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Use of Selective Serotonin Reuptake Inhibitors by Pediatricians: Comparing Attitudes of Primary Care Pediatricians and Child and Adolescent Psychiatrists

Department of Pediatrics, Case Western Reserve University School of Medicine, axh65{at}case.edu

Andrew S. Garner, MD

Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, Ohio, University Hospitals Medical Practice, University Hospitals, Cleveland, Ohio

Amy Storfer-Isser

Department of Pediatrics, Case Western Reserve University School of Medicine, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, Ohio

Karl Kortepeter, MBA

Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Cleveland, Ohio

Ruth E. K. Stein, MD

Department of Pediatrics, Albert Einstein College of Medicine, Children's Hospital at Montefiore Medical Center, Bronx, New York

Sarah McCue Horwitz

Department of Pediatrics, Center for Health Policy and Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, California

To compare attitudes regarding a pediatrician's role in prescribing selective serotonin reuptake inhibitors for children and adolescents, surveys were mailed to 338 primary care pediatricians and 75 child and adolescent psychiatrists; half responded. Child and adolescent psychiatrists were significantly more likely than primary care pediatricians to agree that selective serotonin reuptake inhibitors are safe and effective when used for children and adolescents. Primary care pediatricians were significantly more likely than child and adolescent psychiatrists to agree that black box warnings have changed their prescribing practices. Both had similar beliefs about whether antidepressants should be prescribed only by psychiatrists and whether pediatricians should initiate selective serotonin reuptake inhibitor therapy, without or after consulting a psychiatrist. These data suggest that among child and adolescent psychiatrists and primary care pediatricians, agreement about the pediatrician's role in using selective serotonin reuptake inhibitors therapy is lacking. Strategies that enhance communication and endorse support for defined roles of primary care pediatricians and child and adolescent psychiatrists will ensure that children with mental health needs are treated safely and appropriately.

Key Words: pediatricians • psychiatry • SSRIs

This version was published on March 1, 2008

Clinical Pediatrics, Vol. 47, No. 2, 148-154 (2008)
DOI: 10.1177/0009922807306169


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