Diagnoses associated with antidepressant use in privately insured children

Research has identified increasing trends in the use of antidepressant medications in children and adolescents despite the fact that the majority of these drugs have not been approved for use in children. Using administrative data for a large Midwestern health plan we evaluated the prevalence of antidepressant use and the diagnoses associated with treatment in children 2-18 years of age. The prevalence of antidepressant use along with associated diagnoses was calculated for the period between January 2002 and December 2005. The study population included 172,766 children with a mean age of 10.4 (SD 4.9). A total of 10,431 children (6.04%) received at least one prescription for an antidepressant. Of the children on antidepressants, almost 53% were female. Children 10 years of age and older were over 4 times more likely to receive antidepressants than those under 10 (OR=4.23, 95% CI 4.02, 4.46). The most common diagnosis for children on antidepressants was anxiety (36.7%) followed by other depression (35.3%). Of the children on antidepressants, males were more likely to have a diagnosis of ADD (OR=3.4, 95% CI 3.1, 3.7) or conduct disorder (OR=2.0, 95% CI 1.7, 2.1) than females. Females, were more likely to have a diagnosis of other depression (OR=1.5, 95% CI 1.4, 1.5), major depressive disorder (OR=1.4, 95% CI 1.3, 1.5), and anxiety (OR=1.1, 95% CI 1.1, 1.2) than males. A large number of children in this population were prescribed antidepressants. More research on safety and efficacy of antidepressants in pediatric populations is warranted to justify such widespread use.