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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



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