By Maxine Frith, Social Affairs Correspondent
30 March 2004
Hundreds of thousands of people are being prescribed powerful anti-depressants that they may not need because doctors are using the pills as a "quick fix" solution to mild anxiety problems, according to a report published today.
Desperate shortages of NHS counsellors and therapists mean that over-worked GPs often feel they have no option but to hand out anti-depressants to people who may only need an outlet for discussing their problems. Eighty per cent of GPs admit that they are over-prescribing drugs such as Prozac and Seroxat when patients may simply need someone to talk to.
The survey of 250 GPs by Norwich Union Healthcare found that eight out of 10 admitted that they were over-prescribing anti-depressants, and three-quarters said they were handing out more of the drugs than they did five years ago. A quarter of family doctors said that the dire shortage of therapies and counselling is now one of the most urgent priorities for the NHS.
Jim Thomson, chief executive of the Depression Alliance, said: "This research reveals a worrying level of GPs who think they don't have any other resource apart from handing out anti-depressant drugs.
"Mental health care is the Cinderella service of the NHS - the average waiting time for a counselling appointment is six months, which is far too long for most people. Anti-depressants have helped millions but they should not be handed out as a quick and easy way of getting people through a GP's surgery."
Doctors, patient groups and campaigners are becoming increasingly concerned at the soaring use of anti-depressants in Britain. Prescriptions for the drugs have soared in the past 10 years, from 10 million to 26 million in 2002. It is estimated those prescriptions are given to about three million patients. Correspondingly, the NHS bill for anti-depressants has rocketed from £18m in 1992 to £380m in 2002. One in three GP appointments now involves patients who are reporting depression.
The Depression Alliance estimates that, in addition to the three million people who have been treated for the condition, a further 8.7 million are undiagnosed and untreated.
Most of the prescribing increase has been as a result of the new generation of anti-depressants introduced in the 1990s, such as Prozac and Seroxat. The two brands are types of anti-depressant called SSRIs (selective serotonin reuptake inhibitors) which were initially hailed as a revolution because they lifted patients' moods without any of the side- effects of older medicines. Prozac became known as the "sunshine drug", as millions of people were prescribed it for even mild depression.
However, the safety of SSRIs, in particular Seroxat, has been called into question, with reports of severe side-effects including violent rages and suicidal thoughts. An expert working group set up by the UK drug regulator, the Medicines and Healthcare Products Regulatory Agency, is currently investigating the allegations.
Janice Simmons, of the Seroxat Users' Group, said: "Prescribing of these drugs has become absolutely scandalous. They are powerful drugs and have been shown to have severe side effects. People are getting hooked on them when they didn't even need them in the first place, and yet nothing is being done about it."
Dr Jim Kennedy, prescribing spokesman for the Royal College of GPs, said: "This is not about GPs handing out anti-depressants like candy floss because they don't care. Doctors are in this position because they cannot offer their first-choice treatment, which may be therapy or counselling, because provision in this country is so poor, and has been getting worse over the past five years."
'I was given pills like they were sweets'
Michelle Hancock was first prescribed Prozac when she was 28. Ten years later, she is trying to wean herself off antidepressants.
"I was given pills like they were sweets, but all antidepressants do is paper over the cracks," she says.
Mrs Hancock, from Hartford, Hertfordshire, first went to her GP in 1994 when she was experiencing depression.
"The doctor ... wrote out a prescription for Prozac, saying 'this will make you feel better'." It had taken a terrifying hold of her. "I would wake up in the night and the bed would literally be shaking because I was shaking so much."
Some time later, Mrs Hancock was given Seroxat. She has now been off the drug for eight weeks, but says she is suffering "terrible" side-effects.
"I feel very bitter that doctors are handing out drugs without offering people any other help."