“Villains and Demonisers”

Almost a decade ago, one of the advisors to the Scottish Government on prescribing of antidepressants stated that it was the general public and their “distaste” for antidepressants that were the “real villains”. It was statements like this, from well-meaning colleagues, that led me to write this article, which I called “Window Tax”

Almost ten years on, and the Current Chair of Royal College of Psychiatrists in Scotland, when referring to antidepressant prescribing, describes those who ask questions about this in terms of “demonising”:

For two decades now I have been asking what duration of antidepressant treatment is “appropriate”, being increasingly aware that many of the 1 in 7 who are now estimated to be taking antidepressants in Scotland, are in fact taking them indefinitely.

I do hope that it is not the case that I am considered a “villain” or “demoniser” for having asked this question. This is a question I have put to two (of the five) authors for this 2014 “Key Information” report but they were unable to give an answer:

The above “Key Information” report was cited by the Minister for Mental Health in a recent parliamentary evidence session on PE1651. The Minister for Mental Health stated this:

I have been aware of the paucity and lack of quality of studies into long-term prescribing of antidepressants. This is a recent comment on social media by Dr Ben Goldacre:

“I’ve been thinking and reading RCTs on stopping long-term antidepressants. Look at this bizarre review paper from the FDA. They present results of 15 trials. But the names of the drugs in each are kept secret. This passes without comment. What a world.”

Dr Goldacre continued: “I mean really, look. Do the names of the antidepressants in these trials really need to be kept secret? Who is that helping? Leaves dr’s and researchers uninformed, makes medicine – and industry, regulators – look stupidly secretive. For goodness sake.”

This was the published research that Dr Goldacre was referring to:

In summary:

If patients are to be given “fully informed consent” they need to be told that there is a reasonable chance that they may end up taking antidepressants indefinitely and that the evidence base for this is at best limited. Those who have sought to ask reasonable questions about this have been dismissed in negative terms (as above). It is essential that the experience of those taking antidepressants indefinitely should not be dismissed in the same way.

[the following is a recent letter to the Scotsman]