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More kids prescribed drugs for depression

Preschool rate rose the most, study says
Friday, April 02, 2004
Star-Ledger Staff

The rate at which antidepressants were prescribed to children rose about 10 percent annually between 1998 and 2002, with preschoolers accounting for the sharpest increase, according to a new study.

The study, which looked at prescriptions written for some 2 million pediatric patients nationally, found 2.4 percent were prescribed antidepressants in 2002, up from 1.6 percent five years earlier. That amounts to a 49 percent increase in the number of people under 18 prescribed antidepressants, according to the study in Psychiatric Services, a medical journal published by the American Psychiatric Association.

Among children 5 and under, the increase was even higher, with antidepressant use among girls doubling and among boys rising by 64 percent. Overall, the increase was highest among girls: 68 percent, compared to 34 percent among boys.

The growth in prescriptions written for children occurred even though antidepressants -- with the exception of Prozac -- were never approved for anyone younger than 18. Prozac was approved as a treatment for children, but only two years ago -- after the rise in juvenile prescriptions began.

The findings come amid a widening controversy over antidepressants and alleged links to suicidal behavior and thoughts, especially among children. Last month, the Food and Drug Administration asked drug makers to add explicit warnings to their product labeling.

"This adds to the data showing many children are using these drugs," said Tom Delate, research director at Express Scripts, a pharmacy benefits manager that conducted the study. "The safety and efficacy have to be examined more closely. This may add some impetus."

He cited off-label use as the reason more children are prescribed the drugs. Off-label use refers to a common practice among doctors to write prescriptions even though regulators have not approved a medicine for a specific use.

Many doctors and families contend antidepressants have saved lives. This argument is also cited by drug makers, which deny their pills, including Zoloft, Paxil and Effexor, lead to suicide. The manufacturers include Wyeth, GlaxoSmithkline, Eli Lilly and Pfizer.

Last year, though, British authorities warned doctors not to prescribe the drugs, except for Prozac. They pointed to newly disclosed data showing one drug, Glaxo's Paxil, wasn't effective and could increase the risk of suicide.

Last week, two congressional committees launched a probe into the FDA's handling of the controversy. They want to know why the agency didn't take more action, such as urging doctors not to prescribe the pills.

The committee also wants the FDA to explain why one of its own medical reviewers was prevented from presenting data at a February hearing convened to explore safety risks. The hearing garnered national publicity after many parents testified their children committed suicide after taking an antidepressant.

Consumer advocates, meanwhile, are stepping up calls for the companies that make antidepressants to release all unpublished clinical trial data. Drug makers aren't required to disclose this information, which critics say allows negative findings to remain suppressed.

"Frankly, I call this child abuse," said Vera Sharav of the Alliance for Human Research Protection, a consumer advocate. "There is no medical justification for putting preschoolers on such drugs. And there's nobody protecting the children. It's just a free-for-all."

Ed Silverman can be reached at (973) 392-1542 or esilverman@starledger.com

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Copyright 2004 The Star-Ledger. Used by NJ.com with permission.


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