Depressing…

Kevan Christie’s article “Hike in number of Scots being prescribed antidepressants” (9 September) alerts us to the eye-watering figures recently released by the Scottish Government showing everincreasing antidepressant prescribing.

He quotes a Scottish Government spokesman saying: “We have worked hard to reduce the stigma faced by people with mental ill-health. As stigma declines we would expect more patients to seek help from their GPS. Any prescribing is a clinical decision and there is good evidence GPS assess and treat depression appropriately.”

The Scottish Intercollegiate Guidelines Network (SIGN) clearly recommends initial alternatives to antidepressants in all but the most severe cases of depression. Non-pharmacological alternatives are currently mostly not available when a patient visits their GP suffering typical symptoms of human distress (insomnia, anxiety, depression, panic, etc). Waiting times for availability of any nonpharmacological treatment make a mockery of the practical application of the existing SIGN advice.

The Scottish Government 2014 document Key use of Antidepressants in Scotland is based on the underlying assumption that antidepressants are “safe and effective” and remain so over the long term. The actual patient experience examples made available to the Scottish Petition Committee in a 2017 public petition are sobering evidence of very different outcomes for many patients.

Evidence is becoming increasingly clear that the risks of antidepressants, especially taken over the long term, in many cases far outweigh any possible benefits.

Antidepressant side-effects can be devastating for peohave ple’s lives and relationships. These side-effects commonly include fatigue, weight gain, sexual problems, diminished empathy and suicidality.

Many people are now taking antidepressants as prescribed over the long term because they have not been supported to come off them safely. Unfortunately, GPS have no guidance or understanding of the problems of withdrawal – which can be extremely fraught for patients and their families. This has been recognised by the British Medical Association, which has called for collaborative action.

Furthermore, there is clear evidence of a growing issue of people acquiring a variety of disabling “medically unexplained physical/functional symptoms” (MUS), resulting in rising levels of long-term disability in Scotland.

A striking overlap in the sideeffects, tolerance, withdrawal and protracted withdrawal of antidepressants with the multi-system mind and body symptoms has been discovered which tend to acquire a medical “working diagnosis” of MUS.

Is this the evidence of longterm neurological systemic harm sustained as a consequence of taking these medicines (which, of course, act directly on the human nervous system) “as prescribed”?

MARION BROWN Garelochhead, Helensburgh