Table 2.

The proportion of patients initiating an SSRI on a low dose before and after the 2004 FDA black-box warning

	Pre-2004 FDA warning			Post-2004 FDA warning
	No. low dosea	Proportion initiating on a low dose		No. low dosea	Proportion initiating on a low dose		Percentage- point change
Overall		%	95% CI		%	95% CI	%	95% CI
5 to 17 years	2,221	15	15 – 16	11,522	31	30 – 31	16	15 – 16
5 to 9 years	360	19	17 – 21	1,334	27	26 – 29	8	6 – 10
10 to 12 years	155	6	5 – 7	729	11	10 – 12	5	4 – 7
13 to 17 years	1,706	17	16 – 18	9,459	37	36 – 37	20	19 – 21
18 to 24 yearsb	2,136	17	16 – 17	8,951	23	23 – 23	6	6 – 7
25 to 64 years	18,849	18	17 – 18	57,959	20	20 – 20	3	2 – 3
Depression diagnosisc
5 to 17 years	1,149	15	14 – 16	5,913	32	32 – 33	18	17 – 19
18 to 24 years	832	13	13 – 14	3,576	21	20 – 21	7	6 – 8
25 to 64 years	4,827	13	13 – 14	16,456	17	17 – 18	4	4 – 4
No depression diagnosis
5 to 17 years	1,072	16	15 – 16	5,609	29	29 – 30	14	13 – 15
18 to 24 years	1,304	20	19 – 21	5,375	25	24 – 25	5	4 – 6
25 to 64 years	14,022	20	19 – 20	41,503	22	21 – 22	2	1–2
SSRI agent, 5 to 12 years
Fluoxetine	129	12	10 – 14	919	20	19 – 21	8	6 – 10
Citalopram	49	10	8 – 13	305	20	18 – 22	10	6 – 13
Paroxetine	172	14	12 – 16	139	21	17 – 24	6	3 – 10
Sertraline	165	9	8 – 10	700	15	14 – 16	6	4 – 8
SSRI agent, 13 to 17 years
Fluoxetine	853	34	32 – 36	5,134	50	49 – 51	16	14 – 18
Citalopram	198	13	11 – 15	1,465	33	31 – 34	20	17 – 22
Paroxetine	33	1	1 – 2	33	2	1 – 2	0	0 – 1
Sertraline	622	17	15 – 18	2,827	30	29 – 31	14	12 – 15
Service provider
Psychiatry
5 to 17 years	501	16	15 – 18	2,700	35	33 – 36	18	16 – 20
18 to 24 years	196	14	12 – 16	861	22	21 – 24	8	6 – 11
25 to 64 years	837	13	13 – 14	2,656	18	18 – 19	5	4 – 6
General practiced
5 to 17 years	769	15	14 – 16	3,770	29	29 – 30	14	13 – 15
18 to 24 years	729	16	15 – 17	3,097	22	21 – 22	6	5 – 7
25 to 64 years	4,492	15	15 – 16	15,255	18	18 – 18	3	2 – 3

^aLow dose=5–12 years (<10mg/d citalopram, fluoxetine, and paroxetine immediate release and <25mg/d sertraline), 13–17 years (<20mg/d citalopram and fluoxetine, <10mg/d paroxetine immediate release, and <50mg/d sertraline), 18–64 years (<20mg/d citalopram, fluoxetine, and paroxetine immediate release, <25mg/d paroxetine controlled release, and <50mg/d sertraline); Children 5–17 years: paroxetine controlled release unavailable <12.5mg/d

^bFor young adults (18–24 years) the proportion initiating on a low dose pre-2007 expansion (period 1–3) was 19.1% and post-2007 expansion (period 4) was 24.2%, a percentage-point change of 5.1% (95% CI: 4.4–5.8)

^cDepression diagnosis in the year prior to SSRI initiation (ICD-9-CM codes: 296.2x, 296.3x, 298.0x, 300.4x, 309.0x, 309.1x, 311.xx, 293.83, 296.90, and 309.28)

^dGeneral practice included the service providers pediatrics, family practice, and general practice