As a patient who consumed antidepressants for almost 40 years, I now observe the antidepressant debate in mainstream media and on social media with dismay. If antidepressants are so very effective as many in psychiatry would claim, why are we having this debate at all? After decades on the market, there would surely be clear and unequivocal scientific evidence that antidepressants are indeed very effective and truly do transform people’s lives. I have spoken to very many patients over the years who have consumed these drugs and rather oddly I have never met anyone who said the drugs transformed their lives. More often than not, those who consume them continue to struggle with life, but keep taking the drugs just in case they really are helping or stopping them might make things worse. I also know people who have thrown away the drugs or torn up the prescription or taken them for a short while having no idea they were taking an antidepressant. I know others who would not touch them with a barge pole. And now of course as a member of the online prescribed dependent and harmed community I know very many patients whose lives have been adversely affected or whose lives have been destroyed by these drugs. I also have real-life friends and relatives whose health has been badly affected after decades of consuming antidepressants.
Last month, the media hype around the Cipriani Lancet meta-analysis was wholly unjustified and entirely misleading. Is this how an important scientific paper is now communicated to the public? The public was fed the idea that antidepressants really do work, the debate is over and a million more patients should be taking them. Those with only a passing interest in the subject would have gone no further than the headlines. We already have millions of patients on the drugs and there seems to be no reduction of mental ill-health in our nation, in fact it seems to be on the increase. We have a major problem with prescribed drug dependence and Public Health England is conducting a year long review. Patients are so concerned by the adverse effects of antidepressants they have raised petitions to the Welsh Assembly and Scottish Parliament. The University of Southampton has been funded for six years to the tune of several million pounds to study antidepressant withdrawal. Meantime, Profs Wendy Burn and David Baldwin of RCPsych seem to be completely unaware of any of this and write to The Times stating that antidepressant withdrawal symptoms pass in two weeks for the vast majority of patients. And so 30 clinicians, academics and patients have made a formal complaint to RCPsych seeking a retraction of the letter and quite rightly so.
However, one psychiatrist on Twitter felt this was not “good form” and would shut down the public debate. Prof Simon Wessely agreed. My question is “What has the public debate achieved so far for all the patients suffering from the adverse effects of antidepressants?” The answer clearly is absolutely nothing. Prof Wessely’s wife, Prof Clare Gerada spoke on Radio 4 a few days ago. She also indicated that antidepressant withdrawal is largely unproblematic for the vast majority of patients though did concede it could last longer than 2 weeks and could even last months. Yet again, she had no research evidence to support this. She also downplayed the withdrawal effects from benzodiazepines on Radio 4 in 2011. Prof John Read who also appeared on the programme at least was able to cite the results of a large patient survey which suggested that antidepressant withdrawal was a much bigger problem than suggested by Profs Burn, Baldwin and Gerada. Prior to the programme being aired Prof Wessely tweeted that there was to be more #pillshaming on Radio 4. I heard no such thing listening to the programme and therefore wonder why yet another leading psychiatrist would make such a derogatory comment before the programme was even aired. I noticed this prior to airing of the Panorama programme, Prescription for Murder? last year, when RCPsych seemed very keen to discredit it before anyone had had a chance to view it. Indeed most of the criticism about the programme emanated from RCPsych.
Afterwards RCPsych announced a Twitter question and answer session to dispel the myths around antidepressants. Concerned patients submitted a great many questions but received few answers back. We were left to conclude that this had been another orchestrated attempt to showcase the drugs and no real attempt to engage with the public. The hashtags #pill-shaming and #medsWorkedForMe have been created. And so the prescribed dependent and harmed community has created its own hashtags such as #medsdidntworkforme #MoreThan2Weeks plus a variety of others. After all, if this is how debates are to be conducted why not join in? Strangely though, RCPsych only promotes the hashtags that favour the drugs .. so once again only presents one side of the argument. Why is all this even necessary? If leading psychiatrists were able to communicate effectively with the public and patients, providing scientific evidence in clear and comprehensible terms, and were able to advise the public where no such evidence exists perhaps the debate would never have been reduced to #hashtags.
Meantime, the online patient community and no doubt the patient community in general would like accurate and unbiased information based on research evidence where it exists on the perceived benefits, the risks of dependence, the likelihood of withdrawal symptoms, and the long-term harms. If no such evidence exists this should be made clear. And where there is no agreement between different factions in psychiatry the public needs to hear all sides of the arguments presented clearly and the reasons for disagreement so that patients can make up their own minds whether or not to consume these drugs. The only reason we are reduced to #hashtags and formal complaints is because psychiatry has failed to communicate with patients in an effective and honest manner. Instead it seems to “advertise” only the perceived benefits of the drugs presumably because this is in its own interests. If it was truly interested in patients it would give them the information they need to make an informed decision which of course is essential in the 21st century. It is after all the patient who is taking all the risks of consuming these drugs and not the doctors who are promoting them.