Published: 04 November 2022
The NIHR has published a new report over the use of prescribing antidepressants for children and young people.
The report analyses NIHR-funded research into antidepressant use in these age groups. It concludes GPs are prescribing antidepressants for children and teenagers without them seeing a psychiatrist first. NICE guidelines state this patient group should be treated with antidepressants only after seeing a psychiatrist.
There is an increase in 11-17 year olds being prescribed antidepressants. This is partly due to patients not being able to access mental health services or child and adolescent psychiatrists. In 2018, four in five young people had to wait more than four weeks to start treatment. As a result, some GPs are prescribing medication before psychiatric assessment has taken place to help those in urgent need.
There are also gaps in our understanding over the safety and effectiveness of antidepressants for children and teenagers. Studies on the long-term safety and efficacy of antidepressants are limited.
The review found some antidepressants increased the risk of suicidal thoughts or attempts. Yet it also found some to be effective for treating depression and anxiety disorders. This highlights the need for careful monitoring.
Professor Bernadka Dubicka, Consultant child and adolescent psychiatrist, Greater Manchester Mental Health Trust; Professor, Hull and York Medical School, University of York; Honorary Professor, University of Manchester, said: “Mental health problems in young people have been increasing in recent years, especially emotional disorders like depression and anxiety. It is important that families are able to consider the risks and benefits of treatment, together with their clinician.
“Every child and young person is different and will need an individualised approach, considering all treatment options. Early treatment and prevention of mental health problems in childhood is the most effective way of ensuring that we have thriving future generations.”
Dr Jemma Kwint, NIHR Senior Research Fellow and author for the report, said: “Most trials examined in our Collection did not include children and teenagers at risk of suicide, further widening a hole in our understanding of the impact of antidepressants on children and young people seeking help for depression. The trials were also mostly short term, which means we know very little about the long term effects of antidepressant use. These gaps in our knowledge need to be addressed urgently through further research.
“At the NIHR, we are actively considering new funding calls in children and young people's mental health research and are reviewing the prioritisation of different research topics internally in order to close gaps in knowledge.”
The NIHR is one of the UK's leading funders of research. It has funded more than 100 new mental health projects in areas of unmet need since June 2021.
There are currently nine active funding calls on mental health. Another on children and young people's mental health is scheduled to launch in December. The NHS has also set out in its Long Term Plan how children and young people can better access the mental health services that they need.