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Treatment resistant depression: what are the options?

BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k5354 (Published 18 December 2018) Cite this as: BMJ 2018;363:k5354

Rapid Response:

Re: Treatment resistant depression: what are the options?

At a guess (which others may dispute), Dr Ed White is probably speaking up for thousands, or tens of thousands, of people in the UK, whose lives have been made more miserable by antidepressants.

After a few decades of SSRI use, the data behind the trials, reluctantly revealed, show a definite excess of deaths from suicide in younger people, as well as a failure to show any definite consistent benefit in alleviating depression, compared to psychological therapies. The resulting uncertainty has been noted and referenced in your pages by numerous readers. (1,2,3)

The serious side effects and the problems that many people face when trying to stop SSRI drugs are insufficiently understood by doctors, and hence may not be explained to patients who are prescribed these drugs. This is contrary to the fully informed consent process that is obligatory for UK doctors to follow, since the Montgomery case. (4)

This area of practice was discussed last week at the Welsh Senedd in Cardiff, where Dr David Healy was the main speaker. Healy’s presentation is essential viewing for each and every doctor who prescribes anti depressants. (5)

1 https://www.bmj.com/content/360/bmj.k1073/rr-0
2 https://www.bmj.com/content/356/bmj.j249/rr
3 https://www.bmj.com/rapid-response/2011/10/31/full-disclosure-ssri-data
4 https://www.themdu.com/guidance-and-advice/guides/montgomery-and-informe...
5 https://www.madinamerica.com/2018/12/antidepressant-dependence-welsh-gov...

Competing interests: No competing interests

21 December 2018
Noel Thomas
retired/ part time GP
BronyGarn, Maesteg, wales, CF34 9AL