Health

GPs urged to prescribe the lowest strength dose of anti-depressants to balance benefits and side-effects


GPs should dole out the lowest strength dose of anti-depressants, a major review reveals.

It shows weaker prescriptions provided patients with the best balance between treatment benefits and side-effects.

 GPs have been told to prescribe lower the lowest strength dose of anti-depressants to balance benefits and side-effects

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GPs have been told to prescribe lower the lowest strength dose of anti-depressants to balance benefits and side-effectsCredit: Getty – Contributor

The findings come just a week after doctors were told to warn sick Brits that quitting the pills can often trigger debilitating withdrawal symptoms.

In a major U-turn, the Royal College of Psychiatrists admitted side-effects can go on for months.

Now an Oxford University study in The Lancet Psychiatry on nearly 20,000 patients has found they respond best to low doses.

They examined the effectiveness of common anti-depressants, including Prozac.

‘GIVING THE MAXIMUM DOSE IS NOT BENEFICIAL’

Current guidance from NHS watchdog the National Institute for Health and Care Excellence (NICE) says GPs can slowly increase the dose if patients do not respond – but do not state a maximum limit.

Andrea Cipriani, NIHR Research Professor Psychiatry at the University of Oxford, said: “What we found is that pushing up the dosage doesn’t work.

“There is no increased efficacy for the patient but they are more likely to suffer side-effects or stop taking them.

“Giving them the maximum dose is not beneficial. You are better off trying a different drug or change strategy.

‘CONFLICTING RECOMMENDATIONS’

“When I see patients in my clinic and we agree on prescribing an antidepressant for their depressive episode, the big challenge is not only to prescribe the right medication but also to find the best dosage for each individual, optimising efficacy and reducing side effects.

“Current practice guidelines provide conflicting recommendations.”

Nearly two million people in the UK are thought to suffer from depression at any one point in time.

Last year, GPs doled out record numbers of anti-depressants – with demand doubling in a decade.

NHS Digital data shows medics issued 70.9 million prescriptions for antidepressants last year – at a cost of £203 million – compared with 36 million in 2008.

Marjorie Wallace, chief executive at Sane, said Brexit uncertainty may be fuelling rising demand.

 Nearly two million people in the UK are thought to suffer from depression at any one point in time

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Nearly two million people in the UK are thought to suffer from depression at any one point in timeCredit: Getty – Contributor
Video explains the science behind anti-depressant medication: Selective Serotonin Reuptake Inhibitors (SSRIs)







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