Thread by @BryanMcElroy8

More an more patients are being treated for mild/ moderate depression with #antidepressants in general practice, despite there being very poor evidence for efficacy. In my experience, some people experience a transient benefit between 4&12 weeks (likely placebo mediated) &

https://twitter.com/jdaviesphd/status/1361623469121810432

This transient (non specific) effect of taking antidepressants gradually wears off. Patients present back to their GP with similar symptoms or a variant of the same symptoms & most GPS simply up the dose, meanwhile none or little of the psychosocial distress is being addressed.

Many ppl then become psychologically & physically dependent on higher doses of antidepressants with risk of side effects & withdrawal effects accumulating. Often a significant % of these patients barely meet the criteria for what we call depression & even if they do...

The distress of a]the depressed person is typically due/ related to to accumulated stress, lack of sleep, loneliness, trauma, poverty/ financial strain, relationship breakdown, bereavement, chronic pain etc, GPS have little or no time to meaningfully address any of the above

& with little support or knowledge of alternatives up until now, as well as prescribing for distress becoming more culturally normal, GPs& patients find ourselves in a very dysfunctional situation, no one really knowing where to turn to. Pharmaceutical companies have profited

No doubt for some ppl the specific drug induced effect of antidepressants is helpful, but I wonder what % of ppl this truly the case with real world long term trials e.g. Star D showing a 4% remission rate at 1 year. This thread is not about pill shaming, it’s about creating

Honest transparent dialogue as there is so much misleading information that has had an enormous momentum in overmedicalising distress. There are effective alternatives IMO, but what is most important at this stage is to recognise the flaws in our current ways of dealing with

Human distress & creating dialogue, research & openness to effective alternatives both individually & collectively. I see the effects of this misinformation & poorly thought out systematic approach in practice daily & it frustrates & saddens me.