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GPs cut back on antidepressant prescribing in recent years, study shows



GPs are prescribing fewer antidepressants to patients with newly diagnosed depression than ten years ago, despite the overall rise in antidepressant use, new research shows.

GP prescribing of antidepressants in people with a first bout of depression fell by 12% between 2003 and 2013, from around 73% to 61%.

However, the overall rate of antidepressant prescribing stayed at roughly 70%, because of increase in treatment rates among patients with recurrent episodes, which went up from around 74% to 78% over the same period.

As a result more people are being prescribed antidepressants long term – the mean number of prescriptions given to each patient doubled from two to four per year over the study.

Antidepressant prescribing in primary care has increased markedly in recent years, particularly since the financial crisis hit in 2008.

However, the study authors, led by Professor Tony Kendrick at Southampton University, said their findings showed GPs had responded to the introduction of NICE guidelines and QOF measures that encouraged more targeted use of antidepressants – they found significant ‘step change’ reductions of around 4% in the rate of antidepressant prescribing for first-ever episodes after each of these initiatives were introduced, in 2005 and 2006.

Professor Kendrick told Pulse: ‘GPs did try and follow NICE guidelines to reduce antidepressant prescribing, and that was reinforced by QOF, although it was only for new cases of depression.

‘The reduction in prescribing for new cases was cancelled out by increased longer-term prescribing for recurrent cases, and overall prescriptions went up due to longer courses being prescribed.’

The study was not able to look at the appropriateness of prescribing, and the authors said more research is needed into ‘the potential benefits of reviewing patients with a view to discontinuing treatment’.

However, Professor Kendrick said it was likely some patients who were taking antidepressants long-term could be reviewed and taken off the drugs.

Professor Kendrick said: ‘I think the SSRIs have become like the benzodiazepines, and we need to start taking people off inappropriate long-term antidepressants.’