Population-Based Trends in Antidepressant Dispensing Among Children and Adolescents in Manitoba, Canada

This study quantified temporal trends in antidepressant dispensing among children and adolescents and described patterns by antidepressant class, drug, and demographic subgroups.

This population-based cohort study used administrative health data from Manitoba, Canada and included individuals aged 6-18 years between 2000 and 2024. Antidepressant dispensing was identified in prescription dispensing records using the Anatomical Therapeutic Chemical code N06A. Annual prevalence was defined as the proportion of individuals dispensed antidepressants in a given year; annual incidence rate was defined as the rate of new antidepressant dispensing following a 2-year washout period. Analyses were stratified by antidepressant class, drug, age group (6-12, 13-18), sex and neighborhood income quintiles.

The cohort included 699 526 individuals; 66 895 (9.6%) had an antidepressant dispensing, of which most were dispensed selective serotonin reuptake inhibitors (n = 49 219, 73.6%). The prevalence of antidepressant dispensing increased from 14.9 (95% confidence interval [CI] 14.5-15.5) to 48.7 (95% CI 47.9-49.6) per 1000 individuals in 2000 and 2024, respectively. The incidence increased from 9.2 (95% CI 8.8-9.6) to 17.4 (95% CI 16.8-17.9) per 1000 person-years. A decline in dispensing between 2003 and 2005, and a sharp rise beginning in 2020, were observed. Subgroup analyses showed a temporal increase in antidepressant dispensing across all subgroups, particularly among females and adolescents aged 13-18 years.

This study found a marked increase in antidepressant dispensing in children and adolescents over time, particularly in females and adolescents. Future studies are needed to evaluate appropriateness, clinical outcomes and long-term safety of antidepressant use in this population.