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It is disappointing that, in an issue of BJGP devoted to mental health, the only mention of the increasingly recognised problem of antidepressant dependence is in reference to an article published elsewhere.
I have been in practice long enough to recall the Defeat Depression campaign of the 1990s. I recently came across some of the material distributed to GPs in support of this campaign,1 which was supported by both the RCPsych and RCGP, as well as the pharmaceutical industry. We were told that the then-new SSRIs were safe, effective and non-addictive, they corrected a chemical imbalance in the brain, and that GPs were massively under-recognising and undertreating depression. The professional consensus emerged that it was good practice to prescribe to anyone who had “biological symptoms of depression” for two weeks or more. The studies backing these assertions covered a standard 8 – 12 weeks.
Now we are faced with huge prescription numbers, driven at least in part by long term prescribing, for which there is a very flimsy evidence-base. Many people have developed discontinuation symptoms when stopping these drugs, been told by their doctors that these represent a relapse of their original condition and can now count the years over which they have been dependent on prescribed drugs.
The RCPsych has moved its position, as evidenced by its recent publication “Stopping antidepressants”,2 endorsed...
Competing Interests: None declared.