Prescription Patterns of Antidepressants: The Effect of the Black Box Warning among Pediatric Patients

H. Sher, Z.H. Perry, S. Arbel, H. Reuveni


Introduction: Our aim was to investigate the prescription patterns of antidepressant in the southern Israel during the years 2000 to 2005, before and after the FDA black box warning issued regarding the prescription of antidepressants in children.

Patients and methods: A cross sectional study. Data regarding prescription of anti-depressant drugs was examined retrospectively. All information was obtained from the computerized databases of the Clalit Health care services, southern county. Data was analyzed by using descriptive statistics, and analytical statistics. Multi-variate analysis was performed when applicable.

Results: When comparing the prescription rate of fluoxetine and fluvoxamine versus other SSRI’s included in the health agencies warnings during the years mentioned, there was a gradual increase in the percentage of the other SSRI’s until 2003 from 12.2% in 2000 to 64.2% in 2003 and then a reversal of this trend from 51.9% in 2004 to 47.8% in 2005.

Discussion and conclusions: This study shows that the CSM advice has not had a significant effect in reversing the rising prevalence of antidepressant prescribed to children and adolescents in primary care. It has however changed the choice of antidepressant medication chosen within the group of SSRI’s.

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