Doctors 'forced' to overprescribe antidepressants

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Doctors 'forced' to overprescribe antidepressants

http://www.guardian.co.uk/medicine/story/0,11381,1180809,00.html

 

Sarah Boseley, health editor

Tuesday March 30, 2004

The Guardian

 

GPs know they are overprescribing antidepressant drugs such as Prozac and

Seroxat, but believe the lack of other forms of help for those suffering

from mild depression and stress leaves them no choice, a survey reveals today.

 

The survey shows that 80% of GPs believe they are writing too many

prescriptions for the SSRIs (selective serotonin reuptake inhibitors), as

the class of drugs made famous by Prozac is known.

 

The findings are alarming in the wake of a decision last week by US drug

regulators to demand a warning that some people might become suicidal on

them, and the decision last year by the British regulators to ban most of

them from use in children for the same reason.

 

Sales of Prozac, Seroxat, Lustral, Effexor and other drugs of the class

have boomed as mild to moderate depression, anxiety and stress have become

acceptable diseases of the late 20th and 21st centuries, linked to fast

lifestyles and taxing jobs.

 

They have mostly been handed out by GPs, rather than hospital consultants,

often in response to crises like marriage breakdowns, job loss and

bereavement. Last year 500,000 prescriptions were written for Seroxat alone.

 

According to the survey, commissioned by Norwich Union Healthcare and

carried out by the independent medical research company Dr Foster,

three-quarters of the 250 GPs who responded said they were prescribing more

antidepressants than five years ago.

 

They hand out the pills, they say, because the appropriate psychological

therapies or social care for those with mild to moderate depression are not

available.

 

There has been increasing public concern over the SSRIs. Many of those who

have taken them - often for years because the manufacturers say they are

safe for long-term use - have found it hard to come off them because of

distressing withdrawal effects, which include what patients describe as

electric shock sensations.

 

It has also been alleged that they can cause a small minority of people to

become suicidal or violent, particularly within the first few weeks, or

when the dose is changed.

 

In December, the government's Committee on the Safety of Medicines (CSM),

which advises the UK drug regulatory agency, told doctors not to prescribe

the SSRIs to children because clinical trials showed that more became

suicidal on the drugs than on the placebo. The exception was Prozac - the

only drug of the class licensed for children in the US.

 

Last week the US regulator, the Food and Drugs Administration, announced

that it would require all SSRI manufacturers to put warnings in the product

labelling that those taking the antidepressants might become suicidal. An

expert working group put together by the CSM is considering the issue in

the UK.

 

Richard Brook, chief executive of the mental health charity Mind, said the

survey " highlights an alarming trend that Mind has been tracing for some

years. It serves to reinforce our view that we need more effective

alternatives to antidepressants readily available across the NHS. "

 

He added: " Although many people have undoubtedly been helped by these

drugs, this survey is a clear indication of society's misplaced belief in

antidepressants as some sort of universal panacea. "