Revet Alexis, Montastruc François, Raynaud Jean-Philippe, Baricault Bérangère, Montastruc Jean-Louis, Lapeyre-Mestre Maryse
J Clin Psychopharmacol. 2018 Aug;38(4):327-335. doi: 10.1097/JCP.0000000000000891.
PURPOSE/BACKGROUND: Over the last decade, the use of antidepressants (ATDs) in children and adolescents has markedly increased in several occidental countries, but recent data in French children are missing. This study aimed to assess trends of ATD use in French children (6-11 years) and adolescents (12-17 years) and to characterize changes in ATD prescribing patterns from 2009 to 2016.
Using data from the French Health Insurance Database, annual prevalence and incidence of ATD use and changes in ATD prescribing patterns were analyzed.
Overall ATD prevalence of use rose slightly from 0.51% in 2009 to 0.53% in 2016 (+3.9%), with a decrease in children (0.18%-0.11%; -38.9%) and an increase in adolescents (0.86%-0.98%; +14.0%) and an overall female preponderance (56.7% in 2009; 58.7% in 2016). Serotonin reuptake inhibitor prevalence of use increased from 0.24% to 0.34%, whereas tricyclic ATD use decreased (from 0.20% to 0.16%). Similar trends were obtained with overall incidence of use, from 0.39% in 2009 to 0.36% in 2016 (-7.7%). Sertraline was the most frequently prescribed in adolescents (2009: 22.2% of all ATD prescriptions; 2016: 32.9%), whereas amitriptyline was the most prescribed in children (2009: 42.7% and 2016: 41.2%). Off-label use decreased in adolescents (from 48.4% to 34.8%) but increased in children (from 10.0% to 26.5%).
IMPLICATIONS/CONCLUSIONS: Antidepressant level of use in French children and adolescents was stable in recent years and lower than that observed in other European countries and the United States.
目的/背景：在过去十年中，几种西方国家儿童和青少年抗抑郁药（ATD）的使用显著增加，但法国儿童的最新数据缺失。本研究旨在评估法国儿童（6至11岁）和青少年（12至17岁）使用ATD的趋势，并描述2009年至2016年ATD处方模式的变化。
利用法国健康保险数据库的数据，分析了ATD使用的年患病率、发病率以及ATD处方模式的变化。
总体ATD使用患病率从2009年的0.51%略有上升至2016年的0.53%（+3.9%），儿童患病率下降（从0.18%降至0.11%；-38.9%），青少年患病率上升（从0.86%升至0.98%；+14.0%），总体上女性占多数（2009年为56.7%；2016年为58.7%）。5-羟色胺再摄取抑制剂的使用患病率从0.24%增至0.34%，而三环类ATD的使用则减少（从0.20%降至0.16%）。使用总发病率也呈现类似趋势，从2009年的0.39%降至2016年的0.36%（-7.7%）。舍曲林是青少年中最常开具的药物（2009年：占所有ATD处方的22.2%；2016年：32.9%），而阿米替林是儿童中最常开的药物（2009年：42.7%，2016年：41.2%）。青少年的非适应证用药减少（从48.4%降至34.8%），但儿童的非适应证用药增加（从10.0%增至26.5%）。
影响/结论：近年来，法国儿童和青少年的抗抑郁药使用水平稳定，且低于其他欧洲国家和美国。
