New TGA review as number of children prescribed antidepressants doubles in 10 years

Australia’s health minister has ordered a review into a medicinal drug amid concerns it is being overprescribed in children.

New guidelines on prescribing antidepressants to children could be in place by the end of the year as new Health Minister Mark Butler tries to control the surge in drug use.

Mr Butler has asked his department to review prescribing of the drugs and develop new evidence-based guidelines for their safe use.

It comes as News Corp can reveal prescriptions for antidepressants for children have tripled in the 10 years to 2020 triggering calls for subsidies for the drugs to be banned.

But doctors warn this could make treatment unaffordable for families and leave young people without any help while they languish on waiting lists for counselling that are up to 12 months.

It has emerged many young people are being prescribed the drugs by general practitioners before trying counselling or psychotherapy, prompting calls for better controls in the area.

Acknowledging the record surge in demand for mental health support, Mr Butler told News Corp “mental health is unique among all of the major health conditions that we face in this country in that it tends to emerge at a young age”.

Health and Ageing Minister Mark Butler has asked his department to review prescribing of the drugs and develop new evidence-based guidelines for their safe use. Picture: Joel Carrett

The review by the Therapeutic Goods Administration (TGA) is due at the end of this year.

The TGA has not approved the drugs in children aged under 18 and last year it called on doctors to review their prescribing of them.

A review by independent organisation NPS MedicineWise found prescribing rates of the medicines to people aged 0-14 nearly tripled between 2011 and 2020 and nearly doubled for those aged 15-19.

Studies have found it is extremely hard to come off the drugs which are not meant to be used for more than nine months and they have been associated with youth suicide.

A group of mental health experts is so concerned about prescribing rates it is calling for a ban on Pharmaceutical Benefits Scheme (PBS) subsidies for antidepressants prescribed off-label by GPs to those aged under 18.

A study by University Adelaide child psychiatrist Professor Jon Jureidini, Flinders University researcher Dr Melissa Raven and Curtin University researcher Dr Martin Whitely found a 66 per cent increased use of the drugs coincided with a 49 per cent increase in suicides in young people between 2008 and 2018.

“We recommend that the TGA and the colleges act far more assertively to discourage off-label prescribing of psychiatric medications to children and adolescents,” they said in their latest Psych Watch publication.

“The Australian Government cease PBS subsidisation of antidepressants and other psychiatric drugs that are prescribed off-label to Australians aged under 18 years by GPs.”

Child psychiatrist Jon Jureidini co-authored research that linked an increase in antidepressant use to an increase in youth suicide from 2008-2018.

More than 115,000 Aussie children aged under 18 – including hundreds of preschoolers under the age of four – are on the drugs.

Royal Australian College of General Practitioners (RACGP) Vice President Dr Bruce Willett said there are many reasons for increased rates of prescribing, including the fact that many GPs have noticed increased mental distress caused by the pandemic.

“It’s vital to point out that the Advisory Committee on Medicines, the independent body responsible for providing advice to the Health Minister and TGA, determined that further regulatory action to limit prescriber or Pharmaceutical Benefits Scheme eligibility criteria is not justified on the strength of the current evidence,” Dr Willett said.

Youth mental health service Headspace’s Vikki Ryall said guidelines make it clear that psychological therapies and social supports are the first line of treatment for young people experiencing depression.

Youth mental health service Headspace’s Vikki Ryall. Picture: Rebecca George

“Treatment guidelines for headspace services outline that all young people with a diagnosis of depression are supported to engage with psychological treatment, whether or not antidepressants are determined to be appropriate,” Ms Ryall the Executive Director of Clinical Practice at Headspace said.

“Young people prescribed antidepressants must be closely and regularly monitored,” she said.

Royal Australian and New Zealand College of Psychiatrists board director Dr Melanie Turner Picture: Supplied

Royal Australian and New Zealand College of Psychiatrists board director Dr Melanie Turner said “the debate around the prescribing of antidepressants to younger people is of course a very complex one and as psychiatrists we are continually reviewing current and past data and research”.

“We are aware of the challenges in seeking and finding mental health support,” she said.

“Growing the psychiatry workforce takes time and the College is working with state and federal governments to work on growing the numbers of psychiatrists,” she said.

For help with emotional difficulties, contact Lifeline on 13 11 14 or www.lifeline.org.au

For the Kids Helpline call 1800 55 1800

For help with depression, contact Beyond Blue on 1300 22 46 36 or at www.beyondblue.org.au

The SANE Helpline is 1800 18 SANE (7263) or at www.sane.org

Originally published as New TGA review as number of children prescribed antidepressants doubles in 10 years