Antidepressant dispensing to adolescents and young adults surges during pandemic

Antidepressant dispensing to adolescents and young adults increased sharply after the COVID-19 pandemic began – particularly among females – a new study finds.

While a growing number of young people ages 12 to 25 were receiving antidepressants before the pandemic, the antidepressant dispensing rate rose nearly 64% faster after March 2020, according to Michigan Medicine led findings in Pediatrics.

“Antidepressant dispensing to adolescents and young adults was already high and rising before March 2020. Our findings suggest these trends accelerated during the pandemic,” said lead author Kao Ping Chua, M.D., Ph.D., a pediatrician and researcher at University of Michigan Health C.S. Mott Children's Hospital and the Susan B. Meister Child Health Evaluation and Research Center. Chua is a member of IHPI.

Increase driven by females

Researchers analyzed data from a national database representing 92% of prescriptions dispensed in U.S. pharmacies. They found that the increase in the antidepressant dispensing rate during the pandemic was driven by females.

After March 2020, this rate increased 130% faster among female adolescents ages 12-17 years and 60% faster among female young adults ages 18-25 years.

“Multiple studies suggest that rates of anxiety and depression among female adolescents increased during the pandemic,” Chua said.

“These studies, coupled with our findings, suggest the pandemic exacerbated a pre-existing mental health crisis in this group.”

Male adolescents

In contrast to females, the antidepressant dispensing rate changed little among male young adults after March 2020 and declined among male adolescents, which Chua found surprising.

“It’s hard to believe this decline reflects improved mental health,” he said.

He believes a more likely explanation is that male adolescents may have skipped physicals and other health care visits during the pandemic, decreasing opportunities to diagnose and treat anxiety and depression.

The transition away from in-person learning, he notes, may have also decreased opportunities for teachers and other school staff to detect mental health problems in male adolescents.

Long waits for treatment

Chua said the overall rise in antidepressant dispensing to adolescents and young adults may not only be related to worsened mental health. Long waitlists for psychotherapy, for example, may have also played a role.

“In my primary care clinic, I often heard from patients and families that they were facing six to nine month wait lists for therapy during the pandemic. In those situations, it didn’t make sense to withhold antidepressants and recommend a therapy-only approach,” he said.

Further studies, Chua says, should identify which interventions can best promote the mental health of adolescents and young adults.

In a commentary on the study, published in the same journal, researchers from the University of Nebraska and Creighton University write, "This study reinforces the urgency to understand the factors driving this upsurge and to develop effective prevention and early detection strategies for mental health issues in youth. In many ways, increased prescription of psychoactive medication represents a failure to prevent behavioral and psychological problems and a deficiency of family and community support systems, leaving few alternatives for management."

Additional authors: Include Anna Volerman, M.D.; Jason Zhang, B.S.; Joanna Hua, B.S., and Rena Conti, Ph.D.

Funding: Purchase of the data was supported by the Susan B. Meister Child Health Evaluation and Research Center.

Citation: Antidepressant Dispensing to U.S. Adolescents and Young Adults: 2016-2022,” doi.org/10.1542/peds.2023-064245