Extent and risks of antidepressant off-label use in children and adolescents in Germany between 2004 and 2011
Purpose So far, only little is known about antidepressant off-label use in pediatric patients. This is the first study examining the prevalence and the risks of off-label antidepressant prescriptions in minors over time in Germany and analyzing patterns regarding age, sex, drug class, and type of of...
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| Hauptverfasser: | , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
24 August 2017
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| In: |
Pharmacoepidemiology and drug safety
Year: 2017, Jahrgang: 26, Heft: 11, Pages: 1395-1402 |
| ISSN: | 1099-1557 |
| DOI: | 10.1002/pds.4289 |
| Online-Zugang: | Verlag, Volltext: http://dx.doi.org/10.1002/pds.4289 Verlag, Volltext: http://onlinelibrary.wiley.com/doi/abs/10.1002/pds.4289 
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| Verfasserangaben: | Carsten Schröder, Michael Dörks, Bianca Kollhorst, Tilo Blenk, Ralf W. Dittmann, Edeltraut Garbe, Oliver Riedel |
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| 245 | 1 | 0 | |a Extent and risks of antidepressant off-label use in children and adolescents in Germany between 2004 and 2011 |c Carsten Schröder, Michael Dörks, Bianca Kollhorst, Tilo Blenk, Ralf W. Dittmann, Edeltraut Garbe, Oliver Riedel |
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| 520 | |a Purpose So far, only little is known about antidepressant off-label use in pediatric patients. This is the first study examining the prevalence and the risks of off-label antidepressant prescriptions in minors over time in Germany and analyzing patterns regarding age, sex, drug class, and type of off-label use. Methods We used claims data of about two million individuals (<18 y) to calculate the share of off-label antidepressant prescriptions for the years 2004 to 2011, stratified by age, sex, and drug class. Off-label prescriptions were analyzed regarding underlying diagnoses, the prescribing doctor's specialty, and the type of off-label use. Incidence rates of adverse events were calculated for off- and on-label use, and the risk of suicidal events associated with off- or on-label use was examined in a nested case-control study. Results The prevalence of off-label prescriptions decreased from 58.0% to 40.9%. Selective serotonin reuptake inhibitors were more frequently prescribed off-label than tricyclic antidepressants (37.7% vs 17.5% in 2011). The most common type of off-label use was off-label use by age, followed by off-label use by indication, and off-label use by contraindication. Adverse events were rare with no significant differences between on- and off-label use. Conclusions Although off-label antidepressant use in minors decreased over time, it is still common. However, this rather indicates a lack of approved drugs for the treatment of depression in this population than inappropriate medical treatment. This is supported by the fact that off-label use was not associated with a higher risk of adverse events than on-label use. | ||
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| 650 | 4 | |a suicidality | |
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