Frequency of Provider Contact After FDA Advisory on Risk of Pediatric Suicidality With SSRIs (original) (raw)
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In October 2004, the Food and Drug Administration directed pharmaceutical companies to issue a black box warning about the potential link between the use of antidepressants and suicidal ideation among children. This study analyzed long-run trends in antidepressant use among children before and after the black box warning for those with and without severe psychological impairment. The analysis used data from the Medical Expenditure Panel Survey for children ages five to 17, covering years 2000-2011 (N=75,819). The study used multivariate probit models to compare the changes in the rate of any antidepressant use in the early (2004-2007) and late (2008-2011) postwarning years with the rate in the prewarning years (2002-2003). Recycled predictions methods were used to estimate yearly predicted probabilities of use. After adjustment for all covariates, there was a .5% statistically significant decline in the probability of using any antidepressants during the early postwarning years (200...
European Child & Adolescent Psychiatry
Meta-analyses of randomized-controlled trials have established a heightened risk of suicidality for children and adolescents treated with selective serotonin reuptake inhibitors (SSRIs). The present study examined to what extent daily clinical practice complied with specific recommendations regarding the risk of suicidality when treating children and adolescents with SSRIs. All in- and outpatients aged 0–17 years at the Child and Adolescent Mental Health Services, Capital Region of Denmark with a prescription for SSRI on January 1st, 2016 were identified. Data were obtained for n = 365 patients regarding the level of clinician compliance to deliver pre-consent information about adverse effects, monitor for suicidality, and provide non-pharmacological interventions. 81.7% (n = 298) of patients received pre-consent information about adverse effects. 67.7% (n = 247) were monitored for suicidality within 6 weeks after SSRI initiation. Children (0–13 years) were less likely to be monitor...
Review of Economics of the Household, 2012
We examine how consumer use of antidepressant medications was influenced by warnings provided by the Food and Drug Administration (FDA) about the increased risk of suicidality associated with antidepressant use among children. Using data from the Medical Expenditure Panel Survey, we find evidence consistent with reduced use of antidepressants among the intended population (children), as well as spillover effects of reduced use among an unintended population (adults). Our results indicate that consumers may perceive extra risks beyond those specifically mentioned in warnings.
Persisting Decline in Depression Treatment After FDA Warnings
Archives of General Psychiatry, 2009
the Food and Drug Administration (FDA) issued a Public Health Advisory about the risk of suicidality for pediatric patients taking antidepressants; a boxed warning, package insert, and medication guide were implemented in February 2005. The warning was extended to young adults aged 18 to 24 years in May 2007. Immediately following the 2003 advisory, unintended declines in case finding and nonselective serotonin reuptake inhibitor substitute treatment were shown for pediatric patients, and spillover effects were seen in adult patients, who were not targeted by the warnings. Objective: To determine whether the unintended declines in depression care persisted for pediatric, young adult, and adult patients.
Professional Psychology-research and Practice, 2009
In 2004, the Food and Drug Administration released a black box warning label for all antidepressants, indicating an increased risk for suicidality in children and adolescents. The label was subsequently updated in 2007 to include those up to 24 years of age. Data have since emerged to indicate changes in clinical practice patterns of nonspecialists (i.e., nonpsychiatrists) prescribing medications. Among the changes reported in practice patterns are an increased likelihood of referral and a decreased willingness to prescribe antidepressants. Findings also indicate marked reductions in ambulatory visits for depression among children and adolescents, lower rates of diagnosis of depression in this age group, a spillover effect to adults, inaccurate understanding of the actual risk communicated on the warning label (on the part of primary care practitioners), and increased suicide rates among children and adolescents. Recent findings have important implications for practicing psychologists, and specific recommendations are offered.
Journal of Child and Adolescent Psychopharmacology, 2010
Objective: The aim of this study was to analyze changes in the prevalence and incidence of antidepressant use among children and adolescents in Finland post October, 2003. Method: The sample comprised all children and adolescents in Finland aged 19.0 years (n ¼ 27,676) who collected one or more reimbursed prescriptions for an antidepressant in noninstitutional and nonhospital settings between January, 1998, and December, 2005. Time-series models were used to compare antidepressant use 60 months before and 24 months after the health advisory issued by the Food and Drug Administration (FDA) in October, 2003. Results: The annual prevalence (users=1,000 youths) of antidepressant use increased from 5.24 in 2002 to 5.93 in 2005. There was an increase in the monthly incidence (users ¼ 1,000 youths) of selective serotonin reuptake inhibitors (SSRIs) use (þ0.02498), fluoxetine use (þ0.00691), and sertraline use (þ0.00727) post October, 2003. When considering preadvisory trends in antidepressant use, only fluoxetine use was higher than the predicted post October 2003, use (<0.001). The use of all other SSRIs was significantly lower than predicted. Conclusions: In contrast to many other countries, the use of antidepressants continued to increase among children and adolescents in Finland post October, 2003. While the rate of fluoxetine use increased, there was a decline in the rate at which all other SSRIs were used.