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Prescribing pattern of antidepressants in children and adolescents: Findings from the Research on Asia Psychotropic Prescription Pattern

Chee KY 1 , Tripathi A 2 , Avasthi A 3 , Chong MY 4 , Xiang YT 5 , Sim K 6 Show all authors , Kanba S 7 , He YL 8 , Lee MS 9 , Chiu HF 10 , Yang SY 11 , Kuga H 7 , Udomratn P 12 , Tanra AJ 13 , Maramis MM 14 , Grover S 3 , Mahendran R 15 , Kallivayalil RA 16 , Shen WW 17 , Shinfuku N 18 , Tan CH 19 , Sartorius N 20

Affiliations 

  • 1 Department of Psychiatry & Mental Health, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia
  • 2 Department of Psychiatry, King George's Medical University, Chowk, Lucknow, India
  • 3 Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
  • 4 Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital-Kaohsiung Medical Center and School of Medicine, Chang Gung University, Taiwan
  • 5 Faculty of Health Sciences, University of Macao, Macao SAR, PR China
  • 6 Institute of Mental Health, Buangkok View, Buangkok Green Medical Park, Singapore
  • 7 Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  • 8 Department of Psychiatric Epidemiology, Shanghai Mental Health Center, Shanghai, PR China
  • 9 Department of Psychiatry, College of Medicine, Korea University, Seoul, South Korea
  • 10 Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, PR China
  • 11 Department of Pharmacy, Taipei City Hospital, Taipei, Taiwan
  • 12 Department of Psychiatry, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
  • 13 Department of Psychiatry, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, Indonesia
  • 14 Dr Soetomo Hospital-Faculty of Medicine, Airlangga University, Jawa Timur, Indonesia
  • 15 Department of Psychological Medicine, National University Hospital, Singapore
  • 16 Department of Psychiatry, Pushpagiri Medical College, Thiruvalla, India
  • 17 Department of Psychiatry, TMU-Wan Fang Medical Center and School of Medicine, Taipei Medical University, Taipei, Taiwan
  • 18 Department of Psychiatry, Kobe University, Kobe, Japan
  • 19 Department of Pharmacology, National University of Singapore, Singapore
  • 20 Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
East Asian Arch Psychiatry, 2016 Mar;26(1):10-7.
PMID: 27086755

Abstract

Objective: Pharmacotherapy of depression in children and adolescents is complex. In the absence of research into the efficacy and safety of antidepressants in this group of patients, their off-label prescription is common. This paper aimed to illustrate the prescription pattern of antidepressants in children and adolescents from major psychiatric centres in Asia.
Methods: The Research on Asia Psychotropic Prescription Pattern on Antidepressants worked
collaboratively in 2013 to study the prescription pattern of antidepressants in Asia using a unified research protocol and questionnaire. Forty psychiatric centres from 10 Asian countries / regions participated and 2321 antidepressant prescriptions were analysed.
Results: A total of 4.7% antidepressant prescriptions were for children and adolescents. Fluoxetine, sertraline, and escitalopram were the most common antidepressants prescribed for children and adolescents. Almost one-third (30.3%) of prescriptions were for diagnoses other than depressive and anxiety disorders. There was less antidepressant polypharmacy and concomitant use of benzodiazepine, but more concomitant use of antipsychotics in children and adolescents compared with adults.
Conclusion: Off-label use of antidepressants in children and adolescents was reported by 40 Asian psychiatric institutions that participated in the study. In-service education and regulatory mechanisms should be reinforced to ensure efficacy and safety of antidepressants in children and adolescents.
Key words: Adolescent; Antidepressive agents; Child; Ethnopsychology

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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