GPs prescribe anti-depressants even though they believe other approaches might be more effective, research claims

April 26, 2005
by Mike Andrews

Almost 80 per cent of GPs prescribe anti-depressants even though they believe a non-pharmacological approach might be more effective, according to research by a leading mental health charity.

The Mental Health Foundation also found that 66 per cent of 200 GPs who took part in a survey prescribed anti-depressants because no suitable alternative - such as counselling or "exercise therapy" - was available for them to prescribe.

Following the publication of its research, the charity has launched a campaign for exercise therapy to be a first-choice treatment for GPs to prescribe for people with mild to moderate depression. Exercise referral schemes already operate in some parts of the UK.

In a report launched last week the charity said it wants the government to invest £20 million in developing and promoting exercise referral as a treatment for mild or moderate depression across the UK.

The charity says research demonstrates that a professionally supervised programme of exercise can be as effective as anti-depressants in treating patients with mild or moderate depression.

Yet the Mental Health Foundation's survey found that only five per cent of GPs use exercise referral as one of their three most common treatment responses for such patients.

This compares to 92 per cent who prescribe anti-depressants.

National Institute for Clinical Excellence guidelines stated in December last year that anti-depressants should not be used as a first choice line of treatment for mild or moderate depression

The survey also found that 78% of GPs who prescribed anti-depressants did so believing that an alternative might be more appropriate.

Although 71 per cent of surveyed GPs believe anti-depressants to be 'quite effective', 57 per cent said they were overprescribed.

The Mental Health Foundation stated that this is around five per cent of the annual spend on anti-depressants in England. In 2003, the cost of anti-depressant prescriptions was £395.2m.

The National Institute for Clinical Excellence guidelines recommended that "patients of all ages should be advised of the benefits of following a structured and supervised exercise programme of up to three sessions per week of 45 minutes to one hour.".

Dr Andrew McCulloch, chief executive of the Mental Health Foundation, said: "Patients with mild or moderate depression asking their GPs for help are currently being denied an effective treatment option - exercise referral.

"There are some obstacles standing in the way of exercise on prescription for all... but they're not insurmountable.

"Society needs to be educated about the benefits of exercise in treating mild or moderate depression, and GPs need to be made aware that exercise referral is available."

Read for yourself
The Mental Health Foundation's report entitled 'Exercise Therapy? The treatment of mild or moderate depression in primary care' (pdf)

See also:
Dec 6, 2004: No evidence that SSRI anti-depressants likely to increase suicidal behaviour, watchdog announces - guidelines also issued for treatment of depression

.....

If only I'd known about the benefits of excercise

Comments from: Julie Marie, lawyer, Channel Islands
Date: September 25, 2005

I am currently withdrawing from Seroxat. I have been on this hellish drug for four years and I am down to 2x quarter tablets per week.

I had read about the withdrawal symptons, but I thought that I would only exhibit mild symptons due to my current happy, settled life.

I cannot believe how wrong I could be. I initially went cold turkey and I was fine for about a week. Then the electric shock feelings took over (amongst other symptons). I can only describe them as split second feelings of losing consciousness. I estimate they occured every 15 seconds.

The other awful withdrawal sympton was the horrific nightmares. In the end they terrified me so much I set my mobile phone alarm to go off every three hours during the night so that I would be awoken from these vivid horrendous dreams.

As a result of the above I started to take Seroxat again but I halved my prescription for a week and then last week stopped again. Things were OK and I thought that it was all coming to an end.

No! It was not meant to be! This weekend has been another Nightmare on Elm Street. Vivid scary dreams are still frequent but do not occur on a nightly basis. Fingers crossed for tonight as I have work tomorrow.

My hell this weekend has been my temper. I am normally fairly placid, non aggressive and happy go lucky. However yesterday morning I turned into a foul mouthed, raving lunatic. Unfortunately my two young children were on the receiving end of this behaviour. I have fought all weekend to understand, analyse and try to control my behaviour but to no avail. Sadly I am back on my reduced dose again.

I shall not give up! I will rid myself of this drug (that should be taken off the market).

Ironically when I look back to when I was prescribed Seroxat I think that regular exercise would have helped me enormously. Little did I know of the benefits of exercise to treat mild to moderate depression.

I would be exercising more now if I thought I could control my Seroxat withdrawal induced temper.

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