Abstract
BackgroundIn 2003–2004 and 2007–2008, the regulatory banning of SSRI use in pediatrics and young adults due to concerns regarding suicidality risk coincided with negative media coverage. SSRI use trends were analyzed from 2000–2010 in the Netherlands (NL) and the UK, and whether trend changes might be associated with media coverage of regulatory warnings.MethodsMonthly SSRIs sales were presented as DDDs/1000 inhabitants/day. SSRI-use trends were studied using time-series segmented regression analyses. Timing of trend changes was compared with two periods of media coverage of warnings. Annual Dutch SSRI prescription data were analyzed by age group.ResultsTrend changes in SSRI use largely corroborated with the periods of media coverage of warnings. British SSRI use declined from 3.9 to 0.7 DDDs/month (95%CI 3.3;4.5 & 0.5;0.9, respectively) before the first warning period (2003–2004). A small decrease of −0.6 DDDs/month (−1.2; −0.05) was observed in Dutch SSRI use shortly after 2003–2004. From 2007–2008, British SSRI use stabilized, whilst Dutch SSRI use diminished to −0.04 DDDs/month (−0.4;0.3). Stratified analyses showed a rapid decrease of −1.2 DDDs/month (−2.1; −1.7) in UK paroxetine use before 2003–2004, but only a minimal change in Dutch paroxetine use (−0.3 DDDs/month −0.8;0.2). Other SSRI use, especially (es)citalopram, increased during 2003–2004 in both countries. Significant reductions in Dutch paroxetine use were observed in pediatrics, adolescents, and young adults after 2003–2004.ConclusionChanges in SSRI use (NL & UK) were associated with the timing of the combined effect of media coverage and regulatory warnings. Our long-term assessment illustrates that changes in SSRI use were temporal, drug-specific and more pronounced in pediatrics and young adults. The twofold increase in SSRI use over one decade indicates that regulatory warnings and media coverage may come and go, but they do not have a significant impact on the overall upward trend of SSRI use as a class in both countries.
Highlights
Health care providers and consumers alike seek health and medical information from the news media and act changing their perceptions and behavior [1,2]
SSRI use in the United Kingdom (UK) showed no negative trends during this period, with episodes of rapid increase outside the periods of media coverage of regulatory warnings and episodes of slowed growth during the periods of media coverage of regulatory warnings (Figure 1A+C, appendix table)
The timing of the media coverage of regulatory warnings about the suicidality risk associated with SSRI use coincided with changes in overall use in the NL and UK from 2000–2010
Summary
Health care providers and consumers alike seek health and medical information from the news media and act changing their perceptions and behavior [1,2]. The influence of news media reports or pharmaceutical regulatory warnings for antidepressants has been studied. Another study found a temporal decline in pediatric antidepressant prescriptions in the United Kingdom (UK) related to regulatory actions after 2003 [6]. This regulatory-driven fall in antidepressant use in pediatrics was reported in a study establishing a greater impact of warnings in the UK than in the United States (US) or the Netherlands (NL) from 2003–2005 [7]. SSRI use trends were analyzed from 2000–2010 in the Netherlands (NL) and the UK, and whether trend changes might be associated with media coverage of regulatory warnings
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