NICE guidance linked with rising antidepressant use in children

Researchers suggest that antidepressants mentioned in the 2005 NICE guideline may have been interpreted as an approval for their use in young patients

Fluoxetine bottle

National Institute for Health and Care Excellence (NICE) guidelines from 2005 may have inadvertently led to increased antidepressant prescribing in children aged under 18 years, research published in BMJ Open (7 August 2019) has suggested[1]
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The researchers analysed data from UK GP practices between January 2000 and June 2010 that showed trends in antidepressant prescribing for people aged 4–17 years with a depressive disorder.

Prescription rates of selective serotonin reuptake inhibitors (SSRIs) significantly increased in this age group between 2000 and 2003, but this significantly reversed in 2003 following a Committee on Safety of Medicines warning against them.

However, following the publication of the NICE guideline in 2005, which strongly emphasised psychosocial interventions for children with depression, the trend in increased prescriptions resumed for SSRIs mentioned in the guidelines (fluoxetine, citalopram and sertraline) but not for other antidepressants.

The researchers suggested that mentioning these three antidepressants may have been interpreted as an “approval” of the use of them in young patients.

“It may be that the release of the NICE publication inadvertently encouraged higher rates of antidepressant prescribing, and in particular that of sertraline and citalopram,” they concluded.

References

[1] Tiffin P, Mediavilla J, Close H et al. What were the impacts of the Committee on Safety of Medicines warning and publication of the NICE guidelines on trends in child and adolescent antidepressant prescribing in primary care? A population based study. BMJ Open 2019;9:e028201. doi: 10.1136/bmjopen-2018-028201

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Citation
The Pharmaceutical Journal, PJ, September 2019, Vol 303, No 7929;303(7929):DOI:10.1211/PJ.2019.20206999