Antidepressants: Two million taking them for five years or more

More than a quarter of people in the UK taking antidepressants (about 2 million people) have been on antidepressants for five years, the BBC has revealed.

This is despite limited evidence showing the benefit of taking the drug during that period.

A doctor who runs an NHS clinic that helps people quit drugs says withdrawal symptoms make it difficult for some people to stop taking them.

Withdrawal guidance was updated in 2019, but little has changed.

More than 8 million people in the UK are taking antidepressants, which are prescribed for conditions such as depression, anxiety and obsessive-compulsive disorder. This is 1 million more than five years ago. As NHS Prescription Figures Show.

New figures for long-term use from 2018 to 2022 were provided to BBC Panorama by the NHS following a freedom of information request. While this data provides a picture of the whole picture, it does not reflect the individual patient situation, and some patients may be on antidepressants for long periods of time for legitimate reasons.

The investigation also uncovered evidence that 27 years ago, big pharmaceutical companies tried to cover up the withdrawal effects that certain drugs could cause.

Modern antidepressants called SSRIs (selective serotonin reuptake inhibitors) have been around since the late 1980s, including Prozac. They quickly emerged as silver bullets compared to previous treatments, some of which had serious side effects.

They were thought to treat depression by restoring imbalances in the mood-regulating chemical serotonin in the brain. Researchers are not yet clear on how they work. One theory is that instead of fixing the underlying problem, it simply changes the way you think and feel.

The NHS recommends antidepressants as a treatment for more severe depression. Talk therapy, exercise, and lifestyle changes may be recommended instead of or in combination with drug therapy.

“Throughout my long and extensive career, I have seen people benefit from antidepressants,” said Professor Wendy Byrne, former president of the Royal Psychiatric Association.

“I see them working in my clinical setting and see the lives they change.”

But she added, “People are taking antidepressants longer, but there really aren’t any long-term studies to support that.”

It has long been debated how effective antidepressants are.most Comprehensive researchResearchers at the University of Oxford suggest that antidepressants may help some people, at least in the short term.

But the researchers who led the study said the benefits were relatively modest on average, with people responding differently and not responding at all.

there is some evidence It suggests that long-term use of antidepressants may be associated with health risks such as heart disease and diabetes. It is also believed that long-term use may increase the risk of withdrawal symptoms in some people.

Withdrawal symptoms can occur when you stop taking a drug that your body has become accustomed to.

Taking too much of the drug too soon, before the brain has time to adapt, can lead to symptoms such as depression and anxiety. Withdrawal can be confused with relapse because some symptoms overlap with the original condition for which the drug was prescribed.

Symptoms vary depending on the individual and which drugs have been taken and for how long. Many people can stop taking antidepressants without any problems.

If you have any of the issues described in this article, you can find details of organizations that can help you at the following links. BBC action line

Panorama notes that a large pharmaceutical company that makes SSRI antidepressants has been aware of withdrawal symptoms of all kinds since the mid-1990s, but has been reluctant to share this information with the public and drug regulators. found evidence suggesting that

A copy of a confidential 1996 memo from Pfizer, which originally marketed sertraline, now the most popular antidepressant in the UK, showed employees discussing what the pharmaceutical company would tell Norwegian regulators. is shown.

“We should not be willing to explain withdrawal symptoms and have an agreed list in case they claim,” the memo read.

Withdrawal reactions referred to in this memo include sensory disturbances, sweating, nausea, insomnia, tremors, agitation, and anxiety.

Pfizer no longer produces sertraline. In response to Panorama’s findings, a spokeswoman said the company “has updated its labeling for sertraline as required by regulatory mandates and where necessary.” reported,” he said.

He added, “Public health and specialty medical organizations around the world agree that sertraline and other SSRIs are the treatment of choice for adult depression.” The company said the drug’s label warned against use and was updated “as needed.”

The Royal Psychiatrists’ Association released an update on the withdrawal in 2019, overseen by Professor Byrne, then-President. That was after she heard testimonies from patients who had experienced severe withdrawal symptoms.

Until then, NHS and university guidance had argued that withdrawal symptoms were mostly mild and short-lived, lasting no more than a week.

NHS guidance now reflects that for some people withdrawal can be serious and long-lasting, and withdrawal can last for many months.

Information about stopping antidepressants

A spokesperson for the Royal Psychiatrists’ Association told the BBC: “Like knowledge about the treatment of mental illness, medicine is constantly evolving. As a result, the university will update its guidance as new evidence emerges. ‘ said.

Even health professionals who prescribe antidepressants struggle to stop taking them on their own, due to a lack of awareness of the difficulty of withdrawal.

“It completely wrecked my life,” said Dr. Mark Horowitz, who in 2015 tried to get off an antidepressant he had been taking for 15 years. “When I woke up in the morning, I was in a state of panic, as if I was being chased by an animal.”

The panic he felt continued late into the night, and he started running to distract himself.

“I ran until my legs were bleeding because it gave me a little relief from the feeling of panic.”

He said it was worse than the symptoms that prompted him to take antidepressants in the first place.

Panorama will follow patients who have suffered severe side effects and investigate whether the current generation of antidepressants is living up to its promise.

Watch the story of antidepressants on BBC One Monday 19 June at 20:00 (20:30 in Wales and Northern Ireland). Later BBC iPlayer (UK only)

He worries that far more research has been done on how to start antidepressants in patients and less progress on stopping them.

“For me, it’s the same as allowing a car to be sold without brakes,” he said.

“We have to know how to start and stop the car.”

Dr Horowitz now runs the only NHS antidepressant prescription clinic in the UK. The trial will be set up in London in 2021 to help people struggling to get off their medication.

We are currently seeing about 25 patients.

Despite updated withdrawal guidance, Dr. Horowitz believes patients still struggle to get personalized advice. Guidance for doctors now recommends gradual tapering of the drug, but does not specify how long. It’s different for each person.

The Royal College of General Practitioners told Panorama that primary care physicians are “highly trained to have open and sensitive conversations” with patients about the risks and benefits of antidepressants.

“With excessive workload and workforce pressure, it is becoming increasingly difficult to provide patients the time they need within the constraints of a standard 10-minute consultation,” the company said.

The companies developing the most widely used antidepressants told Panorama that their drugs have been shown to be effective in numerous clinical trials and studies, including those conducted by independent researchers. said there is.

They said millions of people around the world take the drug for potentially devastating and sometimes life-threatening symptoms.

Antidepressants, like all drugs, have potential side effects, which are specified in the prescription, they said. They added that their medicines are safe and considered to have a positive benefit/risk ratio by doctors, patients and regulators around the world.