Following its launch last year and the subsequent criticism of its position by prominent psychiatrists in the The Times and The Lancet Psychiatry, the Council for Evidence-based Psychiatry (CEP) responded by issuing a challenge to its critics to engage in an open, public debate on psychiatric drug harm.
Taking up this challenge, the Institute of Psychiatry at Kings College London will be hosting the 52nd Maudsley Debate starting at 17.30 on 13 May 2015 entitled: ‘This house believes that the long-term use of psychiatric medications is causing more harm than good’.
Speaking for the motion will be Professor Sami Timimi (consultant child and adolescent psychiatrist, University of Lincoln) and Professor Peter Gøtzsche (director of The Nordic Cochrane Centre), both of whom are members of CEP. Speaking against the motion will be Prof Allan Young (professor of mood disorders, King’s College London) and Mr John Crace (journalist at The Guardian).
Professor Gøtzsche will begin by highlighting the deadly impact of psychiatric drugs on the elderly: ‘I have estimated, based on randomised trials and cohort studies, that psychiatric drugs kill more than half a million people every year among those aged 65 and above in the USA and Europe. This makes psychiatric drugs the third leading cause of death, after heart disease and cancer. The drugs furthermore cripple tens of millions. There are no benefits that can justify so much harm.’
Professor Timimi will then challenge the medical establishment to recognise and act upon these harms: ‘We are in danger of creating morbidity on a massive scale with our current non evidence-based mass use of long-term psychiatric medication… The evidence is clear and the big question is not whether long-term prescription of psychiatric drugs does more harm than good but what are we going to do about it. Bodies like the Royal College of Psychiatrists have a scientific and moral duty to do something. If they won’t they are in danger of becoming part of the problem rather than what they should be, which is a strong advocate for patients and those who serve them.’
Around 85 million prescriptions were issued for psychiatric medications last year in England, including over 57 million prescriptions for antidepressants – enough for every man, woman and child. Antidepressant prescribing has increased by 7.5% since 2013, and over 500% since 1992. This level of prescribing is particularly worrying given that the prevalence of severe depression has remained steady for decades.
Recent research indicates that prescriptions are rising because more people are taking antidepressants for longer; often they become dependent on them and cannot stop. However there is no good research supporting the safe long-term use of these drugs, and withdrawal support charities report that over 50% of their enquiries now relate to the negative withdrawal effects, which can be debilitating and sometimes lasts for years.
To reduce harm Professor Gøtzsche believes that prescribing practices urgently need to change: ‘As psychotropic drugs are immensely harmful when used long term, they should almost exclusively be used in acute situations and always with a firm plan for tapering off which can be difficult for many patients. We need new guidelines to reflect this. We also need withdrawal clinics all over the country, as many patients have become dependent on psychiatric drugs, including antidepressants, and need help to get off them slowly and safely.’