OBJECTIVES: To study prescribing trends for antidepressants in Hawai'i following 
the FDA black box warning regarding the possible risk of suicide in children and 
adolescents. We also explored relationships between changes in prescribing 
trends and patient and provider characteristics.
STUDY DESIGN: Analysis of an existing insurance data set of prescriptions to 
children and adolescents within the State of Hawai'i.
STUDY POPULATION: Children and adolescents under 18-years-old insured through 
the largest (>60%) third-party insurance company in the state.
RESULTS: Our results showed variations in changes in prescribing trends for 
different selective serotonin reuptake inhibitors (SSRIs) following the FDA 
black box warning. SSRIs with more evidence-based research supporting their 
safety and efficacy were least affected as were those that were less implicated 
by the FDA analysis of the possible link between SSRIs and Suicidality. Trends 
were apparent for all age groups examined and for both females and males.
CONCLUSIONS: Changes in prescribing patterns of psychiatric medications for 
children and adolescents in Hawai'i were identified. Differing patterns have 
evolved since 2003 following the series of concerns raised regarding SSRIs and 
suicidality in children and adolescents.