- ST. LOUIS (Business Wire)
-- The use of paroxetine and other antidepressant medications continues
to grow by about 10% annually among children and adolescents, according
to a study published in the April issue of Psychiatric Services. The study
profiles trends of prescription antidepressant use in children and adolescents
using prescription claim information from a random, nationwide sample.
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- The study by Express Scripts examined antidepressant
use among approximately two million commercially-insured, pediatric beneficiaries
18 years and younger from 1998 to 2002. The fastest growing segment of
users were found to be preschoolers aged 0-5 years, with use among girls
doubling and use among boys growing by 64%. For the entire sample, antidepressant
use increased from 1.6% in 1998 to 2.4% in 2002, a 49% increase. Over the
course of the study, the growth in use was greater among girls (68%) than
boys (34%) and, for each gender respectively, growth was higher among younger
boys and older girls.
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- "A number of factors acting together or independently
may have led to escalated use of antidepressants among children and adolescents,"
said Tom Delate, Ph.D., Director of Research at Express Scripts. "These
factors include increasing rates of depression in successive age groups,
a growing awareness of and screening for depression by pediatricians and
assumptions that the effectiveness experienced by adults using antidepressant
medications will translate to children and adolescents."
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- Throughout the five-year period of the study, selective
serotonin reuptake inhibitors (SSRI's) were the most commonly dispensed
antidepressants, while tetracyclics were the least. SSRI's include paroxetine
(also known as Paxil(R)), Prozac(R) and Zoloft(R). Use of paroxetine increased
113% and 91% in females and males, respectively, over the study period.
The U.S. Food and Drug Administration (FDA) has recommended that paroxetine
not be used in children and adolescents because, among youths, its efficacy
has not been established for depression and its use is associated with
increased risk of suicidal thinking and suicide attempts. Of the SSRIs,
only Prozac has been approved by the FDA for treating depression in children
and adolescents.
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- More information about these and other studies are available
at http://www.express-scripts.com/other/news_views/outcomes_research.htm.
http://www.nj.com/business/ledger/index.ssf?/base/business-0/1080899456221740.xml
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- NJ Star-Ledger
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- More kids prescribed drugs for depression Preschool rate
rose the most, study says
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- By Ed Silverman 4-2-4
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- The rate at which antidepressants were prescribed to
children rose about 10 percent annually between 1998 and 2002, with preschoolers
accounting for the sharpest increase, according to a new study.
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- The study, which looked at prescriptions written for
some 2 million pediatric patients nationally, found 2.4 percent were prescribed
antidepressants in 2002, up from 1.6 percent five years earlier. That amounts
to a 49 percent increase in the number of people under 18 prescribed antidepressants,
according to the study in Psychiatric Services, a medical journal published
by the American Psychiatric Association.
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- Among children 5 and under, the increase was even higher,
with antidepressant use among girls doubling and among boys rising by 64
percent. Overall, the increase was highest among girls: 68 percent, compared
to 34 percent among boys.
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- The growth in prescriptions written for children occurred
even though antidepressants -- with the exception of Prozac -- were never
approved for anyone younger than 18. Prozac was approved as a treatment
for children, but only two years ago -- after the rise in juvenile prescriptions
began.
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- The findings come amid a widening controversy over antidepressants
and alleged links to suicidal behavior and thoughts, especially among children.
Last month, the Food and Drug Administration asked drug makers to add explicit
warnings to their product labeling.
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- "This adds to the data showing many children are
using these drugs," said Tom Delate, research director at Express
Scripts, a pharmacy benefits manager that conducted the study. "The
safety and efficacy have to be examined more closely. This may add some
impetus."
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- He cited off-label use as the reason more children are
prescribed the drugs. Off-label use refers to a common practice among doctors
to write prescriptions even though regulators have not approved a medicine
for a specific use.
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- Many doctors and families contend antidepressants have
saved lives. This argument is also cited by drug makers, which deny their
pills, including Zoloft, Paxil and Effexor, lead to suicide. The manufacturers
include Wyeth, GlaxoSmithkline, Eli Lilly and Pfizer.
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- Last year, though, British authorities warned doctors
not to prescribe the drugs, except for Prozac. They pointed to newly disclosed
data showing one drug, Glaxo's Paxil, wasn't effective and could increase
the risk of suicide.
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- Last week, two congressional committees launched a probe
into the FDA's handling of the controversy. They want to know why the agency
didn't take more action, such as urging doctors not to prescribe the pills.
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- The committee also wants the FDA to explain why one of
its own medical reviewers was prevented from presenting data at a February
hearing convened to explore safety risks. The hearing garnered national
publicity after many parents testified their children committed suicide
after taking an antidepressant.
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- Consumer advocates, meanwhile, are stepping up calls
for the companies that make antidepressants to release all unpublished
clinical trial data. Drug makers aren't required to disclose this information,
which critics say allows negative findings to remain suppressed.
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- "Frankly, I call this child abuse," said Vera
Sharav of the Alliance for Human Research Protection, a consumer advocate.
"There is no medical justification for putting preschoolers on such
drugs. And there's nobody protecting the children. It's just a free-for-all."
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- Ed Silverman can be reached at (973) 392-1542 or esilverman@starledger.com
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