Antidepressant Use Doubles in UK in Past Decade, Even Greater Increase Last Year

But tonight doctors warned that some people are being
put on the drugs unnecessarily, especially those with milder symptoms of
depression, partly because there is too little access to “talking therapies”,
which use discussion rather than drugs to tackle problems.

“I’m concerned that too many people are being
prescribed antidepressants and not being given counselling and cognitive
behaviour therapy, because access to those therapies, while it is improving, is
still patchy,” said Professor Steve Field, the chairman of the Royal College of
General Practitioners, which represents the UK‘s family doctors.

“More people are being diagnosed with depression, but
many of them would be treated better by having access to talking therapies,
especially those with mild to moderate depression. I’m concerned that these
people are being treated with medication unnecessarily,” he added.

GPs felt “cornered” into giving patients
antidepressants because of a lack of alternatives, he said.

“Talking therapies are just a good [as medication]
for treating mild depression, and CBT can be just as good for more serious
depression. But the provision for these therapies hasn’t been good,” said Field.
However, more GPs were gaining more of a choice between tablets and talking
treatments, he said.

Antidepressant use rises as recession feeds wave of worry

Prescriptions have doubled in decade,
NHS figures show, with doctors warning drugs are covering for counselling
shortage

Seroxat antidepressant pills.
Seroxat [Paxil] antidepressant pills.
Photograph: Jack Sullivan/Alamy

The number of antidepressants prescribed by the NHS
has almost doubled in the last decade, and rose sharply last year as the
recession bit, figures reveal.

The health service issued 39.1m prescriptions for drugs to tackle depression in England in 2009, compared
with 20.1m in 1999 – a 95% jump. Doctors handed out 3.18m more prescriptions
last year than in 2008, almost twice the annual rise seen in preceding years,
according to previously unpublished statistics released by the NHS’s Business
Services Authority.

The increase is thought to be due in part to improved
diagnosis, reduced stigma around mental ill-health and rising worries about jobs
and finances triggered by the economic downturn.

But tonight doctors warned that some people are being
put on the drugs unnecessarily, especially those with milder symptoms of
depression, partly because there is too little access to “talking therapies”,
which use discussion rather than drugs to tackle problems.

“I’m concerned that too many people are being
prescribed antidepressants and not being given counselling and cognitive
behaviour therapy, because access to those therapies, while it is improving, is
still patchy,” said Professor Steve Field, the chairman of the Royal College of
General Practitioners, which represents the UK‘s family doctors.

“More people are being diagnosed with depression, but
many of them would be treated better by having access to talking therapies,
especially those with mild to moderate depression. I’m concerned that these
people are being treated with medication unnecessarily,” he added.

GPs felt “cornered” into giving patients
antidepressants because of a lack of alternatives, he said.

“Talking therapies are just a good [as medication]
for treating mild depression, and CBT can be just as good for more serious
depression. But the provision for these therapies hasn’t been good,” said Field.
However, more GPs were gaining more of a choice between tablets and talking
treatments, he said.

Peter Byrne, the director of public education at the
Royal College of Psychiatrists, whose 12,450 members include the UK‘s 6,300
consultant psychiatrists, echoed Field’s concern. It said it was unsurprising
that prescriptions were rising after a decade of investment in mental health services. “The optimistic view is that
more people are being uncovered and treated. My concern is that people with mild
depression should not be put on antidepressants,” he said.

Consultant psychiatrist Tim Kendall, director of the
National Collaborating Centre for Mental Health, which drafts NHS guidance on
the drugs, said: “Antidepressants are offered too frequently in primary care
because the waiting lists for alternative treatments are too long. Doctors need
to think hard about putting people on these drugs because they can be hard to
get off and have significant side-effects.”

The NHS does not record how many people take
antidepressants, but up to one in six people suffers from some form of
depression during their life. The recession has produced greater demand for NHS
help with mental health problems.

In 2009 all of us – whether we work in general
practice, general hospitals or specialist services – are seeing an increase in

referrals from the recession. The stresses of the downturn are the last straw
for many people,” said Byrne.

The Labour government invested hundreds of millions
of pounds in “talking therapies”, in an effort to help jobless people with
chronic problems get back into work and couples negotiate relationship
difficulties. The Lib-Con coalition has promised to continue prioritising such
treatments. But Byrne disputed claims about long waiting times.

The falling cost of antidepressants may have an
effect. Ten years ago each prescription cost £16, but this has fallen to just £6
today, which means the NHS spend has fallen, from £315m in 1999 to £230m last

year.

Dr Hugh Griffiths, the government’s mental health
tsar, said that while the causes of, and risk factors for, depression were
complex “the recession can have an impact. A rise in prescriptions might also
reflect a greater awareness and willingness to seek support and better diagnosis
by GPs”.

“Psychological therapies, which can be offered
alongside or as an alternative to medication, provide choice in treatment. We
are closely looking at how we can improve access”, said Griffiths.

A survey in March for the mental health charity Mind,
which asked people if they had sought help for work-related stress since the
downturn began, found 7% had begun medical treatment for depression and 5% had
started counselling.

A spokeswoman for Mind, Alison Cobb, said the fact
antidepressants are now licensed for use in a wider range of conditions, such as
social anxiety and post traumatic stress, was also a
factor.

