Antidepressants are being prescribed too readily, according to a GP – but his claim has been rejected by an expert today.
In 2012, 46m antidepressant prescriptions were handed out in the UK. Some believe this rise indicates "over-medicalisation".
Dr Des Spence, a GP from Glasgow, UK, writes in the British Medical Journal today (23 January) that "we use antidepressants too easily, for too long, and they are effective for few people (if at all)".
Although "depression is an important, often stigmatised, illness, for which antidepressants work," he believes "the current definition of depression is too loose and is causing widespread medicalisation".
The current Diagnostic and Statistical Manual of Mental Disorders states that clinical depression can be defined as two weeks of low mood, even if this follows bereavement.
"But with 75% of those who write these definitions having links to drug companies, is this a story of a specialty being too close to industry?" Dr Spence asks. He suggests that our current definition of depression is "medicalising normality", especially as antidepressants are not considered effective for mild depression in the National Institute for Health and Clinical Excellence guidelines.
"Overprescribing of antidepressants serves as distraction from a wider debate about why we are so unhappy as a society," he concludes.
But, writing in the same journal, Professor Ian Reid of Aberdeen University, UK, rejects te claims.
He says there is "a profound suspicion" of antidepressants, despite being just as effective as drugs for other conditions.
He says the rise in prescription rates is due to a "small but appropriate increase in the duration of antidepressant prescription – rather than more patients." This "simply represents gradually improving practice", as it adheres more closely to the guidelines.
"Careless reportage has demonised antidepressants in the public eye, adding to the stigmatisation of mental illness, and erecting unnecessary barriers to effective care," he states.
Spence, D. Are antidepressants overprescribed? Yes. The British Medical Journal 23 January 2013 doi: 10.1136/bmj.f191 [abstract]
Reid, I. Are antidepressants overprescribed? No. BMJ 23 January 2013 doi:10.1136/bmj.f190
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