The study, by researchers at University College London (UCL), and published in Drug and Therapeutics Bulletin aimed to highlight the possible adverse negative side effects present in some patients when they stop using antidepressants after long-term use.
Are antidepressants actually an effective form of treatment?
A large part of this study brings together a body of already existing literature and evidence on the effectiveness of antidepressants, and in doing so suggests that the current way in which antidepressants are being utilised may be largely ineffective.
The authors of the study said:
“We believe that increasing awareness about the difficulty that some patients have in stopping antidepressants should lead to more cautious prescribing practice, with antidepressants given to fewer patients and for shorter periods of time.”
Some of the key findings from the study included emphasising the uncertainty around the benefits of antidepressant use in both short and long-term, especially when considering previous studies that found a similar level of effectiveness between placebos and antidepressants, as an extension of this the study also focused on the possibly severe and long-lasting withdrawal symptoms from antidepressants.
These findings, paired with recent guidance from the Royal College of Psychiatrists, and NICE point to a shift within the psychiatric community away from antidepressants as the first course of treatment handed over to someone attempting access to mental health services in the first instance, especially if their experience of mental-ill health isn’t on the severe side.
The study referred to one particular recent research paper, a Cochrane review, which found ‘no antidepressant had a clinically significant effect compared with placebo’ when assessing adolescents, despite the fact that the number of 12 to 17-year-olds having antidepressants prescribed to them has more than doubled between 2005 and 2017, the UCL research said.
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As well as bringing the effectiveness of antidepressants into question, the study makes pains to emphasise the withdrawal effects from SSRIs that can be both severe and long-lasting
The study cited symptoms such as insomnia, depression, suicidal ideation, and physical symptoms and found through a systematic review of already existing literature on withdrawal symptoms that some of these effects lasted between several months and even years.
The British Psychological Society (BPS) has since responded to the study, with Dr Roman Raczka, chair of the BPS’ Division of Clinical Psychology:
“Research into the effectiveness and the long-lasting impacts of anti-depressant drugs is always welcome. Recognition of the severe withdrawal symptoms which some people experience when they stop taking antidepressant drugs is vitally important and is an important step towards providing better treatment for people with depression.”
“Of course, antidepressants can have a place in the treatment of depression for some people with more severe symptoms, but it is important that their use is weighed up carefully against the risk of harm to the patient. The latest draft guidelines from NICE, (currently under consultation), which encourage offering psychological treatment options before anti-depressants are encouraging.”
“We strongly believe that treatment for depression should be based initially on the use of evidence-based psychological treatments, but in order for this to happen access to psychological therapies must be drastically improved. Where waiting lists are long, where services do not exist or where people are presented with a limited choice of psychological alternatives, antidepressants can sometimes be seen as the only treatment option or are provided as a stop-gap until psychological therapy is available.”
These findings being brought to attention is a vital part of the shift to a better, more nuanced understanding of the value of antidepressants in the treatment of things such as depression, anxiety disorders, trauma disorders and bipolar disorder.
Though, as Dr Raczka points out, in order for this shift to affect real change in treatment, it is the access to a variety of psychological therapies that will make the difference for those who are considering antidepressants, who are currently taking them and for those who might be experiencing withdrawal from them.