Falk Hoffmann1, Gerd Glaeske, Christian J Bachmann. 1. Centre for Social Policy Research, Division Health Economics, Health Policy and Outcomes Research, University of Bremen, Bremen, Germany.
Abstract
PURPOSE: Longitudinal data on prescriptions of antidepressants (AD) in children and adolescents depression are scarce. This study aimed to examine AD prescription trends in children and adolescents in Germany. METHODS: Data of a large statutory health insurance company were analyzed for the period 2005-2012, and outpatients aged 0-19 years with AD prescriptions were identified. Prescriptions were evaluated with respect to age, sex, region of residence (East vs. West Germany) and substance class. RESULTS: Our study population comprised 1.4-1.6 million children and adolescents per year; between 4790 and 6849 of them received AD prescriptions. From 2005 to 2012, the prevalence of AD prescriptions rose from 0.32% to 0.48% (+49.2%), with a significant increase only in the age group 15-19 years (from 0.83% to 1.41%; +71.0%). The prevalence of AD prescriptions rose from 0.41% to 0.63% (+53.3%) for women and from 0.24% to 0.35% (+43.1%) for men. Regarding substance classes, serotonin reuptake inhibitors (SSRI) prescriptions increased from 37.7% to 54.4% of all AD prescriptions, whereas tricyclic antidepressants (TCA) significantly decreased (from 39.6% to 23.0%). In all years, fluoxetine was the substance most frequently prescribed (2005: 12.2% and 2012: 24.3% of all AD prescriptions). CONCLUSIONS: During an 8-year period, prescriptions of AD to children and adolescents in Germany have markedly increased, but almost exclusively in adolescents. Fortunately, in accordance with guidelines, both fluoxetine and SSRI prescriptions have risen over recent years. Yet, there still remain a significant proportion of TCA prescriptions.
PURPOSE: Longitudinal data on prescriptions of antidepressants (AD) in children and adolescents depression are scarce. This study aimed to examine AD prescription trends in children and adolescents in Germany. METHODS: Data of a large statutory health insurance company were analyzed for the period 2005-2012, and outpatients aged 0-19 years with AD prescriptions were identified. Prescriptions were evaluated with respect to age, sex, region of residence (East vs. West Germany) and substance class. RESULTS: Our study population comprised 1.4-1.6 million children and adolescents per year; between 4790 and 6849 of them received AD prescriptions. From 2005 to 2012, the prevalence of AD prescriptions rose from 0.32% to 0.48% (+49.2%), with a significant increase only in the age group 15-19 years (from 0.83% to 1.41%; +71.0%). The prevalence of AD prescriptions rose from 0.41% to 0.63% (+53.3%) for women and from 0.24% to 0.35% (+43.1%) for men. Regarding substance classes, serotonin reuptake inhibitors (SSRI) prescriptions increased from 37.7% to 54.4% of all AD prescriptions, whereas tricyclic antidepressants (TCA) significantly decreased (from 39.6% to 23.0%). In all years, fluoxetine was the substance most frequently prescribed (2005: 12.2% and 2012: 24.3% of all AD prescriptions). CONCLUSIONS: During an 8-year period, prescriptions of AD to children and adolescents in Germany have markedly increased, but almost exclusively in adolescents. Fortunately, in accordance with guidelines, both fluoxetine and SSRI prescriptions have risen over recent years. Yet, there still remain a significant proportion of TCA prescriptions.
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