Mass prescribing

Why in the UK do we have mass prescribing of antidepressants?  Nearly 1 in 5 adults are now taking an antidepressant. It is now being asked if this is a consequence of the 1990s Defeat Depression Campaign? UK prescribing rates of antidepressants have long passed the 1 in 20 prevalence on which the Defeat Depression Campaign was based.

In terms of current prescribing rates, 3 areas of this historical campaign are particularly relevant:

  1. The Defeat Depression Campaign reassured patients and prescribers that antidepressants did not result in dependence/withdrawal. There was very little evidence on which to base this reassurance and the pharmaceutical industry was very heavily involved in supporting the campaign.
  2. The Defeat Depression Campaign, both directly and indirectly, encouraged the use of screening tools to identify cases of depression
  3. The Defeat Depression Campaign was based on Guidelines that advocated prophylactic use of antidepressants to prevent relapse [long-term treatment/maintenance treatment] . Yet there was little evidence provided to support this use [in other words, this was a non-evidenced-based  recommendation].

This matters now because:

[1] Many people are now finding it difficult to stop their antidepressants due to physiological dependence.

[2] The scale of harm that is emerging as a consequence of medication ‘taken as prescribed’

[2] Concern that history may repeat itself in current/future “educational campaigns”.

Vanessa Cameron was the Chief Executive Officer for the Royal College of Psychiatrists for nearly 4 decades. She offered [the following] candid reflection on her retirement in 2016. Her full reflection was published in the Psychiatric Bulletin and can be read in full here.

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