The use of lithium, valproate or lamotrigine for psychiatric conditions in children and adolescents in Norway 2004-2007-A prescription database study

Background: There is an increasing awareness of bipolar disorder in children and adolescents. Our study aimed to explore how common the use of lithium, valproate and lamotrigine in psychiatric conditions in children and adolescents in Norway and to describe concomitant use of other psychotropic drugs. Methods: The Norwegian Prescription Database (NorPD) captures all prescriptions given to individuals in ambulatory care. We investigated prescriptions for lithium, and for valproate and lamotrigine given for psychiatric conditions to children and adolescents under the age of 18 years from 2004 till 2007. We also studied other prescriptions for psychotropic drugs given to the same patients during the period. A comparison was made with the users of ADHD medication. Results: The number below 18 years treated with lithium, valproate or lamotrigine rose from 323 (0.03%) in 2004 till 454 (0.04%) in 2007. Lamotrigine increased most rapidly and lithium was most infrequently used. The users of the three drugs had often also tried antidepressants (14-42%) and atypical antipsychotics (21-51%), but true concomitant use was rarer (7-20% and 16-43% respectively). The users of ADHD medication had a much lower use of other psychotropic drugs, but quite a few users of lithium, valproate and lamotrigine had tried ADHD medication (20-26%) and even used these drugs concomitantly (15-21%). Limitations: NorPD does not include diagnoses, and we do not know if the drugs dispensed were actually used. Conclusion: Overall there has been a slight increase in the use of lamotrigine in Norway during the last four years, most likely prescribed as a mood stabilizer in bipolar disorders. Still the use among the under 14-year-olds is rare in Norway. (C) 2009 Elsevier B.V. All rights reserved.