the prescribing of selective serotonin reuptake inhibitors to children in general practice by accessing a computerised database of 100 British general practices (349 doctors) using the AAH Meditel System 5 computer system to enter medical records (Doctors Independent Network).3We determined the number of children aged 12 and under who had at least …

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