Child/Adolescent Health

Study looks at impact of FDA suicide risk advisory on antidepressant prescribing in children

In October 2003, the Food and Drug Administration (FDA) issued an advisory warning health care providers about a potential increased risk of suicide for children taking antidepressants. In a new study, researchers examined the trends in prescribing antidepressants before and after the FDA released its advisory. It found that children's visits for depression and visits with an antidepressant prescribed declined after the advisory. However, children with major depressive disorder appeared no less likely to be prescribed antidepressants.
Annual data was obtained from two national surveys that focus on ambulatory care in physician practices, outpatient departments, and hospital emergency departments. Between 1998 and 2007, the researchers identified visits made by children aged 5 to 17 years for diagnoses of depression. Visits were also categorized into antidepressant visits where a drug was prescribed and visits where one was not prescribed.
Prior to the FDA advisory release, there was a steady increase in the number of children's depression visits from 3.2 million in 1998–1999 to 4.3 million in 2002–2003. A similar trend was found for antidepressant visits, increasing from 3.4 million to 7.6 million. Following the advisory, children's depression visits shrank back to 3.2 million in 2006–2007. Antidepressant visits also dropped to 6.7 million. Combined depression/antidepressant visits also increased before the advisory and then declined by 2006–2007. However, these rates stabilized to 65 percent during 2004–2005 and to 64 percent in 2006-2007. The study was supported in part by the Agency for Healthcare Research and Quality (HS19024).
See "National trends in prescribing antidepressants before and after an FDA advisory on suicidality risk in youths," by Shih-Yin Chen, Ph.D., and Sengwee Toh, Sc.D., in Psychiatric Services 62(7), pp. 727-733, 2011.