López-León S, Fortuny J, Plana E, Zhu Y, Rivero E. The pattern of use of anti-depressant drugs in a pediatric population in a US managed care population. Poster presented at the 27th International Conference on Pharmacoepidemiology & Therapeutic Risk Management; August 2011. Chicago, IL. [abstract] Pharmacoepidemiol Drug Saf. 2011 Aug; 20(Suppl 1):S101.

BACKGROUND: Antidepressants have become one of the most commonly prescribed groups of medications in the United States (US).

OBJECTIVES: To describe the pattern of use of anti-depressant drugs among pediatric patients in a US commercially insured population.

METHODS: PharMetrics, a national integrated healthcare claims database of managed care plans, was used to identify a cohort of new pediatric users of antidepressant drugs. New users were defined as individuals aged 1–17 years who had a first pharmacy claim for a prescription of an antidepressant with a date (index date) within the period from January 1 through December 31, 2007, and who had not been prescribed with any antidepressant drug during the 6 months prior to the index date. The frequency of antidepressant drug class dispensed, the potential psychiatric indications, and the concomitant medications were analyzed.

RESULTS: Among the population aged 1–17 years enrolled in the database in 2007, a total of 29,456 individuals (0.6%) were identified as new pediatric users of antidepressants. Two thirds of the new users were 13 to 17 years old and 53% were females. Selective serotonin reuptake inhibitors (SSRIs) users accounted for 65%, tertiary tricyclic for 14% and dopamine norepinephrine reuptake inhibitors for 10%. Overall, 74% of new users had any mental disorder diagnosis code (ICD-9 290.xx-319.xx) identified as potential indication within a period of 6 months prior and 6 months after the index date. The most common potential psychiatric indications were depressive disorders (38%), neurotic disorder (34%), attention hyperactivity disorder (25%) and anxiety disorders (20%). Antibiotics were the most commonly concomitant medications prescribed (20.1%). Concomitant psychotherapy treatment was present in 39% of the individuals.

CONCLUSIONS: In 2007, 0.6% of this US commercially insured pediatric population was newly prescribed an antidepressant. SSRIs followed by tertiary tricyclic antidepressants were the most commonly prescribed group. Psychiatric conditions and psychotherapy treatment were common in this patient population.

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