Doctors have made too many people dependent on antidepressants

Publication of the NICE guidance on ‘Medicines associated with dependence or withdrawal symptoms: Safe prescribing and withdrawal management for adults’ has not resolved controversy about antidepressant withdrawal. For example, the All Party Parliamentary Group for Prescribed Drug Dependence accuses NICE of failing to listen to patient evidence (see press release). To be fair, NICE probably couldn’t go further based on current evidence but I agree that it has left ambiguity about this issue.

Although NICE admits that there is considerable debate about the definitions of dependence and addiction, it clearly states that antidepressants cause withdrawal symptoms even though they have not historically been classified as dependence-forming medicines. It sees dependence as characterised by tolerance and withdrawal symptoms. Addiction is said to include the additional characteristics of cravings, lack of control, overuse and continued use despite harm, associated with problematic behaviours.

Dependence and addiction in common parlance tend to mean difficulty in managing without the drug (see my webpage). An effort may be required to do without the drug. It is a psychological state, although it can also be physical. The drug may need to be continued or withdrawal symptoms may occur in its absence.

Regular and frequent use of some substances, such as alcohol and opiates, can cause tolerance, so that people experience withdrawal symptoms in the absence of the drug. This is what is meant by physical dependence. Dependence on antidepressants, and more generally, is not just physical (see previous post). 

People are being indoctrinated into believing they need antidepressants (see eg. previous post). No wonder they may have difficulty in stopping them. Doctors need to take responsibility for making so many patients dependent on antidepressants.