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Treatment duration with selective serotonin reuptake inhibitors among children and adolescents in Finland: a nationwide register study

  • Pharmacoepidemiology and Prescription
  • Published:
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Abstract

Purpose

We assessed treatment duration with selective serotonin reuptake inhibitors (SSRIs) among children and adolescents and investigated the association between treatment duration, age, sex, active ingredient, season of initiation, and reimbursement rate.

Method

Data on reimbursed SSRIs dispensed to children and adolescents aged <18 years in noninstitutional settings in Finland from 1999 to 2005 were extracted from the National Prescription Register. The association between treatment duration and explanatory factors was analyzed using Cox proportional hazards models.

Results

SSRIs were reimbursed for 3,710 (35.8%) male and 6,666 female (64.2%) patients from 1999 to 2004, of whom 3,853 (37.1%) received ≤100 days’ supply. Age ≤11 years [adjusted hazard ratio (HR) 0.87; 95% confidence interval (CI), 0.80–0.94] and 12–15 years (HR 0.89; 95% CI 0.84–0.93) was associated with longer treatment duration compared with adolescents aged 16–17 years. Shorter treatment duration was associated with initiating treatment from September to November compared with the other seasons. Recipients of a higher reimbursement rate had longer treatment duration (HR 0.46, 95% CI 0.39–0.55) compared with those who received a lower reimbursement rate. Shorter treatment duration was weakly associated with use of fluvoxamine (HR 1.16; 95% CI 1.03–1.30) compared with fluoxetine.

Conclusions

Shorter treatment duration was less common among younger children, when initiated from September to November and among recipients of a higher reimbursement rate.

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Acknowledgements

We thank Ms. Hilkka Ruuska of the Social Insurance Institution for assistance with data management.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Research Department, The Social Insurance Institution, P.O. Box 450, 00101, Helsinki, Finland

    Leena K. Saastamoinen

  2. Seinäjoki II Pharmacy, Seinäjoki, Finland

    Mika Wallin

  3. Division of Social Pharmacy, Faculty of Pharmacy, University of Helsinki, Helsinki, Finland

    Marja S. Airaksinen & J. Simon Bell

  4. Kuopio Research Centre of Geriatric Care, University of Eastern Finland, Kuopio, Finland

    Piia Lavikainen & J. Simon Bell

  5. Department of Child Psychiatry, University of Turku and Turku University Hospital, Turku, Finland

    Andre Sourander

  6. Clinical Pharmacology and Geriatric Pharmacotherapy Unit, School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland

    J. Simon Bell

  7. Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, Australia

    J. Simon Bell

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  1. Leena K. Saastamoinen
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  2. Mika Wallin
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Correspondence to Leena K. Saastamoinen.

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Saastamoinen, L.K., Wallin, M., Lavikainen, P. et al. Treatment duration with selective serotonin reuptake inhibitors among children and adolescents in Finland: a nationwide register study. Eur J Clin Pharmacol 68, 1109–1117 (2012). https://doi.org/10.1007/s00228-012-1233-6

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  • DOI: https://doi.org/10.1007/s00228-012-1233-6

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