Intended for healthcare professionals

Rapid response to:

Editorials

Off-label prescribing of antidepressants

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j849 (Published 21 February 2017) Cite this as: BMJ 2017;356:j849

Rapid Response:

Re: Off-label prescribing of antidepressants

Morales and Guthrie highlight an area of concern for many GPs. There is also a growing demand for requests for off label prescribing from secondary care specialists: we have seen requests for this from several specialties, not just with regard to antidepressant use. Aside from professional guidance on prescribing for practitioners, there should be robust systems in place that ensure prescribing off license medication should be undertaken by the initiating specialist ( who should have counselled the patient or parent in the case of paediatric prescribing) rather than passed on to a third party with the accompanying patient expectation that a prescription be issued. Local prescribing support teams should help to ensure safe practice within expected parameters. Systems also need to be supportive rather than adversarial. Increasing workloads and pressures on primary care and reduced secondary care budgets are potential risks which should be taken into account when considering systems. Electronic prescribing in shared systems might facilitate such a process. Avoiding harm and providing efficacious treatment is everyone's aim.

Competing interests: No competing interests

24 February 2017
S R Ross
GP
NHS Greater Glasgow and Clyde