This Editorial can be openly accessed from the Journal of Psychotherapy and Psychosomatics.
It begins:
One of the commonest stories encountered in psychiatric practice is a patient reporting that their withdrawal symptoms after stopping an antidepressant were misdiagnosed by a clinician as either a relapse of a previously diagnosed mental health condition or as heralding the onset of a new mental or physical health condition [1]. We found this theme recurring repeatedly in petitions submitted to Scottish and Welsh parliaments by patients detailing their experiences of antidepressant withdrawal [1], as well as in surveys administered to the tens of thousands of people on online peer support forums, established to assist with antidepressant withdrawal [2‒4].
Despite this real world, widely held experience, which is evidence in itself, the UK and Scottish Governments, and the Royal Colleges, have chosen to prioritise decisions and actions based on short-term studies, largely devised, overseen and generally ghost-written by the pharmaceutical industry.
1 in 5 adults in the UK [for Scotland, this is 1 in 4 ] are now taking an antidepressant. This is mass prescribing. As a result, just about every family has experience, directly or indirectly, of antidepressants. Experiences of such treatment will range widely between good and bad. We should respect all such experience. I certainly do.
I worked as an NHS psychiatrist for over 25 years. Over the same period of time I have had personal experience of taking an antidepressant [in my case it was prescribed for anxiety]. My personal experience was to find that I could not stop [“discontinue”] my antidepressant. However slowly I tried, I experienced hellish physical and mental symptoms which were far worse than my initial ‘presenting symptoms’ to my GP.
When I shared with my colleagues in psychiatry my experience[s] of trying to “discontinue” my SSRI, they were all kind to me but almost without exception politely replied using language that gently implied that I had “relapsed”. It did not seem to matter that my symptoms of withdrawal were markedly different from the symptoms of anxiety that I had initially presented with. I have since wondered if this somehow represented another form of stigma: iatrogenic stigma?
The Editorial by Horowitz and Davies concludes:
Please note: I have previously shared on hole ousia my concerns in relation to the approach, design, methodology, reporting and conclusions of the ANTLER and REDUCE trials. The interpretation of these studies should be cautious.
An old post on hole ousia:
This article was published 30 years ago, at the time of the Defeat Depression Campaign:
What Price Depression? This is an important question. Please click on each image to play a different short film
