Literature DB >> 17404123

Impact of publicity concerning pediatric suicidality data on physician practice patterns in the United States.

Charles B Nemeroff1, Amir Kalali, Martin B Keller, Dennis S Charney, Susan E Lenderts, Elisa F Cascade, Hugo Stephenson, Alan F Schatzberg.   

Abstract

CONTEXT: IMS Health Inc data presented by the Food and Drug Administration (FDA) on September 13 and 14, 2004, at a joint meeting of the Center for Drug Evaluation and Research's Psychopharmacologic Drugs Advisory Committee and the FDA's Pediatric Advisory Committee suggested that the number of children and teenagers who were prescribed antidepressants continued to increase in 2004, despite widespread publicity surrounding 2 FDA advisories regarding the potential for pediatric suicidality with selective serotonin reuptake inhibitor use. These results are contradictory to findings from the Medco Health Solutions, Inc, March 2004 analysis of pharmacy benefit claims and a separate subsequent analysis conducted by NDC Health using dispensing data from March 31, 2004, through June 30, 2005.
OBJECTIVES: To investigate the contradictory findings and provide additional analyses on the prescribing trends of antidepressants across age groups and physician specialties in the United States.
DESIGN: Retail pharmacy prescription data and physician audit data were obtained from Verispan, a joint venture between Quintiles Transnational and McKesson. In addition to examining prescribing trends, a joinpoint regression analysis was conducted to identify the timing for significant changes in prescription use.
RESULTS: The analyses suggest that the number of children and teenagers who were prescribed antidepressants has decreased significantly (P = .02) in the wake of widespread publicity surrounding the FDA public health advisories. Another impact of the advisories seems to be a shift in care from "generalists" to psychiatric specialists when it comes to prescribing antidepressants to patients younger than 18 years. Finally, the analyses highlight a slight shift in prescribing toward the non-selective serotonin reuptake inhibitor bupropion hydrochloride, even though it carries the same FDA "black box" warning as the selective serotonin reuptake inhibitors.
CONCLUSIONS: The effect on antidepressant prescribing volume observed in our analysis of the Verispan data parallels earlier findings reported by Medco Health Solutions, Inc, and NDC Health that the FDA actions have had a significant effect on the prescribing of antidepressants to children and adolescents. Together, these findings underline the importance of presenting a fair balance within the media due to the significant reach of this channel among prescribing physicians.

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Year:  2007        PMID: 17404123     DOI: 10.1001/archpsyc.64.4.466

Source DB:  PubMed          Journal:  Arch Gen Psychiatry        ISSN: 0003-990X


  56 in total

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Authors:  Sigrid Piening; Flora M Haaijer-Ruskamp; Jonie T N de Vries; Menno E van der Elst; Pieter A de Graeff; Sabine M J M Straus; Peter G M Mol
Journal:  Drug Saf       Date:  2012-05-01       Impact factor: 5.606

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Authors:  Craig F Garfield; E Ray Dorsey; Shu Zhu; Haiden A Huskamp; Rena Conti; Stacie B Dusetzina; Ashley Higashi; James M Perrin; Rachel Kornfield; G Caleb Alexander
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4.  Update on trends in antidepressant use: Upswing in 2006 Following Period of Decline.

Authors:  Elisa F Cascade; Amir H Kalali; Jerrold F Rosenbaum
Journal:  Psychiatry (Edgmont)       Date:  2006-10

5.  Medication use and spending trends among children with ADHD in Florida's Medicaid program, 1996-2005.

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6.  Safe use of SSRIs in young adults: how strong is evidence for new suicide warning?

Authors:  Michael F Grunebaum; J John Mann
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Review 7.  Suicide and suicidal behavior.

Authors:  Matthew K Nock; Guilherme Borges; Evelyn J Bromet; Christine B Cha; Ronald C Kessler; Sing Lee
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8.  Decreased Use of Antidepressants in Youth After US Food and Drug Administration Black Box Warning.

Authors:  Tanvir Singh; Ashwin Prakash; Theodore Rais; Neeta Kumari
Journal:  Psychiatry (Edgmont)       Date:  2009-10

9.  News coverage of FDA warnings on pediatric antidepressant use and suicidality.

Authors:  Colleen L Barry; Susan H Busch
Journal:  Pediatrics       Date:  2009-12-07       Impact factor: 7.124

Review 10.  Pediatric generalized anxiety disorder: epidemiology, diagnosis, and management.

Authors:  Courtney Pierce Keeton; Amie C Kolos; John T Walkup
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