Doctors must stop over-prescribing antidepressants to patients who are just lonely, demand leading experts

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Doctors must extremity prescribing antidepressants to patients pinch mild intelligence wellness problems to curb nan country's overreliance connected pills, experts said today.

Antidepressant prescriptions person almost doubled successful England complete nan past decade pinch 85.6million dished retired successful nan past twelvemonth alone.

Experts blasted 'overmedicalising' issues for illustration loneliness for nan steep rise, pinch unnecessary narcotics putting patients astatine consequence of harm while failing to tackle nan guidelines causes of problems.

Instead, manner changes alongside greater usage of societal prescribing, specified arsenic gardening, stepping groups and volunteering, must beryllium utilized to move nan tide connected unnecessary supplier usage.

More than 8.6million people — 1 successful 5 adults — are now prescribed antidepressants annually, contempt mediocre outcomes and imaginable harms specified arsenic dependence.

Over nan past decade, antidepressant prescriptions person almost doubled successful England, rising from 47.3million successful 2011 to 85.6million successful 2022. Pictured: citalopram, a type of selective serotonin reuptake inhibitors (SSRIs), which are nan astir widely-prescribed antidepressants

This number is expected to emergence betwixt 5-10 per cent each twelvemonth complete nan adjacent decade, while unnecessary prescribing has been estimated to costs nan NHS England up to £58million each year.

While not addictive, antidepressants tin origin withdrawal symptoms successful astir half of patients who effort to stop, and terrible withdrawal symptoms successful astir a quarter.

Members of nan caller Beyond Pills All Party Parliamentary Group (APPG), experts and diligent representatives are coming urging wellness leaders to reverse nan complaint of antidepressant prescribing.

In an unfastened missive to nan British Medical Journal today, they said 'a pill for each ill' must extremity and called for a national, 24-hour prescribed supplier withdrawal helpline and website.

Reductions successful antidepressant prescribing should beryllium included successful charismatic NHS targets, they suggest, pinch GPs urged to travel Nice guidelines connected safe prescribing and withdrawal management, including decently informed consent and regular reappraisal of harms and benefits.

What are antidepressants? 

Antidepressants are medicines that dainty slump symptoms. 

There are astir 30 different types that tin beryllium prescribed.

The NHS says that astir group who person mean aliases terrible slump announcement betterment erstwhile they return antidepressants. But it notes that this isn't nan lawsuit for everyone. 

Side effects alteration betwixt different group and antidepressants but tin see nausea, headaches, a barren rima and problems having sex.

Antidepressants aren't addictive but patients whitethorn person withdrawal symptoms if they extremity taking them abruptly aliases miss a dose. 

These tin see an upset stomach, flu-like symptoms, anxiety, dizziness and vivid dreams.

Lord Nigel Crisp, co-chair of nan Beyond Pills APPG, said: 'The precocious complaint of prescribing of antidepressants complete caller years is simply a clear illustration of over-medicalisation, wherever patients are often prescribed unnecessary and perchance harmful narcotics alternatively of tackling nan guidelines causes of their suffering, specified arsenic loneliness, poorness aliases mediocre housing.'

Dr Michael Dixon, a GP and Chair College of Medicine, said: 'As GPs we are facing a tsunami of intelligence wellness problems — particularly slump — and these tin often beryllium helped by changes successful lifestyle, fare and a scope of interventions offered done societal prescribing, without reaching for pills that tin person each sorts of undesired effects.

'It is important that patients cognize astir and are helped to effort these alternatives truthful that pills go nan past edifice alternatively than nan first. It is clip to de-medicalise intelligence wellness and to liberate our patients to find non-drug solutions that activity for them. Our astir urgent privilege now is to equip patients and medics pinch nan intends of achieving this.'

A Department of Health and Social Care spokesperson said: 'We are committed to supporting group pinch their intelligence wellness and we’re going further and faster to toggle shape our country’s intelligence wellness services.

'Up to £2.3 cardinal successful other backing is being invested by nan authorities until 2024 to grow services truthful that 2 cardinal much people, including 345,000 children and young people, tin get nan intelligence wellness support they need.

'The determination to prescribe a peculiar merchandise is simply a objective 1 and should ever beryllium based connected nan patient’s aesculapian needs and champion interests.'

A afloat type of nan missive tin beryllium publication below. 

Today a group of aesculapian professionals, researchers, diligent representatives and politicians telephone for the UK government to perpetrate to a reversal successful nan complaint of prescribing of antidepressants.

Over nan past decade, antidepressant prescriptions person almost doubled successful England, rising from 47.3million successful 2011 to 85.6million successful 2022. 

Over 8.6million adults successful England are now prescribed them annually (nearly 20 per cent of adults), pinch prescriptions group to emergence complete nan adjacent decade. 

Additionally, nan mean long of clip a personification spends connected an antidepressant has besides doubled betwixt nan mid-2000s and 2017, pinch astir half of patients now classed arsenic semipermanent users.

Scotland, Wales and Northern Island person akin rates of antidepressant prescribing.

Over 8.6million adults successful England are now prescribed them annually (nearly 20 per cent of adults), pinch prescriptions group to emergence complete nan adjacent decade. Pictured: fluoxetine, a type of SSRI 

Rising semipermanent usage is associated pinch galore adverse effects, including accrued weight gain, poorer semipermanent outcomes for some, intersexual dysfunction, bleeding and falls. 

Additionally, withdrawal effects are knowledgeable by astir half of patients, pinch up to half of those describing their symptoms arsenic severe, and a important proportionality experiencing withdrawal for galore weeks, months aliases longer.

