A new study led by Dr Amanda Marchant at Population Data Science at Swansea University and funded by MQ Mental Health Research examined the effects of prescribing guidance introduced in 2015/2016 on antidepressant use among children and adolescents. This guidance highlighted that Fluoxetine is the only antidepressant recommended for children and young people based on a balance of benefits and risks. The findings revealed that diagnosed depression among children and young people has continued to rise, highlighting the need for targeted interventions. Antidepressant prescribing changed following guidance but not as expected.
Since 2005, the number of children and young people prescribed antidepressants in the UK has grown along with the rate of children with mental health disorders. Intervention and treatment are vital, as untreated chronic depression can lead to serious short and long-term impacts, including difficulty forming social connections, self-harm, educational underachievement, and financial hardships later in life. This research looked at recent trends of depression and antidepressant prescribing in primary care data over time, including indications for use and whether prescriptions may have been initiated in primary or secondary care.
Supported by the Wolfson Centre for Young Peoples Mental Health and DATAMIND, the study used anonymised data from the Adolescent Mental Health Data Platform (ADP), an international resource supporting research into child and adolescent mental health. Researchers used datasets from the SAIL Databank, a secure repository of health and education records for the Welsh population.
The study examined healthcare records from 643,322 primary care patients aged 6–17 between 2010 and 2019. Key findings included:
- Between 2010 and 2019, the number of young people diagnosed with depression more than doubled.
- Antidepressant prescriptions followed a similar pattern, with Fluoxetine being the most frequently prescribed first-line antidepressant.
- About half of all new antidepressant prescriptions were associated with a diagnosis of depression.
- Before the prescribing guidance was introduced, the use of Fluoxetine, Sertraline, and other antidepressants was already increasing.
- After the guidance, Fluoxetine prescribing levelled off, Sertraline use increased at a faster rate, and Citalopram prescriptions continued to decline as they had before the guidance.
Amanda Marchant, lead author of the study, said:
“Our study highlights a rise in diagnoses of depression among children and young people, alongside an increase in prescribing of antidepressants. While prescribing guidance has influenced antidepressant choices for children and young people, there are lots of factors that influence decision making around antidepressant prescriptions including responses to demand, practitioner-patient relationships and whether secondary services can be accessed expeditiously. We need to ensure that clinicians are supported in providing care for young people, including improving timely access to talking therapies and specialist mental health services”.