Hooked on antidepressants?

Are doctors over prescribing antidepressants?

Daily Telegraph

Antidepressants have kept me happy for years

Prof Peter Gøtzsche, who spends his life trying to expose medical myths - he also thinks that we shouldn't screen women over 50 for breast cancer - yesterday launched the Council for Evidence Based Psychiatry (CEP). Its first task? To tell the world that antidepressants do more harm than good.

Prof Gøtzsche has found that they are being prescribed to people who are only "mildly depressed" (is being mildly depressed a bit like being slightly pregnant?) and that they are handed out for matters as trivial as exam stress, marital breakdown and post-flu fatigue.

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Are antidepressants being prescribed in too large amounts?

By Joe Harker

"A nation hooked on happy pills" screams Friday's Daily Mail headline, reporting that the dosage of antidepressants prescribed is now triple what it was 15 years ago. They also report the UK takes twice as many pills as France or Italy and quote experts who say that people are looking for a quick fix. The UK's rate of consumption for antidepressants is 94.2 per 1000 people, up from 37.6 at the turn of the millennium.

However, part of this can be put down to increased patient awareness and an increased willingness to ask for medical help. Professor Carmine Pariante of King's College London believes that the increased usage of antidepressants can be seen as both good and bad depending on the reason why a person would take them. He said: "People are asking for anti-depressants in situations where perhaps a few years ago they would just wait.

"There are people receiving anti-depressants who ten years ago would not have asked for help and these are medications that can turn their lives around, so it's good that more of them are being used. But there's also more people asking for anti-depressants as a quick fix because either they're not used to feeling sad or less able to tolerate it, or we don't have the resources or social support to get through difficult times."

Over prescribing medication, or prescribing it when a patient would be better off with a different course of treatment could lead to problems. The Royal College of Psychiatry believes that antidepressants are not addictive because you do not have to increase your dosage to receive the same effect and because cravings do not develop after a patient stops taking the drug. However, their own survey found that 63 per cent of people had withdrawal symptoms when they stopped taking the drugs.

Professor Peter Gøtzsche of the Nordic Cochrane argues that half of people who take antidepressants become addicted. He suggests that doctors can mistake withdrawal symptoms for the return of depression, leading them to put the patient back on a course of antidepressants and potentially taking them indefinitely.

Writing in The Independent, Rachel Whitehead suggests that the language being used to talk about medication for mental health is demonising what is an important part of treatment for some people. The use of words such as "hooked" to describe someone taking their prescribed medication is giving the wrong impression and is the wrong way to look at an increase in prescriptions. She wrote: "Take a look at almost any media coverage about antidepressants or antipsychotics and you'll often find this kind of language creeping in.

"The language used in the media around this is very telling. There is a clear dividing line between those who simply 'take' medication, such as people with diabetes, and those who are 'hooked' on it - people with mental health problems."

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The Times

Why Britain is hooked on happy pills

Two important books on psychiatry will be published later this month. One is the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders ( DSM-5, to use the shorthand). DSM-5 is produced by the American Psychiatric Association. First published in 1952, by way of an attempt to standardise previously inconsistent diagnoses of various conditions, the DSM has since become the bible of the psychiatric profession across the world.

The other book is called Cracked. If, in the world of psychiatry, the DSM is Holy Scripture, Cracked is set to become a heretical text.

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