Brexit hope as Boris and Ir­ish PM say they’re on ‘path­way’ to agree­ment — by Hal­loween

Daily Mail - - Front Page - By Ja­son Groves Po­lit­i­cal Ed­i­tor Turn to Page 2

BORIS John­son and Ir­ish PM Leo Varad­kar hailed a Brexit break­through last night fol­low­ing an ex­traor­di­nary sum­mit.

Af­ter three hours of talks at a coun­try manor on Mersey­side, Mr John­son and his Dublin coun­ter­part said they could see a ‘path­way to a pos­si­ble deal’. Mr Varad­kar, who has long been seen as the road­block to an agree­ment, added that he even be­lieved a deal could be ‘done by the end of October’.

He de­scribed the meet­ing – which in­cluded more than 90 min­utes where the two lead­ers ne­go­ti­ated with­out of­fi­cials – as ‘very pos­i­tive’ and said he was ‘ab­so­lutely con­vinced’ Mr John­son wanted an agree­ment.

In the wake of the ap­par­ent break­through, Brexit Sec­re­tary Stephen Barclay trav­elled to Brus­sels for a crunch break­fast meet­ing to­day with EU chief ne­go­tia­tor Michel Barnier.

Both sides hope that if the meet­ing goes well, it will lead to a so- called ‘tun­nel’ of in­ten­sive ne­go­ti­a­tions in the com­ing days – ahead of a crunch EU sum­mit next Thurs­day.

How­ever, both the Bri­tish and Ir­ish gov­ern­ments were tight-lipped about the con­ces­sions that had been of­fered to find a com­pro­mise. Even Cab­i­net mem­bers were not im­me­di­ately briefed

AN­TIDE­PRES­SANTS can cause se­vere side ef­fects last­ing for months, health guide­lines have ac­knowl­edged for the first time. The NHS watch­dog NICE has re-writ­ten ad­vice on how doc­tors should treat adult de­pres­sion, mak­ing it clear that com­ing off the pills can cause long-last­ing symp­toms.

In a move cam­paign­ers hope will sig­nif­i­cantly re­duce the overuse of an­tide­pres­sants, the of­fi­cial body said all pa­tients should be warned of the risks when they start on the med­i­ca­tion.

The change fol­lows a two-year Daily Mail cam­paign rais­ing aware­ness of the side ef­fects of with­draw­ing from the drugs.

For years health of­fi­cials have played down the dif­fi­culty. The pre­vi­ous guid­ance, which had been largely un­changed for a decade, stated side ef­fects were ‘usu­ally mild and self-lim­it­ing’ and would last no more than a week.

The new doc­u­ment states for the first time that, for some, the ‘se­vere’ side ef­fects of com­ing off an­tide­pres­sants can last ‘months or more’. It warns of ‘dis­con­tin­u­a­tion’ symp­toms such as con­fu­sion, anx­i­ety, sweat­ing, sleep prob­lems and ‘al­tered feel­ings’. Bri­tons use more an­tide­pres­sants than al­most every other coun­try in the Western world – which ex­perts be­lieve is partly due to lack of aware­ness of with­drawal prob­lems.

The Royal Col­lege of Psy­chi­a­trists paved the way for the change ear­lier this year when they pub­lished a ‘po­si­tion state­ment’ ac­cept­ing that some pa­tients get pro­tracted side ef­fects com­ing off the drugs.

That move – it­self a re­ac­tion to the stri­dent work of cam­paign­ers – was hugely in­flu­en­tial, rep­re­sent­ing a ma­jor shift in the view of the psy­chi­atric es­tab­lish­ment. But the new guid­ance will reach many more doc­tors, in­clud­ing the GPs who pre­scribe most an­tide­pres­sants.

Psy­chother­a­pist Dr James Davies of the Univer­sity of Roe­hamp­ton, co-founder of the Coun­cil for Ev­i­dence-based Psy­chi­a­try, said last night that the change was ‘hugely sig­nif­i­cantly’, adding: ‘This is the first time any na­tional clin­i­cal guide­line has ac­knowl­edged se­vere and pro­tracted an­tide­pres­sant with­drawal to this ex­tent.’

‘Now se­vere and pro­tracted with­drawal has been of­fi­cially recog­nised, we must never again mis­di­ag­nose with­drawal as re­lapse or deny the pa­tient is in se­vere pain.

‘We must also now press ahead with with­drawal ser­vices and a helpline for those who have be­come de­pen­dent on these and other pre­scribed drugs.’

Ac­cord­ing to the NHS, 16 per cent of adults – seven mil­lion peo­ple in Eng­land – take an­tide­pres­sants each year. Twelve months ago the Mail re­vealed re­search by Dr Davies which sug­gested 56 per cent of peo­ple suf­fer with­drawal ef­fects if they try to come off an­tide­pres­sants.

That study, pub­lished in the Jour­nal of Ad­dic­tive Be­hav­iours, sug­gested the seven mil­lion peo­ple tak­ing an­tide­pres­sants in Eng­land, four mil­lion are at risk of with­drawal symp­toms if they at­tempt to come off the pills.

Some 1.8million are at risk of se­vere symp­toms and for 1.7mil­lion – 25 per cent of pa­tients tak­ing the drugs – the with­drawal ef­fects last at least three months.

An­tide­pres­sants, which in­clude com­mon brands such as Prozac, Cipramil and Seroxat, are proven to be an ef­fec­tive way of treat­ing mod­er­ate to se­vere de­pres­sion. But ex­perts are in­creas­ingly con­cerned about their over-use, with pre­scrip­tions in the UK hav­ing dou­bled in the last decade.

A league ta­ble of an­tide­pres­sant use pub­lished in 2017 put the UK fourth out of the 29 coun­tries in the Or­gan­i­sa­tion for Eco­nomic Co­op­er­a­tion and De­vel­op­ment, up from sev­enth in the year 2000.

Re­search pub­lished by health char­ity Mind ear­lier this month sug­gested the vast ma­jor­ity of pa­tients are left in the dark about the side ef­fects of an­tide­pres­sants and other psy­chi­atric treat­ments.

Four in every five pa­tients with men­tal health prob­lems had not been told the po­ten­tial side ef­fects of their med­i­ca­tions, ac­cord­ing to polling of 12,000 peo­ple. Mind said a key prob­lem is that GPs re­ceive no manda­tory prac­tice-based train­ing in men­tal health, de­spite more than 40 per cent of all ap­point­ments in­volv­ing the is­sue.

Of all GPs who fin­ished their train­ing in 2017, less than half com­pleted an op­tional psy­chi­a­try place­ment.

Dr Paul Chrisp, di­rec­tor of the cen­tre for guide­lines at NICE, said last night: ‘We have amended the guide­line to recog­nise the emerg­ing ev­i­dence on the sever­ity and du­ra­tion of an­tide­pres­sant with­drawal symp­toms. The up­dated rec­om­men­da­tions are in line with the state­ment from the Royal Col­lege of Psy­chi­a­trists and were agreed by our in­de­pen­dent com­mit­tee.’

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