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GPs go forth

50% hike in antidepressant use in UK children

Prescriptions for antidepressants in children rose 54% between 2005 and 2012 in the UK, an international study has revealed.

The World Health Organisation (WHO) said it was ‘very concerned’ by the rise in use of the drugs in children both in the UK and other countries which it said was ‘not justified’.

Similar increases of 60% in Denmark and 49% in Germany were recorded over the same period, while antidepressant use in children went up by 26% in the USA and 17% in The Netherlands.

GP leaders pointed out that the ‘vast majority’ of prescriptions for children are initiated by secondary care specialists in the UK, but warned that rising pressure on specialist child mental health services meant GPs themselves are sometimes forced into prescribing.

The study – published in the journal European Neuropsychopharmacology and led by Kings College London academics – looked at data from The Health Improvement Network (THIN) primary care database and found that the proportion of children aged up to 19 years who had received an antidepressant prescription went up from 0.7% in 2005 to 1.1% in 2012.

This was mainly down to increases in SSRI use, with TCA prescriptions showing a relative decline. The majority - 90% - of SSRIs were initiated in teenagers aged between 15 and 18.

The figures come as research has reignited concerns over the safety of antidepressants in children, finding that increases in risks of suicide and aggressive behaviour – previously mainly linked to paroxetine specifically – may be more widespread, with such hazards reported for a number of different types of SSRIs and SNRIs.

WHO director of mental health Dr Shekhar Saxena told the BBC: ‘These are medicines which have not been tried amongst young people, have no justification for being used widely in young people.

‘There are legal regulations and professional guidelines and off-label use of drugs many times crosses both of them. That’s something the World Health Organization is very concerned about.’

NICE currently recommends GPs should refer children to specialists for anything more than mild depression that might need pharmacological treatment, and that antidepressants should only be used in conjunction with talking therapies in younger people. However, GPs have warned that pressures on Child and Adolescent Mental Health Services mean they have to prescribe sometimes.

Dr Maureen Baker, chair of the RCGP, said the ‘vast majority of anti-depressants for children and young people are prescribed in secondary care’, but added that ‘with such long waits for patients to see a specialist or to get a psychological therapy referral, drug therapy is sometimes seen as the only option for GPs to best support patients, who may be in extreme distress, and their family’.

The Government last year promised an extra £1.25bn investment in child mental health services over the next five years, but Mental Health Network figures revealed yesterday that mental health trusts have received very little of this funding to date.

European Neuropsychopharmacology 2016


Readers' comments (9)

  • Why is there no mention of what's behind the increase of antidepressants in children? Broken homes? Social media? Lack of good teachers? Over-population?
    One union, one child I say.

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  • Vinci Ho

    The fundamental question goes back to ''are people generally happy in a society?'' '' what have we turned into?'' Of course , our children are watching all these in their eyes all through this period of time:
    The utilitarian view always try to simplify happiness into quantity of 'utilities'. I suppose one is happier if you have more and more 'followers' on Twitter and so many 'likes' on clips you put on YouTube.......

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  • Vinci Ho

    I was watching 'to kill a mockingbird bird' again on Sunday night . The kind of joy , excitement and pleasure these three children , Scout, Jem and Dill , having in the film is so unique and natural to that time of history and you wonder what is the price we have paid for 21st century modernisation and civilisation ?

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  • Hence anticipate 54% increase in iatrogenic "bipolar disorder" between 2005 and 2012. Cause and effect. Then add similar increase in iatrogenic "bipolar disorder" resulting from use of ADHD "medication". The "overwhelming of psychiatry" is of our own making.

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  • A young relative went to see 'her' GP.the GP does not know her, never met her before....within ten minutes she was being prescribed anti depressants -for period pains..she is to some extent stressed by working on a PHd - something completely normal - thank goodness as a clinical psychologist. something the GP had not realised, she had the sense to change her practice.....but this complacent treatment of youngsters and children is commonplace in Wales especially in poorer areas.. If challenged the ususal excuse trotted out - lack of time lack of relative needed neither. It is very rare to see a spokesperson from Welsh psychiatry on TV progs which highlight this situation over and over again.

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  • re 12.35..yet another scandal revealed yesterday on Welsh TV of children getting repeat prescriptions for depression for years on boy for over 10 years..children themselves are starting to collectively speak out.maybe that will shame some in politics and medical politics in Wales

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  • I would first question the data the study used, I haven't seen tricyclics used in children except for enuresis in the last 23 years in General Practice

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  • The result of broken homes, support for teenage pregnancies. Parents and schools not allowed to discipline children for fear of being labelled child abuse.Parental responsibility passed to schools and doctors.
    Unhappy children that are not guided on what is right or wrong, unruly, immoral society and a permissive culture.
    When control is needed, they are prescribed medication labelling ADHD, depression etc instead of good old fashioned family discipline.
    A failed social experiment.

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  • Dear Anonymous at 5-19. You need to educate yourself on ADHD. The vast majority of children with ADHD are not naughty or unruly. It's a problem of lack of focus. The child can't concentrate on they which is difficult , boring or tedious. Nothing to do with being naughty. Possibly you mean ODD( oppositional defiant disorder ) or Conduct disorder? Or PDA ( pathological demand avoidance ) ? These conditions together are more common than ADHD and moreover medication is not given to any of children. Thousands of children take stimulants for ADHD and do not get bipolar or anything else. They focus and get on with their school work. I can assure you all the family discipline in the world won't help these children. Sadly even the medical profession know so little about child mental health. And still throw around these ridiculous comments. Yes. Family breakdown is causing a lot of problems but such generalisations are ridiculous. The last three severe depression cases I treated in my GP practice were teenagers in two parent loving normal families. Not a broken home in sight . Sadly let down by camhs No medication given just " talking family therapy " looking for non existent family problems as the cause for profound depression. All got better. With medication. I had started anti depressants. Camhs said "oh you must not do that , you must not label teenagers ". Guess what. I saw them and said. " well you are so much better , I am so pleased. ". Dad replied " camhs was useless . They just went round in circles. We went private. He is on two meds and it's very good. ". The second teenager came for a repeat prescription of a new anti psychotic as well as the anti depressant. And explained. That camhs was just looking at the family and going round in circles. They went private as well and she also received a new anti psychotic. Neither of the three patients were unruly and nobody lacked good old fashioned family discipline

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