Journal of the American Academy of Child and Adolescent Psychiatry · 2026
Discontinuation, Medication Switching, and Augmentation After SSRI in Pediatric Depression.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lee Haeyoung, Camelo Castillo Wendy, Qato Danya M, Rose Roderick, Reeves Gloria, dosReis Susan
Аннотация
OBJECTIVE: To investigate antidepressant regimen change after an initial selective serotonin reuptake inhibitor (SSRI) trial in children and adolescents with depression, and to identify associated factors.
METHOD: This population-based cohort study included children and adolescents aged 8 to 18 years with depression initiating SSRI monotherapy, using the 2010-2022 IQVIA PharMetrics Plus Closed Health Plan database (25% random sample). Eligible individuals received ≥8 weeks of SSRI treatment without switching or augmentation during the initial 12-week treatment. We estimated regimen change after week 12 and used a Cox proportional hazards regression model to identify factors associated with the change. Sensitivity analyses tested allowable treatment gaps and extended follow-up periods.
RESULTS: Of 20,708 individuals (mean age 15.4 years, 66.8% female), 11,067 (53.4%) changed their regimen: 9,369 (45.2%) discontinued, 1,137 (5.5%) switched, and 561 (2.7%) augmented. Older age (hazard ratio = HR 1.05, 95% CI = 1.04-1.06), substance use disorder (HR = 1.24, 95% CI = 1.14-1.34), psychiatric hospitalization (HR = 1.38, 95% CI = 1.19-1.61), and psychiatric emergency department visits (HR = 1.18, 95% CI = 1.04-1.35) were associated with an increased risk of regimen change. Anxiety disorder (HR = 0.89, 95% CI = 0.86-0.93) and psychotherapy (6-10 visits: HR = 0.90, 95% CI = 0.84-0.95; >10 visits: HR = 0.78, 95% CI = 0.73-0.82 vs none) were associated with a lower risk of regimen change. Individuals without a health maintenance organization (HMO) had a lower risk (HR = 0.92; 95% CI = 0.88-0.96) than those with an HMO. An extended follow-up identified additional regimen changes.
CONCLUSION: Our findings showed that over half of children and adolescents initiating antidepressant use do not continue treatment beyond 12 weeks.
METHOD: This population-based cohort study included children and adolescents aged 8 to 18 years with depression initiating SSRI monotherapy, using the 2010-2022 IQVIA PharMetrics Plus Closed Health Plan database (25% random sample). Eligible individuals received ≥8 weeks of SSRI treatment without switching or augmentation during the initial 12-week treatment. We estimated regimen change after week 12 and used a Cox proportional hazards regression model to identify factors associated with the change. Sensitivity analyses tested allowable treatment gaps and extended follow-up periods.
RESULTS: Of 20,708 individuals (mean age 15.4 years, 66.8% female), 11,067 (53.4%) changed their regimen: 9,369 (45.2%) discontinued, 1,137 (5.5%) switched, and 561 (2.7%) augmented. Older age (hazard ratio = HR 1.05, 95% CI = 1.04-1.06), substance use disorder (HR = 1.24, 95% CI = 1.14-1.34), psychiatric hospitalization (HR = 1.38, 95% CI = 1.19-1.61), and psychiatric emergency department visits (HR = 1.18, 95% CI = 1.04-1.35) were associated with an increased risk of regimen change. Anxiety disorder (HR = 0.89, 95% CI = 0.86-0.93) and psychotherapy (6-10 visits: HR = 0.90, 95% CI = 0.84-0.95; >10 visits: HR = 0.78, 95% CI = 0.73-0.82 vs none) were associated with a lower risk of regimen change. Individuals without a health maintenance organization (HMO) had a lower risk (HR = 0.92; 95% CI = 0.88-0.96) than those with an HMO. An extended follow-up identified additional regimen changes.
CONCLUSION: Our findings showed that over half of children and adolescents initiating antidepressant use do not continue treatment beyond 12 weeks.