Wednesday, December 06, 2023

Too much antidepressant prescribing reflects the overmedicalisation of society

As the BMJ reports (see article), a group of politicians, experts, and patient representatives has called for the UK government to reverse the rate of antidepressant prescribing. Their BMJ letter comments on both the increasing rates of prescribing (see previous post) and the increasing duration of time on antidepressant treatment (see another previous post). Long-term outcome for depression is not necessarily good (see yet another previous post). There is even evidence that treatment can create a vulnerability to relapse, meaning that people may do better over the long-term by working through their problems without medication (see previous post). The net ingredient cost of antidepressant drugs is not insignificant, and, in the 2022/3 financial year in England, it was over £235 million (see NHS Business Service Authority data).

This call to reduce antidepressant prescribing needs to be understood in the context of the overmedicalisation of society in general. Such overmedicalisation needs to be reversed in the interests of the country’s health as a whole, as the NHS has become unsustainable (see eg. previous post). The cultural process of creating panaceas for emotional and other mental health problems doesn’t always work and may create more problems than it is worth (see eg. another previous post). This may be particularly obvious with the ever increasing demand for mental healthcare for children and young people over recent years (see eg. yet another previous post).

The letter marks the launch of the Beyond Pills All Party Parliamentary Group (APPG) (see Guardian article), which joins the forces of the former APPG for Prescribed Drug Dependence (see eg. previous post) and the College of Medicine Beyond Pills Campaign (see previous post). A cultural change to reduce the reliance on medication and to support shared decision-making is needed, not least for mental health services. The BMJ itself has recently called for a reset in its campaign against too much medicine (see eg. post on my personal blog).

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