Following the broadcast of Panorama’s ‘The Antidepressant Story’, the Royal College of Psychiatrists has issued the following response:
“Depression is a serious and potentially life-threatening condition that is treatable, usually involving a combination of self-help, psychological therapies and medications.
“Treatment options will depend on a patient’s type of depression, how long it has lasted, and whether they have experienced depression in the past.
“Antidepressants are a clinically recommended treatment, and they are effective at reducing the symptoms of moderate to severe depression, particularly when used in combination with talking therapies. Patients should discuss their treatment options with a qualified practitioner, including their benefits, risks and side effects, to ensure there is informed consent.
“Medicine continuously evolves, as does our knowledge of treating mental illness, as a result, the College updates its guidance, and ensures it is made accessible to healthcare professionals, stakeholders and partners with lived experience, when new evidence comes to light. Over the last 30 years our understanding of how different types of antidepressants work and the variation in side effects has grown considerably.
“We know that on average, most patients will benefit from the use of antidepressants, but some do report mixed or negative experiences. This is why their use should be carefully monitored and regularly reviewed. This is particularly important when stopping antidepressants. Antidepressants usually need to be taken for at least six months after your symptoms have gone away.
“Long-term use of antidepressants should only be considered for people that have recurrent depression and repeated, severe relapses after stopping antidepressants. For those patients, the beneficial effects of continuous use of antidepressants are more likely to balance the potential risks. However, this should be reviewed regularly, and multiple attempts should be made to stop taking these medications after prolonged periods of established wellbeing.
“Most people will be able to stop taking antidepressants without significant difficulty by reducing the dose (known as ‘tapering’) over a few weeks or months. Some people can experience withdrawal symptoms that last longer and may be more severe, particularly when the medication is stopped suddenly.
“As the body of evidence of withdrawal symptoms has improved, the College has pushed for changes to clinical guidance, to have a greater focus on safely managing withdrawal. This has increasingly been reflected in NICE guidance over the last few years. We also published a patient resource in 2020 to help support people to have discussions with their doctor when they are thinking about stopping antidepressants. We believe this was the first of its kind published by a professional medical organisation.
“Ultimately, the use of antidepressants, should always be a shared decision between a patient and their doctor based on clinical need and the preferences of the patient.
“We would advise all those thinking of stopping their antidepressants to talk to their doctor first, as these medications should not be stopped abruptly.”