Position Statement on Radio 4: “a very small number”

On the 30th May 2019 the Royal College of Psychiatrists published this Position Statement:

The Registrar of the Royal College of Psychiatrists, Dr Adrian James, was a guest on the Today show on Radio 4. It is interesting to compare what was said in this radio interview with the position statement itself:

John Humphrys: “Pills to deal with depression can have severe side effects and doctors should warn their patients about them, that is what the Royal College of Psychiatrists will say today. It could severely cut the use of pills and many people would say about time too. Well Dr Adrian James is the Registrar of the Royal College of Psychiatrists. Good morning to you.”

Dr Adrian James: “Good morning”

John Humphrys: “Eh, what should be done therefore?”

Dr Adrian James: “Uh, well the really important thing John is that depression is a really serious condition, uh it causes a great deal of distress and suffering it really can effect people’s lives, their work, their families, and it is very important that they seek treatment for depression and there are effective treatments, and for more mild depression normally that is psychological treatments but for the more severe types of depression antidepressants are very effective often in combination with psychological treatments.”

John Humphrys: “But they do have, or can have, very severe side effects”

Dr Adrian James: “Well like all drugs eh there are side effects, and it’s absolutely . . .” [interrupted by interviewer]

John Humphrys: “. . . well you can become addicted to them that is the point isn’t it?”

Dr Adrian James: “eh, the, the majority of people will have either mild side effects or they will be self-limiting. And the purpose of the our, em, the thing that we published today, uh was that we didn’t think sufficient emphasis had been placed on some patients, a very small number, who had more severe withdrawal effects over a longer period of time. And we are saying that there should be more opportunity to discuss that with their doctors; look at things like tapering over a short period of time, that is gradually reducing the dose, and so that there is an honest debate and that there is an honest discussion with patients.”

John Humphrys: “Because we do hear increasingly don’t we of people, Sarah Vine for instance the columnist in the, eh, Daily Mail has written very powerfully about the effects on the drugs on her and she has not been able to give them up.”

Dr Adrian James: “Uh well, we do know that some people are on antidepressants for a long time, eh, that is sometimes very necessary. We also hear reports also in the press about people who have intractable depression, or depression that goes on for which they require antidepressants so, and eh depression is a really serious condition and it is treatable. Some people will need treatment over a long period of time, but like all medications there will be some people who will have side effects and absolutely you should have that discussion with your doctor.”

John Humphrys: “But is it possible that too many doctors, not all of course, but too many doctors are prescribing them when perhaps they shouldn’t be. I am looking at the statistics: there has been an enormous rise in the prescription of medication – 36 million eh, to 70 million last year. I mean that is a significant increase isn’t it.”

Dr Adrian James: “Eh there has been an increase ah, but the evidence shows that only about a third of people who could benefit from evidence-based treatments for mental health as a whole actually get those treatments. So, the real story here is that there is still not enough access to treatments – so I think patients want a range of treatments, they want choice – and what has often been missing has been the alternatives, so things like psychological therapies, now hey have increased a lot and that is a very positive thing. But we actually need a massive investment in mental health, we have had some investment and that is very good, but this is the start of a journey. So we need a range of options but actually we need doctors to talk to patients about side effects, the risks and the benefits, but I would not want anybody to be discouraged from taking antidepressants because depression is serious, anybody who has experienced depression will know that, and antidepressants are effective. But yes we do need to have an honest discussion about side effects.”

John Humphrys: “Dr Adrian James thank you very much”

[I do not believe that there are any errors in this transcription, but if there are, they are mine]

One Reply to “Position Statement on Radio 4: “a very small number””

  1. “…it is very important that they (patients) seek treatment for depression.”
    “…depression is a really serious condition.”
    “…there are effective treatments.”
    “…antidepressants are very effective.”
    “…with all drugs there are side effects.”
    “…the majority of people will have either mild side effects or they will be self-limiting.”
    “…we do know that some people are on antidepressants for a long time, that is sometimes very necessary
    depression is a really serious condition and it is treatable.”
    “…evidence shows that only about a third of people who could benefit from evidence-based treatments for mental health as a whole actually get those treatments.”
    “…the real story here is that there is still not enough access to treatments.”
    “…patients want a range of treatments.”
    “…we actually need a massive investment in mental health.”
    “…I would not want anybody to be discouraged from taking antidepressants because depression is serious
    antidepressants are effective.”

    So good to hear him tackling the issue about the pain and suffering caused by the brain pellets.

    As I said in my recent blog post. The new position of the college is total spin. It’s an opportunity to talk about how people need brain pellets.

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