September 9, 2016

expert reaction to study looking at antidepressant use and depression in children and teenagers

A paper published in the journal Psychological Medicine has reported an increase in antidepressant prescriptions in children and young people alongside a decrease in recorded depression diagnoses.

Dr Michael Bloomfield, Clinical Lecturer in Psychiatry, MRC Clinical Sciences Centre, UCL, said:

“This new study using GP records finds conflicting evidence regarding rates of depression in young people. Of concern is the finding that depressive symptoms appear to be increasing in this age group. There must be a wider conversation in society to understand the complex reasons underlying this.

“It is important to understand that the term ‘antidepressant’ as applied to describe a class or group of medicines is becoming increasingly unhelpful, given that medicines that have an antidepressant effect can also be useful in treating other mental illnesses, such as anxiety for example. An analogy could be drawn with certain types of blood pressure tablets that can also be useful for different medical problems, such as treating patients who have hearts that go into abnormal rhythms. The fact that antihypertensives (blood pressure lowering drugs) are also widely used as anti-arrhythmics (heart rhythm controlling drugs) is not a bad thing per se and the same logic applies in psychiatry. There is a growing movement in the international psychopharmacology community to use a more helpful system of naming medicines used in treating patients with mental illnesses, however, this will understandably take time to reach international agreement.

“Children and young people suffering mental distress deserve rapid access to expert psychiatric care which includes psychological support alongside careful treatment with medicines where appropriate. In the UK, we are hearing on the ground that this can be difficult to access.”

‘Recent trends in primary-care antidepressant prescribing to children and young people: an e-cohort study’ by A. John et al. published in Psychological Medicine on Friday 9 September 2016. 

Declared interests

Dr Michael Bloomfield: “I am a member of the Royal College of Psychiatrists, a member of the British Association of Psychopharmacology, a young member of the European College of Neuropsychopharmacology, a young fellow of the Royal Society of Medicine and an international member of the American Psychiatric Association. I conduct research funded by the Medical Research Council, the National Institute of Health Research and the British Medical Association. I work in medical research at the Medical Research Council and University College London. I work clinically in the National Health Service. I have no other interests to declare.”