What were the impacts of the Committee on Safety of Medicines warning and publication of the NICE guidelines on trends in child and adolescent antidepressant prescribing in primary care? A population based study

Objectives To assess the impact of both the Committee on Safety of Medicines (CSM) warning (December 2003) and the National Institute for Health and Care Excellence (NICE) guidance (September 2005) on antidepressant prescription rates in children and adolescents within the UK primary care service.Setting Population based study of primary care antidepressant prescribing using the Clinical Practice Research Datalink (CPRD).Participants Under-18s presenting to primary care with a depressive disorder or related diagnostic code recorded in the CPRD.Primary outcome measure Antidepressant prescription rates per month per 100 000 depressed 4–17 year olds.Results Following the CSM warning, the prior trend towards increased prescribing rates for selective serotonin reuptake inhibitors (SSRIs) in children was significantly reversed (β for change in trend −12.34 (95% CI −18.67 to −6.00, p