Pre-Schoolers Lead Growth Of Antidepressant Use

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OUTRAGE - Pre-Schoolers

Lead Growth Of

Antidepressant Use

" And there's nobody protecting the children. It's just a free-for-all. "

Business Wire

4-3-4

 

 

ST. LOUIS (Business Wire) -- The use of paroxetine and other antidepressant

medications continues to grow by about 10% annually among children and

adolescents, according to a study published in the April issue of

Psychiatric Services. The study profiles trends of prescription

antidepressant use in children and adolescents using prescription claim

information from a random, nationwide sample.

 

The study by Express Scripts examined antidepressant use among approximately

two million commercially-insured, pediatric beneficiaries 18 years and

younger from 1998 to 2002. The fastest growing segment of users were found

to be preschoolers aged 0-5 years, with use among girls doubling and use

among boys growing by 64%. For the entire sample, antidepressant use

increased from 1.6% in 1998 to 2.4% in 2002, a 49% increase. Over the course

of the study, the growth in use was greater among girls (68%) than boys

(34%) and, for each gender respectively, growth was higher among younger

boys and older girls.

 

" A number of factors acting together or independently may have led to

escalated use of antidepressants among children and adolescents, " said Tom

Delate, Ph.D., Director of Research at Express Scripts. " These factors

include increasing rates of depression in successive age groups, a growing

awareness of and screening for depression by pediatricians and assumptions

that the effectiveness experienced by adults using antidepressant

medications will translate to children and adolescents. "

 

Throughout the five-year period of the study, selective serotonin reuptake

inhibitors (SSRI's) were the most commonly dispensed antidepressants, while

tetracyclics were the least. SSRI's include paroxetine (also known as

Paxil®), Prozac® and Zoloft®. Use of paroxetine increased 113% and 91%

in females and males, respectively, over the study period. The U.S. Food and

Drug Administration (FDA) has recommended that paroxetine not be used in

children and adolescents because, among youths, its efficacy has not been

established for depression and its use is associated with increased risk of

suicidal thinking and suicide attempts. Of the SSRIs, only Prozac has been

approved by the FDA for treating depression in children and adolescents.

 

More information about these and other studies are available at

http://www.express-scripts.com/other/news_views/outcomes_research.htm.

http://www.nj.com/business/ledger/index.ssf?/base/business-0/108089945622174

0.xml

 

NJ Star-Ledger

 

More kids prescribed drugs for depression Preschool rate rose the most,

study says

 

By Ed Silverman 4-2-4

 

The rate at which antidepressants were prescribed to children rose about 10

percent annually between 1998 and 2002, with preschoolers accounting for the

sharpest increase, according to a new study.

 

The study, which looked at prescriptions written for some 2 million

pediatric patients nationally, found 2.4 percent were prescribed

antidepressants in 2002, up from 1.6 percent five years earlier. That

amounts to a 49 percent increase in the number of people under 18 prescribed

antidepressants, according to the study in Psychiatric Services, a medical

journal published by the American Psychiatric Association.

 

Among children 5 and under, the increase was even higher, with

antidepressant use among girls doubling and among boys rising by 64 percent.

Overall, the increase was highest among girls: 68 percent, compared to 34

percent among boys.

 

The growth in prescriptions written for children occurred even though

antidepressants -- with the exception of Prozac -- were never approved for

anyone younger than 18. Prozac was approved as a treatment for children, but

only two years ago -- after the rise in juvenile prescriptions began.

 

The findings come amid a widening controversy over antidepressants and

alleged links to suicidal behavior and thoughts, especially among children.

Last month, the Food and Drug Administration asked drug makers to add

explicit warnings to their product labeling.

 

" This adds to the data showing many children are using these drugs, " said

Tom Delate, research director at Express Scripts, a pharmacy benefits

manager that conducted the study. " The safety and efficacy have to be

examined more closely. This may add some impetus. "

 

He cited off-label use as the reason more children are prescribed the drugs.

Off-label use refers to a common practice among doctors to write

prescriptions even though regulators have not approved a medicine for a

specific use.

 

Many doctors and families contend antidepressants have saved lives. This

argument is also cited by drug makers, which deny their pills, including

Zoloft, Paxil and Effexor, lead to suicide. The manufacturers include Wyeth,

GlaxoSmithkline, Eli Lilly and Pfizer.

 

Last year, though, British authorities warned doctors not to prescribe the

drugs, except for Prozac. They pointed to newly disclosed data showing one

drug, Glaxo's Paxil, wasn't effective and could increase the risk of

suicide.

 

Last week, two congressional committees launched a probe into the FDA's

handling of the controversy. They want to know why the agency didn't take

more action, such as urging doctors not to prescribe the pills.

 

The committee also wants the FDA to explain why one of its own medical

reviewers was prevented from presenting data at a February hearing convened

to explore safety risks. The hearing garnered national publicity after many

parents testified their children committed suicide after taking an

antidepressant.

 

Consumer advocates, meanwhile, are stepping up calls for the companies that

make antidepressants to release all unpublished clinical trial data. Drug

makers aren't required to disclose this information, which critics say

allows negative findings to remain suppressed.

 

" Frankly, I call this child abuse, " said Vera Sharav of the Alliance for

Human Research Protection, a consumer advocate. " There is no medical

justification for putting preschoolers on such drugs. And there's nobody

protecting the children. It's just a free-for-all. "

 

Ed Silverman can be reached at (973) 392-1542 or esilverman

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