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Antidepressant exposures associated with exploratory behavior among young children reported to United States poison
Matilda Francis1,2, Henry A Spiller3,4, Jaahnavi Badeti1
1Center for Injury Research and Policy, The Abigail Wexner Research Institute of Nationwide Children's Hospital, Columbus, Ohio, USA.
Insights
Young children accidentally exposed to antidepressants experienced serious outcomes, including 13 deaths. Prevention efforts like public education and safer packaging are crucial for child safety.
Area of Science:
- Pediatric Toxicology
- Environmental Health
- Public Health
Background:
- Antidepressant ingestions in young children are a significant public health concern.
- Exploratory ingestion behaviors in children under six necessitate understanding associated risks.
Purpose of the Study:
- To analyze the characteristics and trends of antidepressant exposures in children under six years old.
- To identify specific antidepressant classes associated with severe outcomes in pediatric exploratory ingestions.
Main Methods:
- Utilized data from the National Poison Data System (2000-2020) for children <6 years old.
- Analyzed exposure rates, medical outcomes, and healthcare admissions.
- Calculated odds ratios to assess the association between antidepressant category and severe outcomes.
Main Results:
- Over 215,000 antidepressant exposures in children <6 years old were reported.
- Selective serotonin reuptake inhibitors (SSRIs) were most common, but other classes like bupropion, TCAs, and SNRIs were linked to higher risks of serious outcomes.
- 13 deaths occurred, with tricyclic antidepressants (TCAs) being the primary substance in 7 fatalities.
Conclusions:
- While most exposures were minor, a significant minority resulted in severe medical outcomes or death.
- Enhanced prevention strategies, including public awareness campaigns and improved child-resistant packaging, are essential.
- Urgent measures are needed to reduce accidental antidepressant exposures in young children.
Purpose:
This study investigates characteristics and trends of antidepressant exposures among children <6 years old related to exploratory behavior reported to US poison control centers.
Methods:
Using data from the National Poison Data System for 2000-2020, population-based annual exposure rates by sex, antidepressant category, serious medical outcome, and health care facility admission were analyzed and odds ratios to assess associations of exposure type and antidepressant category with medical outcome and admission were calculated.
Results:
There were 215 909 first-ranked unintentional exploratory exposures involving antidepressants among children <6 years old during the study period, averaging 10 281 annually. Most cases were <3 years old (77.8%), involved a single substance (86.9%), and did not receive treatment at a health care facility (57.6%); however, 7.9% were admitted and 3.4% had serious medical outcomes, including 13 deaths. SSRIs were involved in 56.9% of all cases. Compared with SSRIs, bupropion (OR: 5.22, 95% CI: 4.68-5.82), TCAs (OR: 3.74, 95% CI: 3.44-4.07), SNRIs (OR: 2.39, 95% CI: 2.11-2.71), and lithium salts (OR: 2.00, 95% CI: 1.63-2.46) were more likely to be associated with a serious medical outcome. TCAs were the first-ranked substance in 7 of the 13 deaths.
Conclusions:
Although most unintentional antidepressant exposures related to pediatric exploratory behavior were inconsequential, an important minority of cases required admission to a HCF or had a serious medical outcome, including 13 deaths. Therefore, increased efforts to prevent these exposures among young children are needed, including public education and improved medication packaging.
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