An­tide­pres­sants given to chil­dren as young as six

Ex­perts fear that doc­tors may be over­pre­scrib­ing NHS Eng­land data shows 12% rise over 14 months

The Guardian - - NATIONAL - Sarah Marsh Com­peti­tors in the Tough Mud­der event at Drum­lan­rig Cas­tle, Dum­fries and Gal­loway, yes­ter­day Pho­to­graph: Robert Perry/PA

Tens of thou­sands of young peo­ple in Eng­land, in­clud­ing chil­dren as young as six, are be­ing pre­scribed an­tide­pres­sants.

The num­bers have prompted con­cern that doc­tors may be over­pre­scrib­ing strong drugs be­cause of stretched and un­der­funded men­tal health ser­vices.

Data ob­tained by the Guardian showed 166,510 pa­tients un­der 18, in­clud­ing 10,595 aged be­tween seven and 12 and 537 aged six years or younger, were given med­i­ca­tion typ­i­cally used to treat de­pres­sion and anx­i­ety be­tween April 2015 and June 2016. The NHS Eng­land fig­ures, re­leased un­der the Free­dom of In­for­ma­tion Act, also show a 12% rise in the num­bers tak­ing the drugs in that time.

Dr Marc Bush, the se­nior pol­icy adviser at the char­ity Young Minds, said the sta­tis­tics were “sub­stan­tial” and un­der­lined the num­ber of young peo­ple who were ex­pe­ri­enc­ing men­tal health prob­lems. “Anti-de­pres­sants have a role to play but are not the whole solution,” he said.

Bush added that he felt “ex­treme worry” at the prospect of an un­der sixyear-old re­ceiv­ing an an­tide­pres­sant. “It feels quite dif­fi­cult to com­pre­hend given what we know about the im­pact of phar­ma­col­ogy on peo­ple’s devel­op­ment.”

Ex­perts fear that some chil­dren and young peo­ple are be­ing pre­scribed the drugs be­cause they face such long waits for psy­cho­log­i­cal ther­apy on the NHS.

Dr An­to­nis Kousoulis, a clin­i­cian and assistant di­rec­tor at an­other char­ity, the Men­tal Health Foun­da­tion, said the high pre­scrip­tion num­bers showed a fail­ure to pro­vide age-ap­pro­pri­ate psy­cho­log­i­cal treat­ments. “GPs over­pre­scribe an­tide­pres­sants of­ten be­cause of the long wait­ing lists for spe­cial­ist ser­vices.”

Na­tional In­sti­tute for Health and Care Ex­cel­lence (Nice) guid­ance says an­tide­pres­sants should be given only to teenagers and chil­dren with “mod­er­ate or se­vere de­pres­sion” when psy­cho­log­i­cal ther­apy has failed. It also ad­vises they should be taken along­side other sup­port, such as coun­selling. Flu­ox­e­tine, sold un­der the name Prozac, is the only drug rec­om­mended for chil­dren, but other drugs can be used as sec­ond line treat­ments.

Ac­cord­ing to Nice, flu­ox­e­tine should be “cau­tiously con­sid­ered” for those aged five to 11. How­ever, ev­i­dence for its ef­fec­tive­ness in this age group “is not es­tab­lished”, it says.

David Tay­lor, the Royal Phar­ma­ceu­ti­cal So­ci­ety spokesper­son on men­tal health, said: “An­tide­pres­sants are only used in chil­dren in cir­cum­stances where there is clear sup­port from ro­bust clin­i­cal tri­als.”

A spokesper­son from NHS Eng­land said: “While there are ex­cel­lent psy­cho­log­i­cal treat­ments for chil­dren and young peo­ple, in some cases it is med­i­cally ap­pro­pri­ate to of­fer med­i­ca­tion.”

Ex­perts noted that the fig­ures could in­clude chil­dren un­der 12 be­ing treated for other prob­lems. Tri­cyclic an­tide­pres­sants, for ex­am­ple, are some­times used to treat chronic pain and bed­wet­ting. Some anti-de­pres­sants can also be pre­scribed for man­ag­ing epilep­tic fits.

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