BMJ  2005;330:1450 (18 June), doi:10.1136/bmj.330.7505.1450-c

Letter

The tide of prescribing for depression is turning

The first 150 words of the full text of this article appear below.

EDITOR—Hollinghurst et al report that opportunity costs indicate that the development of psychological therapies is a feasible alternative to antidepressants for depression.1 A change in practice is long overdue.

I did as I was taught. I used a depression rating score and diagnosed depression. This often meant using my position of authority and knowledge to convince patients that they had an illness called clinical depression. I used fluoxetine (Prozac). To begin with, treatment was suggested for three months; later this was extended to six months; and eventually editorials suggested continuing treatment long term. I followed the evidence and expert advice and used selective serotonin reuptake inhibitors (SSRIs) to treat premenstrual tension, eating disorders, anxiety, postnatal depression, panic disorder, obsessive-compulsive disorder, and even social phobia.

Life, children, marriage, and time change your perspective. More importantly, eight years' of full time work in the same general practice gave me a . . . [Full text of this article]

Des Spence, general practitioner

Glasgow G20 9DR destwo@yahoo.co.uk


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Relevant Article

Opportunity cost of antidepressant prescribing in England: analysis of routine data
Sandra Hollinghurst, David Kessler, Tim J Peters, and David Gunnell
BMJ 2005 330: 999-1000. [Extract] [Full Text] [PDF]

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