On the 9th May 2018 Michelle Ballantyne, MSP, raised the important issue of antidepressant overuse in the Scottish Parliament:
This was the first part of the response made by the Minister for Mental Health:
As an NHS doctor who has worked as a psychiatrist in Scotland for over 25 years I am not reassured by this response by the Minister for Mental Health. I have highlighted three aspects of this response which I wish to briefly consider:
CLINICAL DECISION:
I agree that prescribing should follow the principles of informed consent and shared decision making. However informed consent will not be possible if the information that doctors base prescribing on follows marketing and promotion rather than independent, and more objective, continuing medical education. The Scottish Government has consulted the public on the need for mandatory declarations of financial competing interests for doctors and academics in an open, central register. The public made it clear that this was what they felt was necessary. More than two years on from this consultation and there is no such system ensuring the transparency that is necessary for informed decision making between clinician and patient.
GOOD EVIDENCE:
Where is the “good evidence” to support the prescribing of antidepressants to 1 in 7 Scots, a significant proportion of whom are taking antidepressants long term or indefinitely? I have, like others, asked the Scottish Government to provide this “good evidence” but have been provided with no evidence to support such mass prescribing of long term antidepressants.
APPROPRIATELY:
Currently there is a petition being considered by the Scottish Parliament in relation to potential problems with prescribed medications. This has highlighted that an important aspect which should determine the “appropriateness” of prescribing, namely the experience of people who are taking medications, has not been given the weight that it should.