Pediatricians not likely to prescribe antidepressants

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Pediatricians are reluctant to prescribe antidepressant medications to adolescent patients, even those with depression. Pediatric primary care practitioners (PCPs) who are knowledgeable about depression and those who have on-site mental health care providers are more likely to prescribe pharmacological treatments for kids.

Needing better education for PCPs

“With the national shortage of child psychiatrists, education interventions which take into account a primary care provider’s feelings of burden when addressing mental health problems and collaborative care with mental health professionals will be needed to increase appropriate prescribing of antidepressant medications to depressed adolescents,” explained Dr. Ana Radovic of Children’s Hospital of Pittsburgh.

Rather than prescribe, most PCPs would refer to a psychiatrist

For the study, PCPs were given two cases describing two 15 year old girls, one with moderate depression, one with severe depression, neither was suicidal. Only 25% of the doctors said they would prescribe medication for the mildly depressed girl while about one-third said they would prescribe for the severely depressed girl. This is contrary to current guidelines which recommend antidepressant medication and cognitive behavioral therapy for mildly to severely depressed teens. Severely depressed teens respond very well to antidepressants. Instead, most PCPs said they would refer the patient to a child or adolescent psychiatrist for medication management.

Doctors with depression knowledge more comfortable treating the condition

For PCPs who worked in clinics with an on-site mental health care provider, they were five time more likely to prescribe medication. Providers who scored higher on a test of depression knowledge were more likely to recommend antidepressants. Those doctors who felt a professional burden seeing a patient with psychiatric problems were less likely to treat the condition with medication.

Better information for better treatment

“Adolescent depression is a serious and undertreated public health problem,” according to Dr. Radovic. Doctors who know more and are more comfortable discussing mental health are more likely to treat the patient when that patient is in their office.

Source: MedicalNewsToday, Journal of Developmental & Behavioral Pediatrics

 
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