Most primary care pediatricians appropriately prescribing SSRIs

Primary care pediatricians (PCPs) who prescribe selective serotonin reuptake inhibitors (SSRIs) for children with anxiety and/or depression generally document appropriate indications for starting medication and prescribe without involvement of subspecialists, according to a study published online April 17 in Pediatrics.

Talia R. Lester, M.D., from the Stanford School of Medicine in Palo Alto, California, and colleagues conducted chart reviews of 110 patients with at least one visit with a diagnosis of anxiety and/or depression in a large primary care network, who were prescribed an SSRI by a network PCP. The visit when the SSRI was first prescribed (medication visit), the immediately previous visit, and the immediately subsequent visit were reviewed.

The researchers found that in 82 percent of cases, PCPs documented reasons for starting an SSRI at the medication visit, with the most common reason being clinical change (57 percent). At one of the three visits reviewed, 30 percent of patients had documented involvement of developmental-behavioral pediatrics or psychiatry subspecialists. Overall, 33 and 4 percent were referred to unspecified psychotherapy and cognitive behavioral therapy, respectively. Forty-eight percent of the 69 patients with a subsequent visit had documentation of monitoring for side effects.

“These findings encourage subspecialists collaborating with PCPs to make specific therapy recommendations and to ensure that children and adolescents with anxiety and depression on SSRIs receive timely and comprehensive follow-up care,” the authors write.

More information:
Anxiety and Depression Treatment in Primary Care Pediatrics , Pediatrics (2023). DOI: 10.1542/peds.2022-058846m Abstract/Full Text

Editorial

Journal information:
Pediatrics

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