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Child Psychiatrist /Adult Psychiatrist

Antidepressant Use Among Adolescents, Young Adults Spiked After COVID-19

Keypoint: Antidepressant dispensing to adolescent girls rose by 129.6% during the pandemic, relative to pre-pandemic levels.

After COVID-19

Antidepressant dispensing to adolescents and young adults increased by 63.5% during the COVID-19 pandemic, relative to pre-pandemic levels. This increase was largely driven by increased antidepressant dispensing to girls and women, according to study results published in Pediatrics.

Although a wealth of evidence indicates that the COVID-19 pandemic was detrimental to mental health — particularly among adolescents — relatively little is known about the temporal changes in antidepressant dispensing rates during this period. To determine whether antidepressant dispensing patterns changed during the pandemic, researchers used the IQVIA Longitudinal Prescription Database, a comprehensive all-payer national database, to track the distribution of antidepressant prescriptions from 2016 to 2022 among US individuals aged 12 to 25 years.

The researchers categorized individuals into 2 groups: adolescents (12 to 17 years of age) and young adults (18 to 25 years of age). The primary measure was the rate of antidepressant prescriptions dispensed monthly, calculated as the number of adolescents and young adults receiving at least 1 antidepressant prescription per 100,000 people aged 12 to 25 years. The researchers evaluated both slope and level changes in prescription rates and examined variations by sex and age group.

Between 2016 and 2022, a total of 221,268,402 antidepressant prescriptions were dispensed to 18,395,915 individuals from the database. On average, individuals were 19.2 (SD, 3.9) years of age at the time of sample entry and 64.4% were girls/women. Geographically, 38.6% of individuals resided in the South, 25.7% in the Midwest, 19.6% in the West, and 16.1% in the Northeast. Of the total dispensed antidepressant prescriptions, 67.3% were for selective serotonin reuptake inhibitors (SSRIs), and the 3 most common medications were sertraline (24.1%), fluoxetine (18.5%), and escitalopram (16.3%).

From 2016 to 2022, there was a 46.1% increase in the number of adolescents and young adults receiving at least 1 dispensed antidepressant prescription, and the rate of new initiations to antidepressant therapy grew by 31.0%.

The monthly antidepressant dispensing rates increased by 66.3% from January 2016 to December 2022. Prior to March 2020, the monthly dispensing rate was rising at 17.0 (95% CI, 15.2-18.8) individuals per 100,000 per month. While the onset of the COVID-19 pandemic did not lead to an immediate level change in the dispensing rate (-37.4; 95% CI, -153.4 to 78.7), it was linked to an increase in the growth rate to 10.8 (95% CI, 4.9-16.7) per month. After March 2020, the monthly rate of antidepressant dispensing escalated to 27.8 per month (95% CI, 22.1-33.4), representing a 63.5% increase compared with the rate of change before March 2020.

This increase in monthly antidepressant dispensing rates was largely driven by increased antidepressant dispensing to girls and women. Among adolescent girls, the monthly dispensing rate surged by 41.1 (95% CI, 32.9-49.2), a 129.6% increase from the pre-pandemic rate. Young adult women also experienced a 56.6% increase from the pre-pandemic levels, as the dispensing rate rose by 44.8 (95% CI, 33.3-56.3) per month. In contrast, the pandemic caused a level decrease (-224.3; 95% CI, -328.2 to -120.4) and no significant slope change (1.1 per month; 95% CI, -2.3-4.4) among adolescent boys. Young adult men also did not experience significant level (17.8; 95% CI, -51.3-86.8) or slope changes (3.7 per month; 95% CI, -0.8-8.2) after March 2020.

Study authors concluded, “Using 2016 to 2022 data from a national prescription dispensing database, we found that antidepressant dispensing to adolescents and young adults rose 63.5% faster after the COVID-19 pandemic. This change was driven by increased antidepressant dispensing to female patients.”

Study limitations include the lack of data for prescription indications and the modality of prescription encounters (in-person vs telehealth).

Note: This article originally appeared on Psychiatry Advisor

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