Trends in use of antidepressants, lithium, and anticonvulsants in Kaiser Permanente-insured youths, 1994-2003
Trends in use of antidepressants, lithium, and anticonvulsants in Kaiser Permanente-insured youths, 1994-2003
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DOI：
10.1089/cap.2005.15.26
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发表时间：
2005-02-01
影响因子：
1.9
通讯作者：
Hargreaves, WA
中科院分区：
文献类型：
--
作者：
Hunkeler, EM;Fireman, B;Hargreaves, WA
鉴于目前关于儿童和青少年使用抗抑郁药的争议，我们研究了 1994 年至 2003 年北加州 Kaiser Permanente 5-17 岁参与者使用抗抑郁药、锂和抗惊厥药的趋势。我们发现，抗抑郁药的使用量增加了一倍多，从每 1000 名参与者 9.4 人增加到每 1000 人 21.3 人。这种增加大部分与选择性血清素再摄取抑制剂 (SSRI) 有关，该抑制剂从每 1000 人 4.6 人增加到 14.5 人。三环类抗抑郁药 (TCA) 的使用量显着下降，而其他新型抗抑郁药的使用量则从每 1000 人中增加到 21.3 人。每 1000 人 1.3 至 6.5 人。抗惊厥药的使用几乎翻了一番，从每 1000 人 3.5 人增加到 6.9 人。而锂的使用率相对稳定，接近每 1000 人 1 人。在 5-9、10-14 和 15-17 岁这三个年龄组中，男孩和女孩对 SSRIs、新型抗抑郁药和抗惊厥药的使用都有所增加。越来越多的抗抑郁药使用者被诊断为抑郁症，越来越多的抗惊厥药使用者被诊断为双相情感障碍。尽管抗抑郁药物在青少年中的安全性和有效性还需要进一步确定，但这些发现可能反映了精神疾病诊断和治疗方面的进展。
In view of the current controversy regarding the use of antidepressants in children and adolescents, we examined trends from 1994 to 2003 in the use of antidepressants, lithium, and anticonvulsants by enrollees, aged 5-17 years, of Kaiser Permanente in Northern California. We found that the use of antidepressants more than doubled from 9.4 per 1000 enrollees to 21.3 per 1000. Most of this increase is associated with selective serotonin reuptake inhibitors (SSRIs), which increased from 4.6 to 14.5 per 1000. The use of tricyclic antidepressants (TCAs) decreased markedly, while the increase of other newer antidepressants rose from 1.3 to 6.5 per 1000. The use of anticonvulsants nearly doubled, from 3.5 to 6.9 per 1000,. while lithium use was relatively stable at a rate of nearly 1 per 1000. Use of SSRIs, newer antidepressants, and anticonvulsants increased in boys as well as girls in each of three age groups: 5-9,10-14, and 15-17 years. An increasing percentage of the antidepressant users had a diagnosis of depression, and an increasing percentage of anticonvulsant users had a diagnosis of bipolar disorder. Although the safety and efficacy of antidepressants in youths needs to be more firmly established, these findings may reflect progress in the diagnosis and treatment of mental illness.