A letter in the Times: ‘Pills for depression’

On the 25th February 2018 the following letter was published in the Times. It was written by Professor David Baldwin, Chair of the Psychopharmacology Committee, and Professor Wendy Burn, the President of the Royal College of Psychiatrists:

On the 26th February I wrote to Professor Baldwin:

Dear Professor Baldwin,
I am an NHS Psychiatrist for older adults working in Scotland.

I noticed your letter in the Times. Would you mind if I asked you a few questions about this as I am interested to learn more about the evidence-base for long term prescribing of antidepressants.

I am interested in this as in Scotland we now have 1 in 7 adults on antidepressants and the majority are taking them either long term or indefinitely. Professor Ian C Reid, my friend and colleague, who is sadly no longer with us, used to describe this prescribing as “conservative”. Would you agree with Ian Reid, and can you provide the evidence, both in quantitative and qualitative terms, that supports such long term or indefinite prescribing? I am not aware of evidence that has established that 1 in 7 Scots live with chronic or recurrent major depressive disorder. I would be grateful if you could help me with this uncertainty of mine about available evidence.

Petitions have been raised in Scotland and in Wales in relation to antidepressant drug dependency and withdrawal. A large volume of evidence of experience has been submitted and I would suggest to you and Professor Wendy Burn that it is worth reading. I am sure that you will both agree that evidence comes in words and numbers, though neither can be said to fully represent experience:

Scottish petition

Welsh petition:

I would therefore also be grateful if you could share the references that support your conclusions in your Times letter on the potential for antidepressants to cause withdrawal syndromes.

Kind wishes,

Dr Peter J Gordon GMC 3468861
Writing in my own time

Professor Baldwin kindly replied that day, stating that “the best evidence to support long-term antidepressant prescribing (up to 2 years) comes from meta-analyses such as that reported by Geddes in 2003. The evidence for prescribing beyond 2 years is limited but the papers by Kupfer and colleagues describe beneficial effects up to 5 years.”

Professor Baldwin went on to state “as regards symptoms occurring after stopping antidepressants I described such symptoms with paroxetine and escitalopram (and the differences between the drugs) and have also described those symptoms with venlafaxine.”


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