Faced with the often difficult effects of withdrawal and the many side effects, the prescription of anti-depressants should be avoided or reduced.
- The authors were mainly interested in new forms of antidepressants: serotonin reuptake inhibitors.
- The main symptoms of withdrawal are: anxiety, insomnia, depression, restlessness and changes in appetite.
- These drugs can have effects on social and professional life, especially in the event of sudden cessation.
Covid-19 harms our mental health and the consumption of anti-depressants bears witness to this. There were more than 1.9 million additional dispensations of antidepressants between March 2020 and April 2021, compared to what was expected, according to data of the scientific interest group EPI-PHARE. But should these drugs be prescribed to all patients with psychological disorders? No, according to a study published in the British Medical Journal. In this work, scientists question their use, given the difficulties associated with weaning. They believe that fewer antidepressants should be prescribed and for shorter periods.
Disadvantages sometimes outweigh the benefits
The authors of the study, Mark Horowitz, of University College London, and Michael Wilcock, of the Royal Cornwall Hospitals NHS Trust, started from an observation: between 2019 and 2020, 7.8 million people received minus a prescription for antidepressants. This equates to one antidepressant prescribed to one in six adults, with prescription rates 50% higher among women. “Although antidepressants may be of benefit in patients with severe depression, the harms may outweigh the benefits in those with mild to moderate depression or those whose symptoms are not yet considered depression.“, explain the researchers. In some people, these drugs can also cause various side effects: one in five patients suffers from daytime sleepiness, a dry mouth, profuse sweating or weight gain, and one in four patients reports sexual difficulties. They may be more severe for people taking antidepressants for more than three years, they may feel a kind of “fog” mental.
Insufficiently proven effectiveness
Most of the evidence for the effectiveness of antidepressants in adults comes from placebo-controlled trials lasting only 6 to 12 weeks, the UK scientists say. “The results do not meet the threshold of a clinically important difference“, they point out, which means that according to them, between the placebo and the drug, the effects are not significantly different from a clinical point of view. According to them, the results in adolescents and children are even less convincing, as prescriptions for young people aged 12 to 17 more than doubled between 2005 and 2017.
Often difficult weaning
Withdrawal effects from antidepressants are more frequent, longer lasting and more severe than previously thought, say the authors. They deplore a lack of information on this period of shutdown. While gradually reducing the dosage can help, scientists point out that long-lasting side effects are difficult to predict. “Gradual dose reductions and the very small final doses required will necessitate the use of new drug formulations other than the commonly available tablet forms“, they add. Faced with these various uncertainties, the authors call on the medical community to be cautious when prescribing antidepressants.
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