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PROZAC: Young Woman Dreams of Committing Suicide: Illinois

NOTE FROM Ann Blake-Tracy (www.drugawareness.org):

This young woman has NO IDEA how lucky she is! What she is
describing here in dreaming about various ways of killing herself after starting
on Prozac is the beginning of the REM Sleep Behavior Disorder or RBD – a
condition that was not very common before Prozac hit the market.
RBD is a condition in which 86% of those being diagnosed with
it are taking an antidepressant. It is a condition in which people act out their
nightmares and 80% of those hurt themselves or someone else in doing
so.
__________________________________
Paragraphs 13 and 14 read:  “One antidepressant user, who
asked that her name be withheld, said when she sought help for what she
considered to be minor depression, doctors immediately told her drugs
were the answer.
‘They made it seem like my world was falling
apart,’  the 29-year-old said.  ‘They really pushed hard for me to
take drugs, and
I didn’t want to, but they made me think
I really needed it. So I took them’.”

“She said that after a

few weeks on Prozac, she felt numb then started having
dangerous thoughts. ‘I became emotionless.  Like,
things that should’ve made me happy, I was not excited about. Things that should
have made me sad didn’t upset me. I started dreaming about driving my car
into a wall.’
She said that according to her doctor, these were
all symptoms of her depression, but
she thinks it was
the drugs.”

http://news.medill.northwestern.edu/chicago/news.aspx?id=154761

Researchers say that antidepressants are no more effective than placebo
in cases of mild or moderate depression.

Depressing truth about antidepressants

by Tina
Amirkiai

Jan 27, 2010

If you are one of the millions of people taking
antidepressants for mild depression symptoms, you might as well be taking a
placebo.

A study released by a team of researchers led by Jay C.
Fournier, of the Department of Psychology at the University of Pennsylvania,
found that the most commonly prescribed antidepressants do little for mild to
moderate symptoms of depression, having the same results as a placebo.

The study, published in the Jan.6 edition of the Journal of the American
Medical Association, combining previous studies with research from new clinical
trials, concluded, “There is little evidence to suggest that [antidepressants]
produce specific pharmacological benefit for the majority of patients with less
severe acute depressions.”

Dr. Paul Dobransky, a Chicago psychiatrist,
believes professionals need to look closely at each individual patient’s
symptoms and carefully diagnose the best treatment. He said there are three
angles that must be looked at when it comes to mood disorders, which he referred
to as the “bio-psycho-social” aspects.

“The biological or physical
symptoms of mood disorders are where medications are often useful,” he said.
“They cannot however, alter one’s character, personality or fix any external or
social stress the patient might be dealing with.”

Researchers used a
severity scale to evaluate the level of depression symptoms in the hundreds of

clinical trial patients, which ultimately helped determine that the
antidepressants were most effective for those with more severe disorders.

Researchers evaluated the 728 men and women, half of them had severe
depression and the other half had more moderate symptoms. They found that
compared to the placebos, the drugs caused a much steeper reduction of symptoms
in people who scored higher on the severity scale.

Researchers concluded
that, “For patients with very severe depression, the benefit of the medications
over placebo is substantial.”

Dobransky and other critics maintain that
the drug companies should be held accountable for all the advertising and sales
hype in recent years, leading directly to the overuse of drugs like
antidepressants.

In 1997, the Food and Drug Administration loosened the
restrictions on the direct-to-consumer advertising by drug companies. Since
then, pharmaceutical companies have spent billions of dollars advertising their
products to the general public.

Dobransky said a big part of the problem
is patients see advertisements and want to use these drugs as a quick fix.
According to him, patients often assume that mild cases of depression involving
stressful situational causes can be resolved with medicine. But he said quick
fixes like that do not exist.

“Each case needs to be set in its proper
place and in many of these cases, therapy between the patient and their doctor
is the best solution,” Dobransky said.

One antidepressant user, who
asked that her name be withheld, said when she sought help for what she
considered to be minor depression, doctors immediately told her drugs were the
answer. “They made it seem like my world was falling apart,” the 29-year-old
said. “They really pushed hard for me to take drugs, and I didn’t want to, but
they made me think I really needed it. So I took them.”

She said that
after a few weeks on Prozac, she felt numb then started having dangerous
thoughts. “I became emotionless.  Like, things that should’ve made me
happy, I was not excited about. Things that should have made me sad didn’t upset
me. I started dreaming about driving my car into a wall.” She said that
according to her doctor, these were all symptoms of her depression, but she
thinks it was the drugs.

“I just felt like instead of my doctor doing
her job as a therapist, she looked to some drug to cure me, which is
ridiculous,” she said. “It’s basically a quick fix, it solves nothing, and in my
case turned mild symptoms into severe ones.”

A spokesman for
GlaxoSmithKline, who makes paroxetine, sold as Paxil, told Bloomberg News that
“the study used for the analysis in the JAMA paper differ methodologically from
studies used to support the approval of paroxetine for major depressive
disorder, so it is difficult to make direct comparisons between the study
results.”

If you think you might be depressed, the Depression Health
Center on the WebMD Web site advises relying on licensed professionals trained
to treat depression who can help you chose the best course of treatment, which
may or may not include antidepressant drugs.
Dashed line

©2001 – 2009 Medill Reports – Chicago, Northwestern
University.  A publication of the Medill
School
.

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