Up and Down

Richard J B Willis

BUC Health Ministries Director

The over 22 million antidepressant prescriptions issued annually in the UK is now costing the NHS £310 million. With the similar high-rate and cost of drugs being offered in most Western countries, clinical scientists are questioning the efficacy of such treatments.

'Six or seven in every ten depressed people will get better on antidepressants within six to eight weeks, if they take them regularly' says the Royal College of Psychiatry (RCP). Other authorities disagree. University of Nevada's professor of psychiatry and behavioural sciences, David Antonuccio, says: 'I don't think the data support antidepressants as a first choice treatment.' Against the backdrop of these opposing views the Consumer Association has launched its own investigation into the effectiveness or otherwise of antidepressant drugs. Concerns have been raised about the validity of the clinical trials for a variety of drugs since there is good evidence that drug companies are very selective with the material they publish, so the drugs may not be all that they are hyped to be.

Other concerns are focused on the likelihood of dependence and/or an increased suicide risk. The RCP state that if the drugs are used as recommended people do not become addicted. What is not always clear is whether the symptoms experienced when the drug course ends are withdrawal symptoms or a recurrence of the original problem. One drug company believes that withdrawal reactions are rare, occurring in only 2 cases per 1000 patients.

As far as a tendency to suicide is concerned, again the situation is unclear. it is not known whether or not patients kill themselves as a result of taking the tablets or because of the underlying depression which led to the drugs being prescribed. The Health Which? reviewer, David Healy, writes that data from a number of trials leads one to conclude 'that in all probability there is a direct link between antidepressant therapies and suicide induction'. However, like the dependency rate, actual suicide is not a common occurrence.

Prozac, hailed as the new antidepressant wonder-drug, has not turned out to be as effective as at first thought. What beneficial effect it has can be gained naturally by using foods rich in omega-3 fatty acids. These include nuts, seeds, and legumes, as well as the publicised fish-oils.

There is no stigma in getting professional help when we are depressed, it helps to talk things through. As Dr W Blair Stewart said to his junior colleagues in 1901: 'Ten minutes quiet conversation will do much to relieve the worry, excitement, morbid fears and ideas of mental depression'; and we should not stop taking prescribed medications without talking it over with the prescriber. We all have our ups and downs but as with other aspects of health, all that we can do to prevent illness should be done, and we can talk problems over with the Great Physician.

© The Stanborough Press