BNF warning for years about abrupt SSRI withdrawal - source Medawar

jeremy9282 · 11-01-2009, 03:57 AM

source
Mr Charles Medawar
Social Audit Ltd
P.O. Box 111
London NW1 8XG

http://www.socialaudit.org.uk/6050429.htm

extract - 29 April 2005 letter Kent Woods to Medawar

"Antidepressant drugs are effective in the treatment of major depression of moderate and severe degree including major depression associated with physical illness and that following childbirth; they are also effective for dysthymia (lower grade chronic depression). Antidepressant drugs are not generally effective in milder forms of acute depression but a trial may be considered in cases refractory to psychological treatments"

This refutes your case that prescribers are not adequately informed of the need to consider severity of depression carefully before prescribing antidepressants.

On SSRIs specifically (BNF section 4.3.3), prescribers are warned of the risks of abrupt withdrawal; the CSM advice contra-indicating SSRIs for major depressive disorder in children and adolescents is prominently highlighted; and the concluding sentence reads "Suicidal ideation has been linked with SSRIs but causality has not been established".

You refer to the NICE treatment guidelines for depression: "Antidepressants are not recommended for the initial treatment of mild depression, because the risk-benefit ratio is poor"[my underlining]

What aspect of the information to prescribers would you take issue with?

jeremy9282 · 11-01-2009, 04:00 AM

http://bnf.org/bnf/bnf/current/login...F58%2F3294.htm

4.3 Antidepressant drugs: British National FormularyThis information is from the BNF. BNF .... SSRIs have been associated with a specific withdrawal syndrome (section 4.3.3). ...
bnf.org/bnf/bnf/58/3294.htm - Similar -

jeremy9282 · 11-01-2009, 04:02 AM

On SSRIs specifically (BNF section 4.3.3), prescribers are warned of the risks of abrupt withdrawal; the CSM advice contra-indicating SSRIs for major depressive disorder in children and adolescents is prominently highlighted; and the concluding sentence reads "Suicidal ideation has been linked with SSRIs but causality has not been established".

11-01-2009, 03:57 AM	#1
jeremy9282 Join Date: Jul 2009 Posts: 105	BNF warning for years about abrupt SSRI withdrawal - source Medawar source Mr Charles Medawar Social Audit Ltd P.O. Box 111 London NW1 8XG http://www.socialaudit.org.uk/6050429.htm extract - 29 April 2005 letter Kent Woods to Medawar "Antidepressant drugs are effective in the treatment of major depression of moderate and severe degree including major depression associated with physical illness and that following childbirth; they are also effective for dysthymia (lower grade chronic depression). Antidepressant drugs are not generally effective in milder forms of acute depression but a trial may be considered in cases refractory to psychological treatments" This refutes your case that prescribers are not adequately informed of the need to consider severity of depression carefully before prescribing antidepressants. On SSRIs specifically (BNF section 4.3.3), prescribers are warned of the risks of abrupt withdrawal; the CSM advice contra-indicating SSRIs for major depressive disorder in children and adolescents is prominently highlighted; and the concluding sentence reads "Suicidal ideation has been linked with SSRIs but causality has not been established". You refer to the NICE treatment guidelines for depression: "Antidepressants are not recommended for the initial treatment of mild depression, because the risk-benefit ratio is poor"[my underlining] What aspect of the information to prescribers would you take issue with?

11-01-2009, 04:00 AM	#2
jeremy9282 Join Date: Jul 2009 Posts: 105	Check out BNF section 4.3.3 http://bnf.org/bnf/bnf/current/login...F58%2F3294.htm 4.3 Antidepressant drugs: British National FormularyThis information is from the BNF. BNF .... SSRIs have been associated with a specific withdrawal syndrome (section 4.3.3). ... bnf.org/bnf/bnf/58/3294.htm - Similar -

11-01-2009, 04:02 AM	#3
jeremy9282 Join Date: Jul 2009 Posts: 105	Yes all antidep have withdrawal problems - but why are our GP's ingoring BNF? On SSRIs specifically (BNF section 4.3.3), prescribers are warned of the risks of abrupt withdrawal; the CSM advice contra-indicating SSRIs for major depressive disorder in children and adolescents is prominently highlighted; and the concluding sentence reads "Suicidal ideation has been linked with SSRIs but causality has not been established".

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