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Acta Psychiatr Scand. 2020 Jan;141(1):34-42. doi: 10.1111/acps.13116. Epub 2019 Nov 1.

Trends in antidepressant use among children and adolescents: a Scandinavian drug utilization study.

Author information

1
Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark.
2
Research Unit of Child and Adolescent Mental Health, Department of Clinical Research, University of Southern, Odense, Denmark.
3
Department of Psychiatry, Division of Epidemiology, Columbia University, New York State Psychiatric Institute, New York, NY, USA.
4
Centre for Pharmacoepidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
5
Department of Chronic Diseases and Ageing and Centre for Fertility & Health, Norwegian Institute of Public Health, Oslo, Norway.
6
Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
7
Department of Clinical Chemistry & Pharmacology, Odense University Hospital, Odense, Denmark.
8
Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
9
OPEN - Open Patient data Explorative Network, Department of Clinical Research, University of Southern, Odense, Denmark.
10
Odense University Hospital, Odense, Denmark.

Abstract

OBJECTIVE:

To compare antidepressant utilization in individuals aged 5-19 years from the Scandinavian countries.

METHODS:

A population-based drug utilization study using publicly available data of antidepressant use from Denmark, Norway, and Sweden.

RESULTS:

In the study period from 2007 to 2017, the proportion of antidepressant users increased markedly in Sweden (9.3-18.0/1000) compared to Norway (5.1-7.6/1000) and Denmark (9.3-7.5/1000). In 2017, the cumulated defined daily doses (DDD) of selective serotonin reuptake inhibitors were 5611/1000 inhabitants in Sweden, 2709/1000 in Denmark, and 1848/1000 in Norway. The use of 'other antidepressants' (ATC code N06AX) also increased in Sweden with a higher DDD in 2017 (497/1000) compared to Denmark (225/1000) and Norway (170/1000). The use of tricyclic antidepressants was generally low in 2017 with DDDs ranging between 30-42 per 1000. The proportion of antidepressant users was highest among 15- to 19-year-old individuals. Girls were more likely to receive treatment than boys, and the treated female/male ratios per 1000 were similar in Sweden (2.39), Denmark (2.44), and Norway (2.63).

CONCLUSION:

Even in highly comparable healthcare systems like the Scandinavian countries', variation in antidepressant use is considerable. Swedish children and adolescents have a markedly higher and still increasing use of antidepressants compared to Danish and Norwegian peers.

KEYWORDS:

SSRI; anxiety; depression; drug utilization; obsessive-compulsive disorder

PMID:
31618447
DOI:
10.1111/acps.13116

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