A response from the President of the Royal College of Psychiatrists

On the 16th June 2024, this letter on patient safety was sent to the President of the Royal College of Psychiatrists on behalf of a group of people who have suffered life changing harm from antidepressants.

Today, this reply was received from the President of the Royal College of Psychiatrists:

25 September 2024

Dear Dr Gordon

Thank you for your email dated 16 June on antidepressant prescribing. Please accept my apologies for the delayed reply, I receive a huge amount of correspondence, and the last few months has been particularly busy for me with clinical and College commitments.

I am sorry to hear about the experiences you, and those you are writing on behalf of, have had with stopping antidepressants.

This is a matter the College has taken a lead role in raising awareness about over recent years. I therefore disagree with your view that the psychiatric profession and College has a defensive culture, does not prioritise patient safety and chooses to spin evidence about this issue.

We recognised the need for a greater focus on safely stopping antidepressants in our 2019 position statement, and as you note, subsequently published a patient resource to provide information about the risk of withdrawal and how to reduce or avoid these symptoms. This is the first of its kind to be produced by a professional medical organisation in the UK or internationally and has recently been updated. There are also many examples of College statements and public comments which highlight the importance of gradually stopping antidepressants.

You specifically raise concerns about the study published in the Lancet on 5 June by Henssler et al, the subsequent Guardian article by Professor Pariante, and mine and others’ public responses to these. I think it is important to reflect on how the academic uncertainty and debate about the incidence of antidepressant withdrawal has led to significant media and public discourse over the last few years. This has at times lacked balance, risks undermining the important role of antidepressants as a recommended treatment option and may instil a sense of fear about their use. These are concerns the College rightly challenges and that is why I chose to highlight the research study and Guardian article. That does not imply a change in position of the College but is a recognition that there remains an uncertainty about the incidence of antidepressant withdrawal.

I also do not agree it is misleading to have publicly highlighted the research on the basis that there are criticisms of the study methodology, which is a normal occurrence with the publication of new research, particularly in areas where there is a lack of high-quality data. It is of note that in response to the 2019 study on antidepressant withdrawal by Davies and Read – which concluded that the incidence of withdrawal is significantly higher than that found in the research by Henssler et al, and which has also faced criticism of its methodology – the College publicly commented on this recognising that for many people the withdrawal effects can be severe, particularly when antidepressants are stopped abruptly.

You ask in your email that the College makes a statement on how it will support individuals who have been prescribed antidepressants. The 2019 College position statement I mentioned previously already recommends a range of actions to promote optimal use and management of antidepressants and calls for support services for patients affected by more severe and prolonged antidepressant withdrawal, modelled on existing best practice.

Finally, you also suggested the College could address language used by members in relation to individuals sharing their personal experiences. I assume this relates to social media use, for which we do not have a remit to monitor or regulate individual College members activity. We have, however, a social media policy which provides guidance on this matter, and I can assure you that I expect those speaking on behalf of the College, who are currently in an elected or appointed role, to do so in a respectful manner, in line with our College values.

Finally, I am sure that we all agree that the incidence and prevalence of depression across the world, and the inadequate provision of the range of treatment options that we know are effective, is an area we should be focusing on. I hope that you support this view.

Thank you again for taking the time to write to me.

Yours sincerely
Dr Lade Smith

Our reply to the President can be read here or by clicking on the image below: