October 20, 2003

Crackdown on antidepressants given out 'like sweets'

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 depression.

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 The latter was recently withdrawn for people under 18 after it emerged that it had been linked to suicide.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 spasms.

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.