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Trends and Patterns of Antidepressant Use in French Children and Adolescents From 2009 to 2016: A Population-Based Study in the French Health Insurance Database

Revet, Alexis, MD*†; Montastruc, François, MD, PhD*‡§; Raynaud, Jean-Philippe, MD*†; Baricault, Bérangère, MSc; Montastruc, Jean-Louis, MD, PhD*‡§; Lapeyre-Mestre, Maryse, MD, PhD*§∥

Journal of Clinical Psychopharmacology: August 2018 - Volume 38 - Issue 4 - p 327–335
doi: 10.1097/JCP.0000000000000891
Original Contributions

Purpose/Background Over the last decade, the use of antidepressants (ATDs) in children and adolescents has markedly increased in several occidental countries, but recent data in French children are missing. This study aimed to assess trends of ATD use in French children (6–11 years) and adolescents (12–17 years) and to characterize changes in ATD prescribing patterns from 2009 to 2016.

Methods Using data from the French Health Insurance Database, annual prevalence and incidence of ATD use and changes in ATD prescribing patterns were analyzed.

Results Overall ATD prevalence of use rose slightly from 0.51% in 2009 to 0.53% in 2016 (+3.9%), with a decrease in children (0.18%–0.11%; −38.9%) and an increase in adolescents (0.86%–0.98%; +14.0%) and an overall female preponderance (56.7% in 2009; 58.7% in 2016). Serotonin reuptake inhibitor prevalence of use increased from 0.24% to 0.34%, whereas tricyclic ATD use decreased (from 0.20% to 0.16%). Similar trends were obtained with overall incidence of use, from 0.39% in 2009 to 0.36% in 2016 (−7.7%). Sertraline was the most frequently prescribed in adolescents (2009: 22.2% of all ATD prescriptions; 2016: 32.9%), whereas amitriptyline was the most prescribed in children (2009: 42.7% and 2016: 41.2%). Off-label use decreased in adolescents (from 48.4% to 34.8%) but increased in children (from 10.0% to 26.5%).

Implications/Conclusions Antidepressant level of use in French children and adolescents was stable in recent years and lower than that observed in other European countries and the United States.

From the *UMR1027, INSERM, Faculty of Medicine, University of Toulouse III;

Department of Child and Adolescent Psychiatry and

Midi-Pyrénées Centre for Pharmacovigilance, Pharmacoepidemiology and Drug Information, Department of Medical and Clinical Pharmacology, Faculty of Medicine, and

§CIC 1436, Department of Medical and Clinical Pharmacology, and

Centre for Addictovigilance (CEIP), Department of Medical and Clinical Pharmacology, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.

Received October 2, 2017; accepted after revision April 11, 2018.

Reprints: Alexis Revet, MD, Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Toulouse, Hôpital Purpan, Place du Dr Baylac, TSA 40031, 31059 Toulouse cedex 9, France (e-mail: revet.a@chu-toulouse.fr).

No funding was received to conduct this research.

Author Contributions: A.R. and M.L.-M. conceived and designed the experiments. A.R. and B.B. performed the experiments. A.R. and M.L.-M. analyzed the data, contributed reagents/materials/analysis tools, wrote the study, and gave final approval of the version to be published. F.M., J.-L.M., and J.-P.R. critically revised the study for important intellectual content.

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