Abstract
Background
The prevalence of mental health disorders in adolescents, as well as the prescription of psychotropic drugs, especially antidepressants and antipsychotics, has increased in the last decades.
Methods
We analyzed changes in prescription prevalence (PP) and prescription volume (PV), measured as daily defined doses (DDD) per 1000/day of antidepressant and antipsychotic among adolescents aged 12 to 17 covered by the German statutory health insurer AOK from 2015 to 2023. We compared the percentage change between the fourth quarters of 2015 and 2023 and conducted a joinpoint analysis of PP and PV reporting quarterly percent changes (QPC).
Results
In 2023, the antidepressants citalopram, escitalopram, fluoxetine, and sertraline, and the antipsychotics aripiprazole, quetiapine, risperidone, and pipamperone were prescribed with a frequency > 100,000 DDD. Compared to 2015, the most substantial PP increases were seen for sertraline (girls: 482 %, boys: 344 %) and escitalopram (girls: 194 %, boys: 103 %). Concerning antipsychotics, while overall PP declined in boys (-9.7 %), driven primarily by reductions in risperidone, an overall rise in girls was detected (26 %) as a result of increases in aripiprazole (110 %) and quetiapine (59 %).
Discussion
Our results indicate an increase in pharmacotherapy for mental disorders in adolescents, especially among girls. The quantity and quality of changes in the prescription of psychotropic drugs are greater than would be expected based solely on the increase in diagnoses. This could indicate a change in prescribing behavior, in the sense of earlier drug intervention for mental disorders and/or more off-label prescriptions. This gives rise to concerns about the appropriateness of psychotropic prescriptions to this group of patients.
The prevalence of mental health disorders in adolescents, as well as the prescription of psychotropic drugs, especially antidepressants and antipsychotics, has increased in the last decades.
Methods
We analyzed changes in prescription prevalence (PP) and prescription volume (PV), measured as daily defined doses (DDD) per 1000/day of antidepressant and antipsychotic among adolescents aged 12 to 17 covered by the German statutory health insurer AOK from 2015 to 2023. We compared the percentage change between the fourth quarters of 2015 and 2023 and conducted a joinpoint analysis of PP and PV reporting quarterly percent changes (QPC).
Results
In 2023, the antidepressants citalopram, escitalopram, fluoxetine, and sertraline, and the antipsychotics aripiprazole, quetiapine, risperidone, and pipamperone were prescribed with a frequency > 100,000 DDD. Compared to 2015, the most substantial PP increases were seen for sertraline (girls: 482 %, boys: 344 %) and escitalopram (girls: 194 %, boys: 103 %). Concerning antipsychotics, while overall PP declined in boys (-9.7 %), driven primarily by reductions in risperidone, an overall rise in girls was detected (26 %) as a result of increases in aripiprazole (110 %) and quetiapine (59 %).
Discussion
Our results indicate an increase in pharmacotherapy for mental disorders in adolescents, especially among girls. The quantity and quality of changes in the prescription of psychotropic drugs are greater than would be expected based solely on the increase in diagnoses. This could indicate a change in prescribing behavior, in the sense of earlier drug intervention for mental disorders and/or more off-label prescriptions. This gives rise to concerns about the appropriateness of psychotropic prescriptions to this group of patients.
| Original language | English |
|---|---|
| Article number | 116831 |
| Number of pages | 8 |
| Journal | PSYCHIATRY RESEARCH |
| Volume | 355 |
| Issue number | 355 |
| DOIs | |
| Publication status | E-pub ahead of print - Nov 2025 |
Assignment to FIZ
- FIZ Public Health & Health Services Research
