Increased Antidepressant Prescriptions for Children and Adolescents with Major Depressive Disorder in Japan Based on a Claims Database

Keisuke Nomoto,1,2 Ataru Inagaki,3 Keita Yamauchi1 1Graduate School of Health Management, Keio University, Fujisawa, Kanagawa, Japan; 2Medical Affairs, Viatris Pharmaceuticals Japan G.K., Minato-ku, Tokyo, Japan; 3College of Education, Psychology and Human Studies, Aoyama Gakuin University, Shibuya-ku, Tokyo, JapanCorrespondence: Keisuke Nomoto, Medical Affairs, Viatris Pharmaceuticals Japan G.K., 1-3-1 Azabudai, Minato-ku, Tokyo, 106-0041, Japan, Email [email protected]: Currently, no therapeutic antidepressants are approved for pediatric patients with major depressive disorder (MDD) in Japan. In addition, few longitudinal studies have been conducted in Japan on antidepressant prescriptions for children and adolescents with MDD. The purpose of this study is to clarify the actual pharmacotherapy for child and adolescent patients with MDD during fiscal year (FY) 2010–FY2017.Patients and Methods: We investigated trends in the prescription of antidepressants and concomitant psychotropic drugs for child and adolescent patients aged ≤ 18 years with MDD from FY2010 to FY2017 using a large-scale Japanese health insurance claims database.Results: From FY2010 to FY2017, the database recorded claims for an average of 443,977 patients annually. Antidepressant prescriptions increased year by year, with particularly large increases in the 13– 18 age group (4.72/1000 persons in FY2010; 6.14/1000 persons in FY2017). By drug class, a higher proportion of selective serotonin reuptake inhibitors, especially sertraline and escitalopram, were prescribed in any given FY, with an increasing trend in the 13– 18 age group (2.64/1000 persons in 2010, 3.55/1000 persons in 2017). However, the overall antidepressant prescription rate among patients with MDD declined gradually, particularly among those in the 13– 18 age group (68.7% in FY2010, 57.0% in FY2017).Conclusion: The rate of child and adolescent patients prescribed antidepressants increased, while the antidepressant prescription rate among child and adolescent patients with MDD declined, indicating that Japanese physicians have become more cautious about the use of antidepressants. It is critical to generate new clinical data on the efficacy and safety of antidepressants for Japanese child and adolescent patients with MDD and to consider the development of additional pediatric indications for antidepressant therapy.Keywords: depression, pediatric, prescribed drug, trend, psychotropic drug, longitudinal study