Sunday Independent (Ireland)

Anti-depressant use among children soars

There’s been a huge rise in the numbers on these drugs since 2010 but medics insist — prescribin­g them is not done lightly, reports Ali Bracken

- Ali Bracken

THERE has been a significan­t increase in the number of children under the age of 11 being prescribed anti-depressant­s over the past decade.

New figures released to the Sunday Independen­t show that over a 10-year period, children under 11 have been prescribed this medication on 1,593 occasions between 2010 and 2019.

In total, children up to age 15 have been prescribed anti-depressant­s 4,571 times over the same period.

The figures were released under the Freedom of Informatio­n Act. The data does not include this year, which encompasse­s the Covid-19 pandemic, during which there has been a huge rise in both children and adults struggling with their mental health.

OVER the past 10 years, the number of children under the age of 11 being prescribed anti-depressant­s by their doctors has skyrockete­d.

New figures released to the Sunday Independen­t show that children under 11 have been prescribed this medication on 1,593 occasions between 2010 and 2019.

The year-on-year rise in young children being placed on anti-depressant­s is stark. In 2010, just 43 children in this age category were on anti-depressant­s, while last year 358 under-11s were taking this medication.

The figures for adolescent­s aged between 12 and 15 are even higher.

Last year, some 1,011 youths in this age bracket were taking these drugs, compared with just 94 10 years previously —a ten-fold increase.

There was also a huge jump over the most recent 12-month period — with 602 youths on anti-depressant­s in 2018, compared with 1,011 last year.

In total, children up to the age of 15 have been prescribed anti-depressant­s 4,571 times over the 10-year period.

The figures were released under the Freedom of Informatio­n Act.

The data does not include this year, which encompasse­s the period of the Covid-19 pandemic, during which there has been a huge rise in the numbers of both children and adults struggling with their mental health.

In addition, the data covers only anti-depressant­s prescribed to children whose parents have a medical card or a GP card. Therefore, the figures released do not include private prescripti­ons, meaning the true figure is much higher.

Dr Maeve Doyle, consultant child and adolescent psychiatri­st, said that the general public might be shocked that young children are being put on anti-depressant­s.

However, a decision to put youngsters on such medication is not taken “willy-nilly” but only in cases where children are in serious psychologi­cal distress, she added.

“It might come as a shock that children would need pharmacolo­gical medication.

“Some children are so anxious they are unable to eat and their breathing is fast.

“They can have bad physical manifestat­ions. Their minds are racing, some of them are not able to go to school and cannot play with their peers,” said Dr Doyle, who is also director of communicat­ions and public education with the College of Psychiatri­sts of Ireland.

“If children are feeling like that, they may not be able to access talk therapy.

“They might need medication to avail of talk therapy. Child psychiatri­sts do not reach for the SSRIs [anti-depressant­s] first.”

Children and adolescent­s who are prescribed antidepres­sants would have been referred to a secondary mental health clinic, called Child and Adolescent Mental Health Services (CAMHS).

These nationwide facilities deal with youths with moderate to severe mental health disorders, Dr Doyle added.

“We would do an extensive assessment first, including talk therapy. We might also try cognitive therapy. When symptoms are severe, we will try medication in addition to therapy.”

There are currently 2,000 youths on a waiting list to be seen by medical profession­als at the service nationwide, she said.

‘Some children are so anxious they can’t eat’

CAMHS received 18,000 referrals last years — 8,000 of which have yet to be dealt with, although some of these cases have been referred elsewhere, she said. “We are under strain, we are struggling to keep up with demand.”

But Dr Doyle said she “wouldn’t agree” that the increase in numbers being prescribed anti-depressant­s was down to long waiting times.

She suggested an increase in population could be one possible reason.

Dr Vincent McDarby, a chartered member of the Psychologi­cal Society of Ireland (PSI), said there were also “huge waiting times” for children with mental health problems at a primary care level, which deals with mild to moderate cases. “They are massive, a year to a year-anda-half. That is a problem.

“If left unaddresse­d, a mild issue in a child of anxiety or depression can develop into a more serious problem.

“By the time they get to the top of the waiting list, they can have much more serious problems. And then that child does need to be referred to CAMHS.”

Dr McDarby, who has a background in working with children, said anti-depressant­s are “much more effective” when combined with talk therapy.

However, he did question whether anti-depressant­s were being over-prescribed for children. “There are certain children who would benefit from them. If there is an increase of anti-depressant­s being prescribed to children, does that mean more need them?

“Or does it mean that more children are being inappropri­ately prescribed them? I don’t know.

“There hasn’t been much research on the use of anti-depressant­s in children.”

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