It is welcome to see this advice on withdrawing from SSRI drugs published.1 I congratulate the authors and the BJGP. The Royal College of Psychiatrists (RCPsych), 4 years ago, published a position statement on antidepressants and depression,2 so I had expected similar advice to be published in the equivalent journal for psychiatry. This has not yet happened.
The BJGP article states that ‘Inaccurate guidance on antidepressant withdrawal has resulted in many patients experiencing distressing, debilitating symptoms’ and in ‘Take-home messages’ [Box1] that ‘GPs should educate patients on withdrawal’. Box 1 reminded me of when I was training in psychiatry. At this time, a 5-year-long ‘Campaign’ was underway to ‘Defeat Depression’. I recall the ‘key messages’, for example, in the article ‘Lay people’s attitudes to treatment of depression: results of opinion poll for Defeat Depression Campaign just before its launch ’, which stated unequivocally ‘Patients should be informed clearly when antidepressants are first prescribed that discontinuing treatment in due course will not be a problem.’3
In 2023, across the UK, 1 in 6 adults are now taking an antidepressant. Such mass prescribing is well beyond the 1 in 20 prevalence on which the Defeat Depression Campaign was based. Vanessa Cameron, Chief Executive Officer for RCPsych for nearly 4 decades, offered the following candid reflection on her retirement in 2016: ‘After the Defeat Depression Campaign we produced guidance that said we wouldn’t use Pharma for any public education activities.’4
The Cumberlege report First Do No Harm5 (July 2020) acknowledged mistakes made in the adoption of new medical interventions and made a number of recommendations to prevent future iatrogenic harm to patients. To my knowledge, the RCPsych has made no public comment on any of the recommendations made in the Cumberlege Report. We all need to acknowledge the consequences of failing to learn lessons from our and patients’ experience, otherwise history will repeat itself.
REFERENCES
- 1.Palmer EG, Sornalingam S, Page L, Cooper M. Withdrawing from SSRI antidepressants: advice for primary care. Br J Gen Pract. 2023. DOI: . [DOI] [PMC free article] [PubMed]
- 2.Royal College of Psychiatrists PS04/19. Position statement on antidepressants and depression. 2019.
- 3.Priest RG, Vize C, Roberts A, et al. Lay people’s attitudes to treatment of depression: results of opinion poll for Defeat Depression Campaign just before its launch. BMJ. 1996;313:858–859. doi: 10.1136/bmj.313.7061.858. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 4.Poole R, Robinson CA. Profile: Vanessa Cameron — 36 years at the Royal College of Psychiatrists. BJPsych Bull. 2016;40(6):341–345. doi: 10.1192/pb.bp.116.055459. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 5.Cumberlege J. First do no harm: the report of the Independent Medicines and Medical Devices Safety Review. DHSC; 2020. [DOI] [PubMed] [Google Scholar]