Prevalence, duration and indications for prescribing of antidepressants in primary care

Abstract

SIR—Depression is thought to occur in 10% of the adult population in Britain at any one time [1]. In older people, the incidence of depression rises to 15% [2]. We know that the volume of antidepressants prescribed in English primary care, where most people receive treatment for depression, has increased substantially over recent years [3, 4], but there are no data on the prevalence of antidepressant prescribing at patient level and the extent of continuation of prescribing in individual patients. Guidelines suggest withdrawal of antidepressants after 6 months of effective treatment [5], but long-term prescribing (2 years or more) may be appropriate if the illness is chronic or relapsing. A more worrying reason for long-term prescribing would be difficulty with stopping antidepressants because of unpleasant withdrawal reactions. Patients may also remain on treatment by therapeutic momentum—because the prescriber does not suggest or attempt withdrawal or does not review the continuing need for the medicine.