Antidepressant Use in a 3- to 12-Year Follow-up of Anxious Youth: Results from the CAMELS Trial

Abstract

The current study explored whether patient characteristics predicted patterns of antidepressant use (i.e., never used, single episode of use, or two or more episodes) in a naturalistic follow-up. Participants in the child/adolescent multimodal (CAMS) extended long-term study. (n = 318) indicated medication use over the course of eight follow-up visits, 3–12 years after receiving treatment in CAMS. 40.6% of participants reported never using an antidepressant during follow-up, 41.4% reported a single episode of antidepressant use, and 18.0% reported multiple episodes of antidepressant use. Greater baseline anxiety severity marginally predicted a single episode of antidepressant use; baseline depression severity predicted multiple episodes of use. Reasons for discontinuing antidepressants included perceived ineffectiveness (31.8%), side effects (25.5%), and improvement in symptoms (18.5%). Exploratory analyses examined predictors of medication use. Findings suggest that antidepressant use is common among anxious youth, as is discontinuation of antidepressant use. Clinical implications and future directions are discussed.

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Notes

  1. 1.

    Medications in this category included SSRIs, SNRIs, and related medications, including Sertraline, Fluoxetine, Citalopram, Escitalopram, Paroxetine, Fluvoxamine, Venlafaxine, Desvenlafaxine, Duloxetine, and Bupropion.

  2. 2.

    CAMELS participants were more likely to be female, of non-Hispanic ethnicity, and of higher SES than non-participants. Among those who completed less than three visits 12.7% (n = 8) were Hispanic; 49.2% (n = 31) were female, and 28.6% (n = 18) were of lower SES.

  3. 3.

    Some participants endorsed both stopping one antidepressant and starting another within the same follow-up interval, but data were not gathered as to whether these occurred concurrently or separately within that period of time. Thus, some participants may have stopped one antidepressant and began another many months later, while others may have switched directly from one to another.

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Funding

This research was supported by the National Institute of Mental Health (NIMH) grants MH064089 to Dr. Ginsburg, MH064003 to Dr. Sokolsky, MH64088 to Dr. Piacentini, MH64092 to Dr. Albano, MH64107 to Dr. March, and MH063747 to Dr. Kendall. The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Correspondence to Elana R. Kagan.

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Conflict of interest

Dr Kendall. received royalties from the sale of materials related to the treatment of anxiety in youth. He has also received support for his research from NIMH and NICHD. Dr. Birmaher. receives NIMH grants and royalties for books. Dr. Ginsburg. receives funding from NIMH and DOE, and has been a paid consultant for Syneos Health, Inc. in the past year Dr. Albano. receives royalties from Oxford University Press. Dr. Sokolsky receives funding from NIMH and a speaking fee from Northwell Health. Dr. Peris receives research funding from NIMH, PCORI, and the TLC Foundation for Body-Focused Repetitive Behaviors. She also receives royalties from Oxford University Press. Dr. Piacentini receives grant support from NIMH, TLC Foundation for BFRBs, and Pfizer Pharmaceuticals. He receives book royalties from Guilford Press and Oxford University Press. He received speaking/travel support from the International OCD Foundation, Tourette Association of America, and the TLC Foundation for BFRBs Ms. Frank is supported by a grant from NIMH. No other authors have any financial support or conflicts of interest to disclose.

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Kagan, E.R., Frank, H.E., Norris, L.A. et al. Antidepressant Use in a 3- to 12-Year Follow-up of Anxious Youth: Results from the CAMELS Trial. Child Psychiatry Hum Dev 52, 41–48 (2021). https://doi.org/10.1007/s10578-020-00983-w

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Keywords

  • Anxiety
  • Treatment
  • Antidepressant
  • Longitudinal