Doctors 'forced' to overprescribe antidepressants

By Sarah Bosely

GPs know they are overprescribing antidepressant drugs such as Prozac and Seroxat, but believe the lack of other forms of help for those suffering from mild depression and stress leaves them no choice, a survey reveals today.

The survey shows that 80% of GPs believe they are writing too many prescriptions for the SSRIs (selective serotonin reuptake inhibitors), as the class of drugs made famous by Prozac is known.

The findings are alarming in the wake of a decision last week by US drug regulators to demand a warning that some people might become suicidal on them, and the decision last year by the British regulators to ban most of them from use in children for the same reason.

Sales of Prozac, Seroxat, Lustral, Effexor and other drugs of the class have boomed as mild to moderate depression, anxiety and stress have become acceptable diseases of the late 20th and 21st centuries, linked to fast lifestyles and taxing jobs. They have mostly been handed out by GPs, rather than hospital consultants, often in response to crises like marriage breakdowns, job loss and bereavement. Last year 500,000 prescriptions were written for Seroxat alone.

According to the survey, commissioned by Norwich Union Healthcare and carried out by the independent medical research company Dr Foster, three-quarters of the 250 GPs who responded said they were prescribing more antidepressants than five years ago.

They hand out the pills, they say, because the appropriate psychological therapies or social care for those with mild to moderate depression are not available.

There has been increasing public concern over the SSRIs. Many of those who have taken them - often for years because the manufacturers say they are safe for long-term use - have found it hard to come off them because of distressing withdrawal effects, which include what patients describe as electric shock sensations. It has also been alleged that they can cause a small minority of people to become suicidal or violent, particularly within the first few weeks, or when the dose is changed.

In December, the government's Committee on the Safety of Medicines (CSM), which advises the UK drug regulatory agency, told doctors not to prescribe the SSRIs to children because clinical trials showed that more became suicidal on the drugs than on the placebo. The exception was Prozac - the only drug of the class licensed for children in the US.
Last week the US regulator, the Food and Drugs Administration, announced that it would require all SSRI manufacturers to put warnings in the product labelling that those taking the antidepressants might become suicidal. An expert working group put together by the CSM is considering the issue in the UK.

Richard Brook, chief executive of the mental health charity "Mind", said the survey "highlights an alarming trend that "Mind" has been tracing for some years. It serves to reinforce our view that we need more effective alternatives to antidepressants readily available across the NHS." He added: "Although many people have undoubtedly been helped by these drugs, this survey is a clear indication of society's misplaced belief in antidepressants as some sort of universal panacea."


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