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GPs hamstrung when treating depression

I read with interest the feature 'What you need to know about depression'. GPs have been unfairly criticised too often for their management of depression.

What limits many of them is the Lilliputian strings that tie them down and a QOF that can incentivise them to manage the health of the population in preference to meeting the needs of individuals.

That GPs are hamstrung in their treatment decisions is evident from Depression Alliance's recent report Daring to Choose.

The charity's poll of 52 GPs found 81% felt restricted in the medication they were able to prescribe, 39% rarely or never prescribed non-drug treatments, a further 38% prescribed 'quite often', and 78% felt some restriction in their ability to prescribe non-drug treatments.

The gold standard comparator for cognitive behaviour therapy is antidepressant treatment. While the placebo effect operates in all these studies, a statistically significant additional treatment effect occurs with antidepressants.

Clinicians must be able to assert their professional expertise and patients their informed choice in selecting the most suitable antidepressant, since recent research has blown the lid off the notion that all SSRIs are the same.

This is consistent with the notion of a 'world-class' NHS and a Government commitment to enabling choice and evidence-based practice.

From Dr Chris Manning, former GP and director, UPstream Healthcare

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