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Pharmacists to update patients on risks of antidepressants and to support withdrawal


By Isabel Shaw

22 Oct 2021

Pharmacists and other health professionals should ensure their patients are aware of the risks associated with taking antidepressants and other dependence-forming medicines, NICE has said.

The guidelines, published today (22 October), advised that patients should also be made aware that support is available for withdrawal from their medication through regular reviews.

In the UK, 11.5 million adults received a prescription for a medicine associated with dependence or withdrawal symptoms, including antidepressants, opioids and sleeping tablets, from 2017 to 2018.

The new guidance considers how healthcare professionals in primary care — including doctors, nurses and pharmacists — can better support safe prescribing and withdrawal management of medicines associated with dependence or withdrawal symptoms for adults.

Healthcare professionals should provide patients who are taking or considering coming off dependence-forming drugs with regular review meetings by phone, video or face to face, the guidance said.

The reviews should check whether the condition for which the medicine was prescribed has been resolved, and if it has, whether the person wants to stop taking the medication.

They should also consider whether the potential harms of the medicine outweigh the benefits and if problems linked with dependency while on the medicine have developed.

‘Patients taking these medications will struggle to stop and will require the support of healthcare professionals to safely reduce their dosage until it is no longer required’, the guidance explained.

The number of antidepressant items prescribed in England has increased over the past five years, with 20.5 million antidepressants prescribed between April to June of this year, a 7% increase compared to the same period last year.

Similarly, the use of opioids increased by 40% during the pandemic, when some patients were forced to wait longer for orthopaedic surgery.

This week (17 October), NHS England and NHS Improvement announced it was considering a further expansion to the NMS, which could see the addition of depression as another therapeutic area.

Last month (September), research published in The New England Journal of Medicine found that patients who have been taking antidepressants for a long period are significantly less likely to experience a relapse into a depressive episode if they continue to take their medication than those who decide to stop.

It follows a Cochrane review earlier this year, which found little evidence that current approaches for stopping long-term antidepressant use were safe and effective in people with recurrent depression.

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