The use of antidepressants in children increased about 10% a year between 1998 and 2002, with a far greater increase among girls than boys, a new study says.
And although medication of preschool children remains limited to less than one half of 1%, the percentage of girls age 5 and younger on antidepressants doubled from 1998 to 2002, while use among preschool boys increased 64%. Still, only 0.16% of girls and 0.23% of boys in this age group were on antidepressants by 2002.
For children of all ages, antidepressant use increased 68% among girls and 34% for boys. Use was highest among girls age 15 to 18, at 6.8%.
The study appears in the current issue of the journal Psychiatric Services and was conducted by Express Scripts, a pharmacy benefit management company. Researchers analyzed antidepressant use among 2 million privately insured children.
Overall, antidepressant use among patients 18 and younger increased to 2.4% in 2002 from 1.6% in 1998, an almost 50% increase, they found.
The report showing continuing increased reliance on antidepressants for this population coincides with growing concern over the safety of certain antidepressants in children. Questions about the effectiveness of some of the drugs for children also have been raised.
"There are two differing viewpoints," said Thomas Delate, director of research at Express Scripts and an author of the study. "One is the concern that antidepressants are being prescribed to youths without adequate information."
On the other hand, he said, "Mental health advocates would say that we're finally getting some recognition of the problem of depression in children."
Last summer, Britain barred use of the selective serotonin reuptake inhibitor (SSRI) Paxil for depression in children because of an increase in self-harm and suicidal behavior.
The U.S. Food and Drug Administration later also recommended Paxil not be used to treat depression in children, saying trials showed it was no more effective than a placebo.
The study found the overall increase in antidepressant use in children was driven by an increase in the prescription of SSRIs -- the newest class of antidepressants.
Antidepressants are used to treat a wide range of disorders in children besides depression and are often used to treat attention deficit disorder, especially in boys.
Most of the uses are not specifically approved by the FDA, though doctors legally can use the drugs for nonapproved purposes.
