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Twinned historic and present-day case reports

This is from Chapter 5 of  Thinking About Medicine – An Introduction to the Philosophy of Healthcare, by David Misselbrook:

TWINNED HISTORIC AND PRESENT-DAY CASE REPORTS

It was the mid-1990s when Alex came to see young Dr Finlay. Alex was 25 years old and complained of a low mood for several weeks. Dr Finlay assessed Alex as being mildly to moderately depressed. Dr Finlay had been impressed by authoritative evidence from the “Defeat Depression Campaign” run jointly by the College of General Practitioners and the Royal College of Psychiatrist which showed that doctors woefully under-treated depression, and ought to prescribe antidepressants more often [1]. Dr Finlay started Alex on one of the safe new non-addictive selective serotonin re-uptake inhibitor (SSRI) antidepressants, as well as arranging for Alex to see the practice counsellor in two weeks’ time.

It is the early 2020s and Robin, one of Alex’s adult children, developed a persistently low mood. Robin came to see Dr Finlay, now reaching the end of his career. Dr Finlay assessed Robin as being mildly to moderately depressed. Dr Finlay had been impressed by the evidence that antidepressants were of little value in mild to moderate depression, and were associated with many side effects, and the increasing concerns that doctors woefully over-medicated depression.[2,3,4] (Indeed, he remembered well the terrible withdrawal effects that Alex had after attempting to wean off SSRI antidepressants, and which he had initially put down to the recurrence of Alex’s depression.[5,6]) Dr Finlay was able to recommend various social prescribing options to Robin and to put Robin on the long waiting list to see the practice counsellor.

References:
[1] Impact of a national campaign on GP education: an evaluation of the Defeat Depression Campaign, British Journal of General Practice, February 1999
[2] Are antidepressants overprescribed? ,The BMJ, 2013;346:f191, 22 January 2013
[3] Methodological Flaws, Conflicts of Interest, and Scientific Fallacies: Implications for the Evaluation of Antidepressants’ Efficacy and Harm, Front Psychiatry, 2017
[4] Prophylactic effects or withdrawal reactions? An analysis of time-to-event data from antidepressant relapse prevention trials submitted to the FDA, Therapeutic Advances in Psychopharmacology, 10 August 2021
[5] What I have learnt from helping thousands of people taper off antidepressants and other psychotropic medications, Therapeutic Advances in Psychopharmacology, 16 March 2021
[6] Guidance for psychological therapists: information for GPs advising patients on antidepressant withdrawal, British Journal of General Practice, 2020
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