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Antidepressant use doubled among adolescents from 1997 to 2002, with no change among children younger than 13 years

Overall pediatric use of antidepressants significantly increased from 0.9 million children (1.3 percent) in 1997 to 1.4 million children (1.8 percent) in 2002. This increase was driven by a doubling in adolescent antidepressant use from 2.1 percent in 1997 to 3.9 percent in 2002, with no change in antidepressant use among children younger than 13 years. Use of selective serotonin reuptake inhibitors (SSRIs) and other new antidepressants increased, while use of older tricyclic antidepressants (TCAs) remained stable in adolescents and declined in younger children.

However, the rate of antidepressant use remained stable even for adolescents during the 2000-2002 period. This may have been due to publicized concerns about a possible antidepressant-induced increase in the risk of suicidal behavior, which ultimately resulted in a warning label on all antidepressants in 2004-2005, explains Samuel H. Zuvekas, Ph.D., of the Agency for Healthcare Research and Quality. The increase in antidepressant use was most evident in groups that previously had lower levels of use, such as girls, blacks, and children from low-income families who were covered by public insurance. Thus, by 2002, there was no significant difference in antidepressant use among privately insured, publicly insured, and uninsured children or between higher- and lower-income children. Antidepressant use was similar among males and females and higher among whites than blacks and Hispanics.

The study's findings are consistent with the recognized higher prevalence of depression in adolescents (about 6 percent) than in younger children (about 2 percent). Antidepressant medications are used to treat children and adolescents with a variety of disorders that include depression, anxiety, attention-deficit/hyperactivity disorder, and enuresis. The findings were based on analysis of the Medical Expenditure Panel Survey (MEPS) database for the years 1997-2002. MEPS is a nationally representative survey of U.S. households conducted by AHRQ.

More details are in "National estimates of antidepressant medication use among U.S. children, 1997-2002," by Benedetto Vitiello, M.D., Dr. Zuvekas, and Grayson S. Norquist, M.D., M.S.P.H., in the March 2006 Journal of the American Academy of Child and Adolescent Psychiatry 45(3), pp. 271-279. Reprints (AHRQ Publication No. 06-R037) are available from the AHRQ Publication Clearinghouse.

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