BRITAIN is becoming a
nation kept artificially happy by pills, with doctors handing
out eight million more prescriptions for depression, anxiety
and stress than five years ago.
About two million people are estimated to be taking
antidepressants every year, costing the NHS £380 million,
according to government figures. Amid fears that doctors are
prescribing drugs for the normal problems of life, The
Times has learnt that the Government is to advise them
that antidepressants should no longer be used as a first-line
treatment in such cases.
Recent trials showed almost no clinical difference between
antidepressants and placebos in the treatment of mild
Department of Health statistics show that the number of
prescriptions for all types of antidepressants in England rose
from 10.8 million in 1993 to 26.6 million last year. Over that
period the health service increased spending on the drugs from
£100 million to £381 million.
Almost all the increase has been in a new class of
antidepressants known as SSRIs, which include Prozac and
Seroxat. In 1992, 500,000 prescriptions were made for SSRIs.
Last year the figure was 15 million.
Mental health experts say that the rise is partly because
of an increased awareness of depression among GPs and waits of
up to a year for counselling services, which could be offered
as an alternative.
However, there are also concerns that antidepressants have
become lifestyle drugs, promoted by the media, and handed out
“like sweets” to patients. The antidepressant Zispin was made
available this month in an orange-flavoured version that melts
in the mouth.
Many patients are also unaware of the potential
side-effects of such “wonder drugs” as Prozac and Seroxat. The
latter was recently withdrawn for people under 18 after it
emerged that it had been linked to suicide. The listed
side-effects of Prozac include nausea, diarrhoea and muscle
Andrew McCulloch, head of the Mental Health Foundation,
said that SSRIs were better than the previous generation of
antidepressants but still needed to be treated with care.
“There is no doubt that we are reaching many more people
suffering from depression than we did before, and that is a
very good thing,” he said.
“But on the negative side some GPs are becoming trigger
happy and giving patients a prescription to make them go away.
There is a danger that if people think a pill is the solution
they will not tackle real underlying problems which could be
better treated by something like cognitive behavioural
therapy.” The National Institute for Clinical Excellence, the
government agency that decides which drugs should be available
on the NHS, says in new recommendations that people with mild
depression often respond to simple interventions, such as
exercise or self-help.
It concludes that antidepressant drugs be used only when
simpler methods have failed to produce an adequate response.