Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
J Korean Med Sci. 2017 Oct;32(10):1694-1701. doi: 10.3346/jkms.2017.32.10.1694.
Antidepressant prescription for youths has recently been on the increase. There is a growing concern over the increasing off-label usage of antidepressants. Current data on off-label antidepressant usage vary across countries and healthcare systems. Therefore, we examined the extent and pattern of antidepressant prescription for Korean children and adolescents using population-based data. Our data was retrieved from the Korean National Health Insurance Service National Sample Cohort of the year 2013. Among 0.2 million children and adolescents aged 6-18 years from the cohort, subjects who had received any antidepressant medication in the year 2013 were investigated for the prescribed medication, concomitant psychotropic medication, and the associated diagnosis. A total of 2,190 children and adolescents (boys, 55.4%) received antidepressant medication. The most common diagnosis was depressive disorders (n = 469, 21.4%), followed by attention-deficit/hyperactivity disorder (n = 442, 20.2%). Among the prescriptions (n = 3,370), escitalopram (n = 650, 24.1%) and fluoxetine (n = 553, 20.5%) were the two most frequently prescribed drugs. A majority of prescriptions (n = 2,039, 60.5%) included concomitant psychotropic agents, consisting of antipsychotics (n = 901, 26.7%), sedatives (n = 263, 26.3%), medication for attention-deficit/hyperactivity disorder (n = 822, 24.4%), and some others. Our study shows the prescription pattern of antidepressants for children and adolescents in Korea, of which a large proportion is off-label. The results call for close monitoring by clinicians treating this population.
抗抑郁药在年轻人中的处方最近有所增加。人们越来越关注抗抑郁药的非适应证使用不断增加。目前各国和各医疗体系的抗抑郁药非适应证使用数据各不相同。因此，我们利用基于人群的数据，调查了韩国儿童和青少年抗抑郁药的使用情况及模式。我们的数据来自于 2013 年韩国国家健康保险服务全国抽样队列的韩国国家健康保险服务全国抽样队列。在该队列中，0.2 百万名 6-18 岁的儿童和青少年中，对 2013 年接受过任何抗抑郁药物治疗的患者进行了处方药物、伴随精神药物和相关诊断的调查。共有 2190 名儿童和青少年（男孩，55.4%）接受了抗抑郁药治疗。最常见的诊断是抑郁障碍（n=469，21.4%），其次是注意缺陷多动障碍（n=442，20.2%）。在处方（n=3370）中，艾司西酞普兰（n=650，24.1%）和氟西汀（n=553，20.5%）是最常用的两种药物。大多数处方（n=2039，60.5%）包含伴随的精神药物，包括抗精神病药（n=901，26.7%）、镇静剂（n=263，26.3%）、治疗注意缺陷多动障碍的药物（n=822，24.4%）和其他一些药物。我们的研究显示了韩国儿童和青少年抗抑郁药的处方模式，其中很大一部分是非适应证用药。结果呼吁治疗该人群的临床医生密切监测。
