Web Issue 1900 December 18 2003   
NHS fears over children being prescribed anti-depressants
BILLY BRIGGS December 18 2003
THE NHS is to collect information on the number of youngsters in Scotland being given anti-depressants for the first time, because of fears that GPs are over-prescribing them.
Health campaigners estimate there could be as many as 5000 children north of the border being given controversial drugs, such as Seroxat, by their family doctors.
The move follows a report last week by the Committee on Safety of Medicines, which said the majority of the most commonly-prescribed type of anti-depressants are not suitable for children.
Children's depression is different from that of adults, partly because the brain is still developing.
The committee found there was an increased rate of insomnia, agitation, weight loss, headache, tremor, loss of appetite, self-harm and suicidal thoughts in those treated with some anti-depressants, known as selective serotonin reuptake inhibitors (SSRIs), compared with a placebo.
The NHS has no details of the sex and age of children being prescribed the drugs, or details of where they live.
The report found the risks of treating depressive illness in under-18s with certain SSRIs Lustral, Cipramil, Cipralex, Faverin, Seroxat, and Efexor outweighed the benefits.
However, clinical trials found that Prozac appears to have a positive balance of risks and benefits in the treatment of depressive illness in the same age group.
In June, medical experts expressed concern over the use of Seroxat for children because of fears it can increase the risk of suicidal thoughts and self-harm.
Yesterday, in response to growing concern, the information and statistics division (ISD) for NHS Scotland announced that it would start collating figures in the new year.
An ISD spokesman said: "This will help us provide information to the NHS that shows they are being prescribed appropriately and to identify how many children are taking anti-depressant drugs and what areas they are coming from."
Young Minds, a charity committed to improving mental health among children, said it was worrying that the NHS in Scotland had no idea how many children are being prescribed anti-depressants. It said that without accurate figures it was impossible to ensure children are being prescribed properly or to answer questions about the drugs' use.
Urging doctors to look at alternative treatments, Lee Miller, a spokesman for the charity, said: "This could be having a terrible consequence on the health of children in Scotland.
"It is important to be able to have accurate information so that we can look to see how young people are when they are prescribed these drugs, to see if they are getting younger from year to year."
Mr Miller said it was important to make sure that other therapies, such as cognitive behaviour therapy and family therapies, which have very good track records in treating children with depression, are invested in as much as drugs.
Richard Norris, director of policy at the Scottish Association for Mental health, said GPs should look to "talking treatments" as often as possible, adding: "They (GPs) can offer counselling and psychological intervention. There may be social problems for the child as well, so pyscho-social intervention may help.
"Nutritional remedies can also work if there are issues with diet and vitamins deficiencies.
"The problem for doctors, however, is there are six to nine-month waiting lists for these treatments, so what does a doctor do when presented with a youngster with depression and in need of immediate treatment? Sometimes prescribing a drug is the only option."
Ruth Lane, information officer for Depression Alliance Scotland, said that depression is not something that can easily be measured.
"It is a disorder with many symptoms which people can suffer from in different ways and to varying extremes.
"Recording the number of children being prescribed anti-depressants, and what areas in the country are worst affected, is certainly something to be welcomed."
Professor Gordon Duff, chairman of the Committee on Safety of Medicines, emphasised that young people taking any SSRI other than Prozac should not stop taking their medicine without consulting with their doctor first.
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