Trends in antidepressant use among children and adolescents: a Scandinavian drug utilization study

Acta Psychiatr Scand. 2020 Jan;141(1):34-42. doi: 10.1111/acps.13116. Epub 2019 Nov 1.

Abstract

Objective: To compare antidepressant utilization in individuals aged 5-19 years from the Scandinavian countries.

Methods: A population-based drug utilization study using publicly available data of antidepressant use from Denmark, Norway, and Sweden.

Results: In the study period from 2007 to 2017, the proportion of antidepressant users increased markedly in Sweden (9.3-18.0/1000) compared to Norway (5.1-7.6/1000) and Denmark (9.3-7.5/1000). In 2017, the cumulated defined daily doses (DDD) of selective serotonin reuptake inhibitors were 5611/1000 inhabitants in Sweden, 2709/1000 in Denmark, and 1848/1000 in Norway. The use of 'other antidepressants' (ATC code N06AX) also increased in Sweden with a higher DDD in 2017 (497/1000) compared to Denmark (225/1000) and Norway (170/1000). The use of tricyclic antidepressants was generally low in 2017 with DDDs ranging between 30-42 per 1000. The proportion of antidepressant users was highest among 15- to 19-year-old individuals. Girls were more likely to receive treatment than boys, and the treated female/male ratios per 1000 were similar in Sweden (2.39), Denmark (2.44), and Norway (2.63).

Conclusion: Even in highly comparable healthcare systems like the Scandinavian countries', variation in antidepressant use is considerable. Swedish children and adolescents have a markedly higher and still increasing use of antidepressants compared to Danish and Norwegian peers.

Keywords: SSRI; anxiety; depression; drug utilization; obsessive-compulsive disorder.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Age Factors
  • Antidepressive Agents / therapeutic use*
  • Antidepressive Agents, Tricyclic / therapeutic use
  • Child
  • Child, Preschool
  • Denmark
  • Drug Labeling / statistics & numerical data
  • Drug Utilization / trends*
  • Female
  • Humans
  • Male
  • Norway
  • Scandinavian and Nordic Countries
  • Serotonin Uptake Inhibitors / therapeutic use*
  • Sex Factors
  • Sweden
  • Young Adult

Substances

  • Antidepressive Agents
  • Antidepressive Agents, Tricyclic
  • Serotonin Uptake Inhibitors