Intended for healthcare professionals

Rapid response to:

Editorials

Judging the benefits and harms of medicines

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j3129 (Published 30 June 2017) Cite this as: BMJ 2017;357:j3129

Rapid Response:

Requested Co-operation to Prevent Harms from Antidepressant Withdrawal

Routinely in PILs the withdrawal and dependency inducing qualities of psycho-active drugs are understated. The long term effects of antidepressants are unknown. There is no research on the horizon, yet these drugs are probably some of the most over-prescribed in medicine and are routinely used for far longer than the 12 weeks of human trials.

Compounding this situation, medicine is failing patients by denying that withdrawal symptoms can be serious or that they can last longer than the three/four months which is optimistically used as a time frame for symptoms. Seizures, systemic disorders, movement disorders, akathisia and suicidality to name but a few of the most serious effects are reported by patients in withdrawal, and often these symptoms follow withdrawal advice that medicine gives out which is too fast.

To achieve a slower speed of taper and get off these medicines safely, patients are forced to take drastic measures. In the absence of liquid versions of drugs, they grind up tablets to make solutions and open capsules to count out beads as they cannot manage to withdraw over the medically advised time frames without nasty and often dangerous symptoms. They need to follow micro-tapers but medicine advises standard doses. This article in The New Scientist explains: https://www.newscientist.com/article/2140106-people-are-hacking-antidepr...

Specific protocols which recognise these potential harms and support safe withdrawal are long overdue and appropriate tapering doses are required.

Patient support groups currently offer superior advice to medicine precisely because they are not in denial about the potential harms. Yet doctors routinely discourage online help assuming theirs is better. In truth,patients are choosing this advice because yours is failing them. The standard statement, “seek medical advice” is pointless to hand out. Referring people to their doctors for advice meets with protocols which induce symptoms or harms and once harmed by medicine and an ill-advised withdrawal medicine turns it’s back. What should support groups and patients do?

For sure, something needs to be done here. Patient safety is in jeopardy and anger is mounting. As this report highlights medicine is in crisis when it comes to confidence in research and yet still widely in denial. Whose advice are doctors adopting and who needs to be challenged? Pharma, the NHS, Government Ministers and advisors, the Royal Colleges, the medical defence unions or the lot? Patients and the reputation of medicine is suffering and this level of denial is unsafe and frankly insulting.

Competing interests: No competing interests

08 July 2017
Pauline C Dove
patient
SSRI withdrawal patient support groups
Lincoln