Managed Care

Pediatric antidepressant use drops 18 percent

After an FDA advisory committee called for stronger warnings to health care providers that some children and teenagers can become suicidal when prescribed antidepressants, the percentage of eligible patients taking these agents dropped considerably. Medco Health Solutions reports an 18 percent decrease in the number of pediatric patients taking an antidepressant in the first quarter of 2004, and an additional 5 percent decrease in the second quarter, contrasting sharply with a general increase in 2002 and 2003.

The decrease follows the FDA's October 2003 Public Health Advisory that reported risks of suicide (including suicidal ideation and suicide attempts) in children being treated with certain antidepressants for major depressive disorder, according to the Medco data.

"Information that linked antidepressant use and suicide among teenagers started coming out last year," says Ann Smith, a spokeswoman for Medco. "It takes time for prescribing habits to change. In addition, patients can have a 60-day and 90-day supply."

"Prescribing patterns tend to evolve slowly," says Robert Epstein, MD, Medco's chief medical officer. "The dramatic and almost immediate impact of the heightened scrutiny given to children taking these medicines to combat their depression shows that the medical community can respond quickly to new information."

Antidepressant use begins downward slide in 2003–2004


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