Rising antidepressant prescribing is not associated pinch an betterment successful intelligence wellness outcomes astatine nan organization level, which, according to immoderate measures, person worsened arsenic antidepressant prescribing has risen. 

Questions stay astir nan grade to which mediocre outcomes are fuelled by specified adverse effects, and nan mediocre efficacy of antidepressants for galore groups.

Multiple meta-analyses person shown antidepressants to person nary clinically meaningful use beyond placebo for each but nan astir severely depressed patients, which is why NICE guidance states that they should not beryllium routinely prescribed arsenic first-line curen for little terrible depression, while still respecting nan value of shared determination making.

WHAT IS DEPRESSION? 

While it is normal to consciousness down from clip to time, group pinch slump whitethorn consciousness persistently unhappy for weeks aliases months connected end.

Depression tin impact anyone astatine immoderate property and is reasonably communal ¿ astir 1 successful 10 group are apt to acquisition it astatine immoderate constituent successful their life. 

Depression is simply a genuine wellness information which group cannot conscionable disregard aliases 'snap retired of it'.

Symptoms and effects vary, but tin see perpetually emotion upset aliases hopeless, aliases losing liking successful things you utilized to enjoy.

It tin besides origin beingness symptoms specified arsenic problems sleeping, tiredness, having a debased appetite aliases activity drive, and moreover emotion beingness pain.

In utmost cases it tin lead to suicidal thoughts.

Traumatic events tin trigger it, and group pinch a family history whitethorn beryllium much astatine risk.

It is important to spot a expert if you deliberation you aliases personification you cognize has depression, arsenic it tin beryllium managed pinch manner changes, therapy aliases medication. 

Source: NHS Choices 

Despite this, rates of prescribing to patients pinch mild and mean slump stay high. 

One study shows 69 per cent of diagnosed slump successful older group was of mild severity, and different that of those taking antidepressants 26.4 per cent reported mild depressive symptoms. 

Furthermore, 1 UK study showed that 58 per cent of group taking antidepressants (2> years) grounded to meet criteria for immoderate psychiatric diagnosis.

Additionally, location are now evidence-based objections to prescribing antidepressants for sufferers of chronic pain, wherever efficacy is very low, alongside grounds of disproportionate prescribing to women, older group and those surviving successful deprived areas. 

This raises questions astir nan grade to which we are wrongly medicalising and medicating nan effect of disadvantage and deprivation.

As good arsenic nan quality costs of unnecessary antidepressant prescribing, location are now important unnecessary economical costs being incurred by nan NHS successful England of up to £58million annually - money that could beryllium amended spent boosting non-pharmacological provision. 

The problem has been recognised by nan NHS successful its National Medicines Optimisation Opportunities 2023/24 statement.

We judge a reversal successful nan complaint of antidepressant prescribing tin beryllium achieved by pursuing done pinch various nationalist wellness recommendations, successful statement pinch nan NHS National Medicines Optimisation Opportunities 2023/24.

These include:

1) Stopping nan prescribing of antidepressants for mild conditions

2) Adhering to nan 2022 NICE guidance connected safe prescribing and withdrawal guidance including decently informed consent and regular reappraisal of harms and benefits

3) Funding and delivering section withdrawal services integrated pinch societal prescribing, manner medicine & psychosocial interventions

4) Including nan simplification of antidepressant prescribing arsenic an parameter successful nan NHS Quality and Outcomes Framework (QOF)

5) Funding and delivering a nationalist 24 hr prescribed supplier withdrawal helpline and website

Finally, we dream different countries pinch precocious levels of antidepressant prescribing will besides perpetrate to a reversal successful prescribing rates.

Lord Nigel Crisp (Co-Chair, Beyond Pills All Party Parliamentary Group)

Professor Sir Sam Everington (Vice President BMA, Deputy Chair, College of Medicine)

Baroness Professor Sheila Hollins (Professor of Psychiatry, St Georges, University of London)

Professor Joanna Moncrieff (Professor of Critical and Social psychiatry, University College London)

Dr James Davies (Associate Professor of Medical Anthropology and Psychology, University of Roehampton)

Professor John Read (Chair, The International Institute for Psychiatric Drug Withdrawal)

Danny Kruger MP (Chair, Beyond Pills All Party Parliamentary Group)

Dr Michael Dixon (Chair, College of Medicine)

Dr Bogdan Chiva Giurca (Global Lead and Clinical Lead National Academy for Social Prescribing)

Prof Guy Chouinard (Professor of Clinical Pharmacology, McGill University)

Michael Dooley (Treasurer, College of Medicine)

Dr Anne Guy (Secretariat, Beyond Pills All Party Parliamentary Group)

Dr Mark Horowitz (North East London NHS Foundation Trust, UCL (honorary))

Professor Peter Kinderman (Professor of Clinical Psychology, University of Liverpool)

Dr Lucy Johnstone (Consultant Clinical Psychologist, Bristol)

Luke Montagu Secretariat (Co-Founder, Council for Evidence-based Psychiatry)

Professor Antonio E. Nardi (Professor of Psychiatry, Federal University of Rio de Janeiro)

Sarah Stacey (Co-Founder, College of Medicine Beyond Pills Campaign)

Dr Andrew Tresidder (Clinical Lead for Medicines Management NHS Somerset)

Jo Watson (Psychotherapist, Worcestershire)

Stevie Lewis (Lived Experience Advisory Panel for Prescribed Drug Dependence)

Professor Marcantonio Spada (Professor of Addictive Behaviours, London South Bank University)

Chris van Tulleken

Norman Lamb (Former Minister of State for Community and Social Care)