Antidepressant Prescriptions, Including Tricyclics, Continue to Increase in Canadian Children

Area of Science:

• Pediatric Psychiatry
• Pharmacovigilance
• Public Health

Background:

• Limited longitudinal data exists on pediatric antidepressant prescribing trends post-2004 Black Box warning.
• Understanding current prescribing patterns is crucial for child mental health.
• Canadian pediatric antidepressant use trends require updated investigation.

Purpose of the Study:

• To describe trends in antidepressant recommendations for Canadian children aged 1-18 from 2012 to 2016.
• To identify the most frequently recommended antidepressant classes and specific drugs.
• To explore any notable changes in prescribing patterns for specific antidepressant types.

Main Methods:

• Utilized the Canadian Disease and Therapeutic Index (CDTI) database.
• Analyzed quarterly pediatric antidepressant recommendations from 652 Canadian office-based physicians.
• Projected data to represent the entire Canadian pediatric population (2012-2016).

Main Results:

• Total antidepressant recommendations for children increased between 2012 and 2016.
• Selective serotonin reuptake inhibitors (SSRIs) were the most recommended class.
• Fluoxetine was the most frequently recommended antidepressant; Tricyclic antidepressants (TCAs) showed increased recommendations, often for non-depressive conditions.

Conclusions:

• Overall antidepressant recommendations for Canadian children increased during the study period.
• Fluoxetine remains the leading antidepressant recommendation for pediatric patients.
• The rise in TCA recommendations for non-depressive pediatric conditions warrants further investigation.