Antidepressant prescription patterns and CNS polypharmacy with antidepressants among children, adolescents, and young adults: a population-based study in Sweden
Antidepressant prescription patterns and CNS polypharmacy with antidepressants among children, adolescents, and young adults: a population-based study in Sweden
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DOI：
10.1007/s00787-018-01269-2
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发表时间：
2019-08-01
影响因子：
6.4
通讯作者：
Chang, Z.
中科院分区：
文献类型：
--
作者：
Lagerberg, Tyra;Molero, Y.;Chang, Z.
本研究调查了 2006 年至 2013 年期间瑞典 0-24 岁年轻人的抗抑郁药物配药趋势，以及抗抑郁药物的处方模式和中枢神经系统 (CNS) 多重用药。利用瑞典国家登记册的链接，我们确定了2006年1月1日至2013年12月31日期间服用至少一种抗抑郁药物的所有0-24岁瑞典居民（此处定义为抗抑郁药物使用者）（n=174,237），并将他们分为儿童（0-11岁）、青少年（12-17岁）和年轻人（18-24岁）。 2006 年至 2013 年间，抗抑郁药配药率从 1.4% 上升至 2.1%，其中青少年相对增幅最大 [男性增加 97.8%（从 0.6% 增加到 1.3%），女性增加 86.3%（从 1.1% 增加到 2.1%）]。大多数不同年龄段的人都服用了选择性血清素再摄取抑制剂，他们的处方来自精神科专家护理，并且治疗时间超过 12 个月。中枢神经系统多重用药（除抗抑郁药外还配用其他中枢神经系统药物类别）的患病率在各个年龄段都有所增加，总体患病率从 2006 年的 52.4% 增加到 2013 年的 62.1%。儿童中三种或以上精神药物类别的多重用药增幅最大 (4.4-10.1%)。抗焦虑药、催眠药和镇静药是服用抗抑郁药的人中最常见的其他中枢神经系统药物类别。这些研究结果表明，在瑞典，年轻人中抗抑郁药的使用很普遍，而且还在不断增长。接受抗抑郁药物治疗的年轻患者中枢神经系统的大量用药需要仔细监测并进一步研究潜在的益处和危害。
This study examines trends in antidepressant drug dispensations among young people aged 0-24years in Sweden during the period 2006-2013, as well as prescription patterns and central nervous system (CNS) polypharmacy with antidepressants. Using linkage of Swedish national registers, we identified all Swedish residents aged 0-24years that collected at least one antidepressant prescription (here defined as antidepressant users) between 1 January 2006 and 31 December 2013 (n=174,237), and categorized them as children (0-11years), adolescents (12-17years), and young adults (18-24years). Prevalence of antidepressant dispensation rose from 1.4 to 2.1% between 2006 and 2013, with the greatest relative increase in adolescents [by 97.8% in males (from 0.6 to 1.3%) and by 86.3% in females (from 1.1 to 2.1%)]. Most individuals across age categories were prescribed selective serotonin reuptake inhibitors, received their prescriptions from psychiatric specialist care, and had treatment periods of over 12months. Prevalence of CNS polypharmacy (dispensation of other CNS drug classes in addition to antidepressants) increased across age categories, with an overall increase in prevalence from 52.4% in 2006 to 62.1% in 2013. Children experienced the largest increase in polypharmacy of three or more psychotropic drug classes (4.4-10.1%). Anxiolytics, hypnotics, and sedatives comprised the most common additional CNS drug class among persons who were prescribed antidepressants. These findings show that the dispensation of antidepressants among the young is prevalent and growing in Sweden. The substantial degree of CNS polypharmacy in young patients receiving antidepressants requires careful monitoring and further research into potential benefits and harms.