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Row over antidepressant use

A SCOTTISH doctor has spoken out about the over-prescribing of antidepressants, saying they have been handed out "too easily for too long".

In an article in the BMJ medical journal, likely to spark controversy, Glasgow GP Des Spence argues treating depression like a medical condition is distracting attention from what really makes patients unhappy.

He describes the diagnostic criteria for depression as two weeks of low mood, irrespective of any change in the circumstances of the patient which might have left them feeling down.

Dr Spence writes: "It even proposes that being low two weeks after bereavement should be considered depression."

He admits his comments are likely to rattle psychiatrists and says their defensiveness was stifling legitimate discussion about antidepressant use. Dr Spence adds: "As a generalist prescribing antidepressants daily in primary care, I think we use antidepressants too easily, for too long and that they are effective for few people (if at all).

"But even questioning current care is considered stigmatising towards mental illness and populist anti-medicine rhetoric."

The number of people in Scotland prescribed antidepressants has reached record levels, with more than one in seven people taking the drugs.

There has been a steady rise in usage. There were 1.26 million drugs dispensed in 1993/94, increasing to 5.01 million in 2011/12. The cost to the NHS in Scotland last year was £31.3 million.

As well as exposing patients to medication, with potential side effects, Dr Spence's key concern about the widespread use of antidepressants is they leave the real reason for someone's poor mood unexplained.

He said: "Improving society's wellbeing is not in the gift of medicine nor mere medication, and over-prescribing of antidepressants serves as distraction from a wider debate about why we are so unhappy as a society."

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