Use of Antidepressant Drugs by Colombian Adolescents: A Study of Prescription Indication

Objective: To determine the indications for the use of antidepressants by adolescents (14-19 years old) in Colombia. Materials and methods: A cross-sectional study using data on adolescent patients of both sexes who were receiving antidepressants in January 2015-June 2016. Medical records were reviewed to assess sociodemographic, pharmacological, and clinical variables including diagnosis, indication (approved or not) and co-medications. Multivariate analyses were performed. Results: A total of 350 adolescents treated with antidepressants were evaluated, with a mean age of 16.3±1.4 years and a slight predominance of females (59.7%). Most antidepressants were prescribed by general practitioners (n=258; 73.7%). The most commonly used antidepressants were fluoxetine (n=130; 37.1%), sertraline (n=56; 16.0%), and trazodone (n=47; 13.4%). The main indications for use were depression (n = 92; 26.3%), anxiety (n=53; 15.1%), migraine (n=48; 13.7%), abuse of psychoactive substances (n=34; 9.7%), and insomnia (n=20; 5.7%). Only 150 (42.9%) prescriptions were in conformity with approval by regulatory agencies. Multivariate analysis of unapproved prescription indications showed that suffering from depression (or: 0.004; 95% ci: 0.001-0.018), anxiety (or: 0.028; 95% ci: 0.010-0.076), or bipolar affective disorder (or: 0.071; ic95 %: 0.011-0.461) was associated with a lower likelihood that drug use was unapproved. Discussion: The prescribing of antidepressant drugs to adolescent Colombian patients is being practised most frequently with fluoxetine, sertraline, and trazodone, mainly for unapproved indications. There are no guidelines in Colombia for clinical practice, including the use of these drugs by the adolescent population.