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Antidepressant use in children rises 12% in a year

GPs may be overprescribing because of stretched, underfunded mental health services

Louise Prime

Tuesday, 20 June 2017

Over the past year, over 11,000 young children, including more than 500 aged just six or younger, were prescribed medicines licensed to treat anxiety and depression, an investigation by The Guardian has revealed. Experts told investigators for the newspaper they were worried that pressure on mental health services could be behind a 12% rise in the number of under-18s taking these drugs.

NICE guidance on identifying and managing depression in children and young people advises that “Antidepressant medication should not be used for the initial treatment of children and young people with mild depression … Following multidisciplinary review, offer fluoxetine if moderate to severe depression in a young person (12-18 years) is unresponsive to a specific psychological therapy after four to six sessions … Following multidisciplinary review, cautiously consider fluoxetine if moderate to severe depression in a child (5-11 years) is unresponsive to a specific psychological therapy after four to six sessions, although the evidence for fluoxetine’s effectiveness in this age group is not established.”

Despite this, NHS England figures obtained by The Guardian under the Freedom of Information Act showed that between April 2015 and June 2016 there were 166,510 under-18s prescribed medication typically used to treat depression and anxiety – including 10,595 seven-to-12-year-olds and 537 children aged six or younger.

Dr Antonis Kousoulis, a doctor and researcher, as well as assistant director at the Mental Health Foundation, told The Guardian he believed the figures show “we are failing to provide a choice of age-appropriate psychological treatments at the point of the need”.

He added: “GPs overprescribe antidepressants often because of the long waiting lists for specialist services. But the evidence that these medicines are effective in children is not as comprehensive as is it for‎ drugs for other conditions.”

The Liberal Democrats have long called for an end to the “historic inequality” between the NHS’s treatment of physical and mental health and to the stigma against mental ill health, and for waiting times for mental health care to match those for physical health care.

Their health spokesperson, former health minister Norman Lamb, told The Guardian he agreed that there is “no doubt a significant link” between the “immense” pressure on children’s mental health services and the growing use of antidepressants.

He said: “Children’s mental health services are in desperate need of more resources. The Conservative government has failed to invest properly and has failed to make good on the funding promises we made in the coalition. Money isn’t getting through to the frontline, and now we are seeing the consequences of this neglect.”

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