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Did COVID drive a spike in teen antidepressant use?

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LA Post: Did COVID drive a spike in teen antidepressant use?
April 04, 2024
Mia Wallace - LA Post

A startling new study by Pediatrics Journal reveals the hidden pandemic fallout - antidepressant prescriptions for teens and young adults have exploded by over 64% compared to pre-COVID levels. This jarring spike mirrors the decline in youth mental well-being throughout the crisis and its aftermath.

Most strikingly, the findings expose profound gender-based disparities underpinning this trend. For adolescent females between 12-17 years old, the rate at which antidepressants were dispensed skyrocketed by an astonishing 130% above pre-pandemic levels after March 2020. The situation was scarcely improved for young adult women aged 18-25, with the dispensing rate for this demographic spiking by an equally concerning 60% over the same period. In stark contrast, the data reveals essentially no change for young adult males, while among adolescent boys, there was an unexpected decline in antidepressant prescriptions post-pandemic.

"The divergence along gender lines is without a doubt the aspect of these findings that stood out most prominently," remarked lead author Dr. Kao-Ping Chua, a pediatrician and professor at the University of Michigan's School of Public Health. "I personally found myself prescribing antidepressants at unprecedented rates far exceeding any prior level during the pandemic. Numerous fellow pediatricians have confided that they feel reduced to solely functioning as mental health clinicians."

While earlier studies examined national dispensing data through 2020, this new analysis based on the IQVIA prescription database is purportedly the first to concentrate specifically on adolescents and young adults grappling with declining mental health both during and after the most acute phases of the COVID crisis. Across the 2016-2022 timeframe, the researchers discovered the overall monthly antidepressant dispensing rate for those aged 12-25 had increased by a remarkable 66.3% - a pace that sharply accelerated as the pandemic took hold in 2020.

"As someone witnessing firsthand the devastating toll the pandemic has taken on youth mental health in my child and adolescent psychiatry practice, I cannot profess surprise at these results," commented Dr. Neha Chaudhary, Chief Medical Officer at Modern Health. "It follows logically that we would observe a commensurate rise in antidepressant prescriptions, as these medications frequently form an integral part of treatment for more moderate to severe conditions like depression."

A constellation of factors has undoubtedly coalesced to propel this profoundly disturbing escalation in antidepressant usage among America's youth. Social isolation, the immense grief of losing loved ones, disruptive upheavals to education and activities, and the overwhelming anxiety of an enduring public health emergency of historic proportions conspired to create a proverbial perfect storm jeopardizing young people's mental well-being. Moreover, greater public awareness and evolving attitudes have helped reduce stigma, potentially empowering more youths to seek professional support proactively.

The rise of telehealth eliminated previous barriers to obtaining prescriptions, as patients could connect virtually with providers rather than mandating in-person visits. However, Dr. Chua posits that constrained therapy access during COVID peaks - itself a function of surging demand outpacing supply - may have compelled providers to prescribe antidepressants as an interim "bridge." At the same time, counseling queues remained oversubscribed, with lengthy wait times.

Experts unanimously caution that interpreting the stagnant data for adolescent boys and young men should not be misconstrued as signaling improved resilience. Rather, the lack of increased prescribing among these groups potentially signals a "concerning possibility" that males are increasingly disengaging from critical mental health treatment and support systems.

While cautioning against overly stigmatizing antidepressants, Dr. Chua stresses these medications carry risks and are "not something to be started trivially." The FDA mandates a black box warning about increased suicidal thoughts, particularly for young patients initiating antidepressant treatment. Potential side effects like insomnia and weight fluctuations typically subside within two weeks, but prompt reevaluation is required if problematic symptoms persist.

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