Characterizing declines in pediatric antidepressant use after new risk disclosures

Abstract

Steep declines in pediatric antidepressant use were documented following the 2004 release of new safety information associating antidepressants with a risk of suicidality. The authors examine whether declines in pediatric antidepressant use were steeper among individuals with certain clinical or family characteristics. The authors find that declines in antidepressant use were associated with new (as compared with ongoing) treatment episodes. Although rates of antidepressant use were higher among children of college-educated parents prior to risk disclosures, these children were more likely to forgo antidepressant medication than children of less educated parents after risk disclosures. The authors find that both children with and without psychiatric impairment experienced declines in antidepressant medication use following the risk warnings, although the decline occurred more quickly in the latter group. The authors' findings highlight the need for additional data to assess the effects of risk disclosures on treatment patterns and health outcomes.

Figure 1

Adjusted probability of new antidepressant use by psychiatric impairment status among children ages 5 – 17, calendar years 2002–2006 Panel A: No Psychiatric Impairment (CIS<16) Panel B: Psychiatric Impairment (CIS>=16) Source: Authors' calculations using 2002–2006. Notes: MEPS = Medical Expenditure Panel Survey. Results adjusted by age, sex, low income status, race/ethnicity, and insurance status. The scale for Panel A differs from the scale for Panel B. Significance levels indicate differences between noted year and 2003. *p<.10; **p<.05; ***p<.01.

Figure 1

Adjusted probability of new antidepressant use by psychiatric impairment status among children ages 5 – 17, calendar years 2002–2006 Panel A: No Psychiatric Impairment (CIS<16) Panel B: Psychiatric Impairment (CIS>=16) Source: Authors' calculations using 2002–2006. Notes: MEPS = Medical Expenditure Panel Survey. Results adjusted by age, sex, low income status, race/ethnicity, and insurance status. The scale for Panel A differs from the scale for Panel B. Significance levels indicate differences between noted year and 2003. *p<.10; **p<.05; ***p<.01.

Figure 2

Adjusted probability of new antidepressant use by parent education among children ages 5 – 17, calendar years 2002–2006 Source: Authors' calculations using 2002–2006. Notes: MEPS = Medical Expenditure Panel Survey. Results adjusted by age, sex, low income status, race/ethnicity, and insurance status. Significance levels indicate differences between noted year and 2003. *p<.10; **p<.05; ***p<.01.