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.
— KB
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