The Antidepressant Quandary: A Qualitative Investigation into the Opinions of Healthcare Professionals Regarding the Prescription of SSRIs in Paediatric Medicine.

Martin, Emily (2008) The Antidepressant Quandary: A Qualitative Investigation into the Opinions of Healthcare Professionals Regarding the Prescription of SSRIs in Paediatric Medicine. [Dissertation (University of Nottingham only)] (Unpublished)

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Abstract

Background: Concern exists that childhood and adolescent major depressive disorder is increasing, along with the quantity of prescribed antidepressants to the same age group. The relationship between antidepressants, particularly selective serotonin reuptake inhibitors, and an increase in suicidal behaviours has received much attention over the past few years. Consequently the use of such medications in paediatrics is of some concern.

Aims: To identify how healthcare professionals of varying professions view the prescription of antidepressants to under 18s in light of the recent press, and their own experiences in treating these children and adolescents.

Methods: Five semi-structured interviews were carried out on doctors and nurses of varying levels of experience within the field of child and adolescent psychiatry. The findings elicited were analysed using interpretative phenomenological analysis, and subsequent emerging themes allowed conclusions to be drawn in terms of similarities, differences and overall opinions of the interviewees.

Findings: This research appears to mirror the findings that fluoxetine has a favourable benefit to risk ratio, in that few negative experiences were reported compared to the majority of favourable ones. All the interviewees supported the prescription of antidepressants to varying extents; some supporting only the use of the NICE (2004b) recommended fluoxetine, and others giving support for the use of off label prescription. The guidelines set out by NICE (2004b) appear to be followed to a certain extent, but major flaws within them were identified. Future research should be centred around in-depth pharmaceutical trials to gauge a more accurate perception of which SSRIs could safely be used in paediatrics. Furthermore, improvement in diagnosis will only serve to develop successful treatment strategies for doctors and nurses alike.

Conclusions: Although the NICE (2004b) guidelines exist and are followed to a greater extent, they are open to local discretion in order to formulate the most effective treatment plan for each individual. Fluoxetine appears to be the medication of choice, having a positive benefit to risk ratio, although alternative antidepressants are still in use within paediatrics. The biggest concern for the future is the lack of readily available psychotherapies, leading to increased prescription rates to children and adolescents who may not necessarily require medication if they had other support.

Item Type: Dissertation (University of Nottingham only)
Keywords: MNursSci, Master Of Nursing Science, Qualitative, Anti-Depressant
Depositing User: EP, Services
Date Deposited: 11 Dec 2008
Last Modified: 01 Nov 2016 19:31
URI: http://eprints.nottingham.ac.uk/id/eprint/22549

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