Unhappy legacy of prozac
May 24 2004 By The Journal
Doctors too quick to hand out prescriptions - expert
The number of people taking anti-depressants in the region is spiraling out of control with doctors dishing out more than half a million prescriptions in the past year.
North doctors say the new forms of anti-depressants, Selective Serotonin Re-uptake Inhibitors (SSRIs), are only prescribed to people suffering severe symptoms of clinical depression.
But health experts claim GPs are handing out far too many prescriptions for the drugs without exploring other options such as counselling services.
Worldwide expert on anti-depressants Shirley Trinkett, who has been campaigning against the use of the drugs for the past 10 years, last night hit out at GPs for over-prescribing the medication.
Mrs Trinkett, of Sunderland, said: "The use of antidepressants is spiraling out of control in the region and across the country.
"A lot of people are being prescribed the medication for minor symptoms of depression, who would be better off with short-term sedation drugs or counselling.
"Unfortunately it is a lot easier for doctors to pull out a prescription pad and write Prozac on it than it is to offer people the help they may need. But until there is a counsellor attached to every doctors' surgery, things aren't going to get any better.
Mary Douthwaite, consultant psychologist, North Tyneside Primary Care Trust, said the increase in the use of Selective Serotonin Re-uptake Inhibitors (SSRIs) comes down to a lack of counselling services in the region.
She said: "I think GPs are faced with such a high level of people experiencing depression symptoms that the availability of talking therapies is inadequate to meet the demand.
"GPs feel they need to help their patients and anti-depressants are more easily available.
"I'm sure a large number of doctors would prefer talking therapies for their patients. But given the fact that there isn't enough psychological therapy available then the medication is the only alternative." Sunderland-based psychologist Dr Paul Miller, chairman of the British Medical Association's consultants and specialists committee, said SSRIs are prescribed only to patients experiencing clinical symptoms of depression.
Dr Miller said patients experiencing these symptoms are initially given a prescription lasting for one month and urged to return to their GP for repeats.
He said: "Anti-depressants should only be prescribed when people have clinical symptoms of depression, along with feeling low and down in the dumps.
"These include not getting any enjoyment or pleasure from life and having no energy to do anything at all, severe sleep disturbance and lack of appetite along with seeing the world very bleakly. Prescriptions would rarely be given out for more than one month and it usually takes three to six months before they are back to their normal self again."
A spokeswoman for the Northumberland, Tyne and Wear Strategic Health Authority defended the high prescription rates saying the new forms of anti-depressants are safer and more effective.
She said: "Approximately 50pc of all anti-depressants prescribed by GPs are SSRIs compared to only one per cent in 1991.
"This is because the newer forms of anti-depressants can offer more effective treatment, are generally safer and have fewer side-effects than some older varieties.
"National data shows that prescriptions of SSRIs within Northumberland and Tyne and Wear have grown in line with national trends."
The Journal: Today's Voice of the North
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The facts
What is Fluoxetine/Prozac?
Fluoxetine Hydrochloride, as it is generically known, was discovered in 1972 by scientists working for US-based Eli Lilly and Company.
It first went on the market in Belgium in 1986, America in 1987 and was launched in the UK in October, 1988.
Prozac is used for the treatment of clinical depression, with or without associated anxiety, bulimia nervosa and obsessive-compulsive disorder.
Prozac was the first of the new SSRI drugs to go on the market and is the world's most widely prescribed brand name anti-depressant available in more than 100 countries.
What are Selective Serotonin Re-uptake Inhibitors (SSRIs)?
SSRIs are a widely used group of anti-depressants, which includes Fluoxetine, Citalopram, Fluvoxamine, Paroxetine, Sertraline and Escitalopram. They are mostly used for treatment of depression, but individual members of the group have other, specialised uses eg anxiety, panic disorder, obsessive compulsive disorder, eating disorders, and social phobia.
How do SSRIs work?
The drugs are used to increase the levels of a brain chemical called serotonin.
Serotonin is known to influence many brain functions including regulation of mood and is linked to other psychological functions such as sleep and appetite.
Depressed patients have low levels of serotonin in the brain and it is believed an increased level improves a person's mood.
What are the side effects of Fluoxetine/Prozac?
Ely Lilly and Company list a range of side effects including nausea, difficulty sleeping, drowsiness, anxiety, nervousness, weakness, loss of appetite, tremors, dry mouth, sweating, decreased sex drive, impotence and yawning.
The firm says these tend to be mild and usually go away within a few weeks of starting treatment.
But critics claim the side-effects are more far-reaching.
Their list of side effects includes loss of hair, an abnormal walk, vertigo, hallucinations, paranoia, amnesia, irregular heartbeat, asthma, herpes and arthritis.
And in rare cases, they claim Prozac can cause sores and blisters on the skin, speech impediment, paralysis, coma, insanity, Parkinson's disease, thoughts of suicide, stroke, incontinence, gout, bleeding from eye, abnormal hairiness, abortion, partial blindness and deafness.
