OBJECTIVES: Estimated 12.8% American adolescents age 12 to 17 years old had at least one major depressive episode in 2016. Drug-drug interactions (DDIs) can cause unwanted adverse reactions, which lead to possible adherence problems and affect the improvement of clinical outcome. The study aimed to analyze the prevalence and trend of DDIs in the adolescent population in U.S. ambulatory care settings.

METHODS: Using the National Ambulatory Medical Care Survey (NAMCS) from 2010 to 2014, a retrospective cohort study was conducted. Subjects included the adolescents with diagnosis of major depression. Drug Interaction Facts was used to define DDIs. Evaluation of prevalence on potential DDIs was analyzed using a series of weighted descriptive analyzes. Mann-Kendall (M-K) trend test was applied to test the data trend. The multifaceted sampling design by NAMCS database was adjusted using the SAS PROC SURVEY applications.

RESULTS: Approximately 23.28 million visits with depression from 2010-2014 in US outpatient settings. 52.7% of adolescents received at least one antidepressant. Among them, 66.7% of the prescribing had a risk for potential DDIs at either major or severe levels. SSRI are among the highest drug class with a 32.7% of DDIs, followed by Phenylpiperazine (23.6%), CNS stimulant (18.2%), and atypical antipsychotic (12.7%). The most common drug yielded DDIs is Trazodone with 31.7%, followed by Sertraline 24.4%, Aripiprazole 17.1%, and Venlafaxine 14.6%. No significant trend was found across study time-period.

CONCLUSIONS: The study discloses a high prevalence rate of potential DDIs in adolescents receiving major depressive disorder treatment. Monitoring drug-drug interaction is a crucial part of medication safety, especially in this population.