KEY POINTS:
The Government drug-buying agency Pharmac needs to do a complete review of the use of antidepressant drugs to treat children and adolescents, a health expert has said.
AUT University dean of health and environmental sciences Professor Max Abbott today expressed alarm at reports of widespread prescription of antidepressant
drugs to young children, including babies.
Pharmac figures released to the United Future Party showed 4728 antidepressant prescriptions were written for children under 10 in 2004-05, almost halving to 2425 in the last June year.
Causing most alarm are the figures for babies, even though they dropped sharply during the three years from 2004 to 2007.
For one-year-olds, 768 prescriptions were written in 2004-05, down to 24 by last year. For those under one, there were 453 prescriptions in 2004-05 but only nine last year.
Antidepressants are not usually prescribed to children younger than eight, and are not commonly used on those younger than 13. They are powerful psychiatric drugs with potentially severe side-effects.
Pharmac medical director Peter Moodie has admitted he is baffled by the figures and suggested the anomalies could relate to errors in data processing.
Prof Abbott today called for a formal review of the use of these drugs, extending to adolescents and adults as well as children.
He said there was no medical justification for administering powerful antidepressants to young children and that extreme caution should be exercised in their use with older children and adolescents.
In these groups, the risk of suicide and cardiovascular complications generally outweighed any potential benefits, he said.
"Pharmac figures for children are so off the wall that the first thing to do is to check them very carefully," Prof Abbott said.
"Adolescent figures should also be checked, and if correct, the prescribing doctors identified. If widespread, there might be a case for restricting prescription rights."
The extent of antidepressant use by adults was also of concern, he said.
"The good news is depression and anxiety-related disorders are now more out in the open and that GPs are picking them up. The bad news is they appear to be over-relying on chemical treatments rather than psychological and psycho-social interventions."
The Primary Health Care Strategy was falling short and failing to deliver timely, affordable mental health care.
He said while District Health Board mental health services had greatly improved, there were deficiencies in child and youth services and most did not engage well with primary health organisations.
"Sadly, in primary care, mental health remains the poor relation. In hindsight I fear that public health depression awareness campaigns have been more about boosting pharmaceutical sales than providing comprehensive treatment and stimulating the development of prevention programmes."
The number of state-funded antidepressant prescriptions has nearly doubled since 2000 to more than a million a year, costing the Government about $30 million.
- NZPA
