GPs should wean patients off antidepressants to ease withdrawal symptoms and help reduce the millions reliant on the drugs, new guidelines suggest.
NHS watchdog Nice said adults who wanted to stop taking antidepressants should have doses reduced in stages, as opposed to going ‘cold turkey’.
Experts hope that easing people off the pills over time will cut the severity of withdrawal symptoms, helping more people to quit them successfully.
But charities are worried family doctors are not equipped to taper individuals’ medications and urged fewer prescriptions to begin with.
GPs should wean patients off antidepressants to ease withdrawal symptoms and help reduce the millions reliant on the drugs, new guidelines suggest
The changes come as record numbers of antidepressants are being dished out. In 2021-22, an estimated 8.3 million patients received an antidepressant drug – up on the previous year’s 7.9 million
How do antidepressants work?
It’s not known exactly how antidepressants work.
It’s thought they work by increasing levels of chemicals in the brain called neurotransmitters, which are linked to mood and emotion.
While antidepressants can treat the symptoms of depression, they do not always address its causes.
So they are usually used in combination with therapy to treat more severe depression or other mental health conditions.
Research suggests that antidepressants can be helpful for people with moderate or severe depression.
Studies have shown that they’re better than placebo for people with these conditions.
They’re not usually recommended for mild depression, unless other treatments like therapy have not helped.
The Royal College of Psychiatrists estimates that 50 to 65 per cent of people treated with an antidepressant for depression will see an improvement, compared to 25 to 30 per cent of those taking a placebo.
The changes come as NHS data shows record numbers of pills are being dished out, with prescriptions of antidepressants rising by 5.1 per cent in 2021/2022 – the sixth consecutive annual increase.
Official figures show some 21.4million antidepressant drugs items were prescribed between July and September 2022 alone.
Under the new draft guidelines, patients who wish to come off the drugs permanently should first agree with their doctor whether it is right to stop taking the medication, then the speed and duration of withdrawal from it.
Any withdrawal symptoms need to have been resolved, or to be tolerable, before making the next dose reduction, according to the panel of experts.
The quality standard, which sets out priority areas for quality improvement for the care of adults with depression, said more should be done to support ethnic minorities to access mental health services.
Just 11.9 per cent of people from mixed, Black, Black British, Asian or Asian British family backgrounds completed a course of treatment for depression compared with 79.9 per cent of people from a white family background, it said.
Dr Paul Chrisp, of Nice, said millions of people were taking antidepressants and it was vital those who want to stop taking the medication should be helped by their GP or mental health team.
He said: ‘It should be stressed there is no one size fits all approach to coming off antidepressants.
‘The way it should be done has to be down to the individual and their healthcare professional, to agree a way which it can work and only when side-effects can be safely managed.’
The Daily Mail has long campaigned to raise awareness about overprescribing, warning that patients were often unwittingly being led into prescription medicine dependency.
Antidepressants, which include common brands such as Prozac, Cipramil and Seroxat, are proven to be an effective way of treating moderate to severe depression.
But research from charities has found many patients are left in the dark about the side effects of antidepressants and other psychiatric treatments.
In 2019, the watchdog changed its guidelines to acknowledge that for some, ‘severe’ side effects of coming off antidepressants can last ‘months or more’ with symptoms such as confusion, anxiety, sweating, sleep problems and ‘altered feelings’.
Mental health charity Mind welcomed the new guidelines, which it hopes will ‘provide a focus for improvement in this area’. But the charity said GPs would need help to deliver it, as there is no mandatory practice-based training in mental health, despite an estimated 40 per cent of all appointments involving the issue.
Stephen Buckley, Head of Information at Mind, said: ‘Unfortunately, we know that the vast majority of GPs don’t feel they really have the skills to help people taper their medicines.
‘As such GPs will need to receive proper support, resource and training to effectively help patients to do this.
‘It’s also important that patients are given enough information when they’re first prescribed medication, so that they understand the length of time for which they may be being prescribed them, or the potential difficulties they might face to stop taking them down the line.’
Professor Kamila Hawthorne, Chair of the Royal College of GPs, said antidepressants can be an effective treatment when prescribed appropriately, but most patients should not have to rely on medication long term.
She said: ‘More generally, what we do need to see improved is access to alternative mental health treatments in the community right across the country – and for staffing in general practice to be addressed, including increasing numbers of mental health therapists.’