Most GPs are over-prescribing antidepressants
More than 80 per cent of GPs admit to over-prescribing antidepressants to patients with depression, anxiety and stress, a new survey reveals this week.
The doctors say that they are often forced to prescribe these drugs because
appropriate psychological therapies or social care for mild to moderate
mental health conditions are not available.
The survey, conducted by research company Dr Foster for Norwich Union
Healthcare, also showed that nearly three-quarters of GPs say they prescribe
more
antidepressants now than they did five years ago. A quarter of GPs told
researchers that more widespread availability of psychological therapies
is one of the most pressing priorities for the NHS.
NICE guidelines
NICE guidelines on the management of depression and the management
of generalised anxiety disorder and panic disorder are at the
end of their consultation periods and are due to be published
in June.
The draft guidelines for depression say that, although antidepressants
are recommended in moderate to severe disease, they are not advised
in initial treatment of mild depression. No treatment, with reassessment
within a fortnight, can also be used for patients with mild depression
expected to recover with no intervention. Psychological treatment
such as counselling is advocated in mild to moderate depression.
The guidelines for anxiety rate the long-term efficacy of cognitive
behavioural therapy better than medication or self help. |
Celia Feetam, clinical psychiatric pharmacist and senior teaching fellow,
Aston University, Birmingham, told The Journal that these findings were
reflected by prescribing trends. She added that although GPs may want
to refer patients for psychological therapies, these are sparse in primary
care and doctors have little option other than to prescribe medication.
However, she hoped that the survey and forthcoming National Institute for Clinical Excellence guidelines (see Panel) would increase the impetus
for more funding for psychological help from suitably trained staff.
She added that pharmacists may be able to help by making patients aware
of non-pharmacological strategies for the treatment of depression and
anxiety, especially if patients are not taking their prescribed
medicines. Patients wanting other services should demand them from their
primary care trusts, she said.
Although medication could help with
biological effects, such as appetite and sleep loss, in depression caused
by life events, patients often needed long-term coping skills, she explained.
Norwich Union says that its study also showed that a third of people
interviewed claimed to know someone, or were themselves, suffering from
a mild or moderate mental health condition. Seventeen per cent had sought
help or advice from a health care professional for mild anxiety, depression
or stress. The company has launched an online resource explaining mental
health conditions and their therapies with a guide to health service
provision by postcode or specialty (www.personalhealthmanager.co.uk). |
The
Pharmaceutical Journal
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