Following campaigning by CEP, the All Party Parliamentary Group for Prescribed Drug Dependence and numerous members of the #prescribedharm community, the Royal College of Psychiatrists has today changed its position on antidepressant withdrawal. It has issued a revised policy statement updating its guidance to doctors, and calls upon NICE to update its guidelines as well. This follows many months of work by CEP and its members, including the publication of research which indicates that antidepressant withdrawal is more widespread, more severe and more long-lasting than suggested by current guidelines.
Specifically, the College is calling for the following changes:
- There should be greater recognition of the potential for severe and long-lasting withdrawal symptoms on and after stopping antidepressants in NICE guidelines and patient information
- NICE should develop clear evidence-based and pharmacologically-informed recommendations to help guide gradual withdrawal from antidepressant use
- The use of antidepressants should always be underpinned by a discussion with the patient about the potential level of benefits and harms, including withdrawal
- Discontinuation of antidepressants should involve the dosage being tapered, which may occur over several months, and at a reduction rate that is tolerable for the patient
- Monitoring is needed to distinguish the features of antidepressant withdrawal from emerging symptoms
- Adequate support services should be commissioned for people affected by severe and prolonged antidepressant withdrawal, modelled on existing best practice
- There should be routine monitoring on when and why patients are prescribed antidepressants
- Training for doctors should be provided on appropriate withdrawal management
- Research is needed into the benefits and harms of long-term antidepressant use
Dr James Davies, co-founder of CEP, says, “We welcome these changes in policy which, if acted upon, will help reduce the harm that is being caused to huge numbers of patients through overprescribing, inadequate doctor training and often disastrous withdrawal management. CEP calls upon the College to follow through with these demands, and help ensure that NICE guidelines in particular are updated to reflect the latest evidence. In addition, we look forward to the publication of the Public Health England report on prescribed drug dependence later this year, with the hope that the government will also respond to the urgent need for withdrawal support services, including a 24 hour national helpline.”
” the Royal College of Psychiatrists has today [30may2019] changed its position on antidepressant withdrawal ”
its about damn time.
Congratulations to CEP for this. Thankyou so much.
Hopefully now ‘withdrawal’ will now be a word added to doctor vocab and to their reference manuals. Why on earth did this take so long to get acknowledged.
Could this mean the propaganda, false narratives and victim blaming will stop….I certainly hope so!
“Monitoring is needed to distinguish the features of antidepressant withdrawal from emerging symptoms”
This one has me worried though. This has left the door open for blaming the person. Unless one has experienced this for themselves there is no way of being able to distinguish these. The emerging symptoms are withdrawal! In my opinion you may as well push the delete button on any other reason. Its all withdrawal and may go on for years.
“Discontinuation of antidepressants should involve the dosage being tapered, which may occur over several months, and at a reduction rate that is tolerable for the patient”
For many the reduction rate that ends up being tolerable for the patient may well be in the ‘many years’ category. ‘Several months’ for a massive number will be far too fast.
Excellent development for Luke and all at CEP to have influenced a change in attitude of the Royal College of Psychiatrists. I greatly admire the courage and determination of Luke and his family with Dr James Davies.
The problem remains how to change the attitude of the poorly educated doctors and psychiatrists who persuaded their patients of the need for antidepressant treatment followed by addictive benzodiazepine sleeping pills to counteract the adverse effect of insomnia.
The only exam for medical students to test ‘competence to prescribe’ has only been around for the past 3 years and qualified doctors are not challenged on their knowledge of iatrogenic (treatment induced) harm) and how to recognise early signs of intolerance . I hope Luke and James will join my charity APRIL.org.uk in our effort to improve medical education.
My daughter Karen died in an avoidable accident, following suddenly stopping taking the benzodiazepine sleeping pill, Temazepam, as we had not been warned of the need for slow withdrawal.
Her health had deteriorated due to 3 times the dose of Kemadrin (procyclidine) an anti-parkinson drug used to counteract the dystonic effects of other drugs. Over prescription by 3 times the required dose, the psychiatrist admitted.
Karen also experienced Akathisia, which is extreme agitation, triggered by an antidepressant. This side-effect often leads to increasing the dose of the drug that caused this life threatening adverse drug reaction (ADR) by prescribers unaware this is an (ADR). In Karen’s case, it also nearly led to severe harm as she resorted to taking several sleeping pills, to ‘Calm herself down’.
During the 24 years since Karen’s death, I too have campaigned, had meetings with the BMA, MPs, NICE and got nowhere. I was informed at a private meeting at the BMA by a GP, he found Professor Heather Ashton’s Benzo withdrawal protocol ” too much to read”.
Where are we going to find enough people, with the patience to study withdrawal protocols to enable support for the thousands of people wishing to withdraw safely from antidepressants and benzodiazepines?.
The influence of Luke and his father who first brought the subject up in the House of Lords, has made all the difference. Now the issue is to stop the over prescribing of these drugs in the first place.
Wonderfully well put, Millie. Our son Olly died by suicide or should one say, prescripticide, following years of prescribed RoAccutane isotretinoin for his severe acne, and then antidepressants and antipsychotics to raise his low mood on it, and then to calm down his ensuing terrible hellish akathisia. He was finally finished off by Olanzapine and Sertraline which he was also intolerant to. I have been ‘allergic’ to or intolerant of, a whole plethora of medications all my life, the latest being omeprazole for reflux problems . I think there are those of us who just cannot, for some epigenetic reason, maybe to do with metabolism, tolerate many many drugs. Steroids pitched me into akathisia on just an 11 day course some years ago and it took me a year to get my mind working normally again. I’m sure my son, who had the same kind of acne as me, and was allergic to dog and horse hair as I am, and to cat hair as my grandmother was, had asthma as did she, was epigenetically unable to tolerate many medications including the RoAccutane isotretinoin and the ensuing neuroleptic drugs, but no doctor would listen. When I try to point out the worry I have, before being offered anything to take, having suffered anaphylaxis on iodine dye and hay fever injections years ago, they just smile and say, things have moved on. Till I got breathing difficulties on Omeprazole a few weeks ago, whereupon they just looked exasperated as though all this is my fault and under my control! My wonderful son died because no doctor would listen. Thank heavens at last James Davies has got this new approach started. Heather Roberts, of the Olly’s Friendship Foundation.
Dear Heather, I have often heard about your poor son Olly, from Jon Medland who also lost his son to iatrogenic suicide. I think Prescripticide is a good term too. I begged the Cornoners to include iatrogenic suiicide in their list of possible verdicts. Or at least to have a data base of drugs used or stopped in the months prior to a sudden death.
The Manchester Coroner who spoke at the last APRIL charity conference thought many of the sudden deaths or so called ‘accidents’ were linked to prescribed medicines.
I would like more details of your organisation please so can you email time at
info at april.org.uk (using proper email characters) – I spread it to avoid spam.
I have just returned from Edinburgh Festival Fringe where I told the true story of my daughter’s history of ADRs and named the drugs. I got two 4* reviews and met doctors who are interested to help in the quest to improve the poor education many health professionals have revived in the area of pharmacology.
Best wishes and heartfelt condolences for your loss.
Millie
some typos eg revived should be received.
Yes, indeed “Now the issue is to stop the over prescribing of these drugs in the first place” you are right. But we still have a big problem, better stated two big problems, there is an urgent need to further develop other kinds of places and treatments to help us when we are suffering altered state of mind, what is now tag as “mental illness” . On the line of Soteria houses for persons that have never been given drugs, to other similar places but with extra support for people already been “medicated (drug)”, and there is still to mention thousands of subjective records of patients which will need to be “updated” …. In order to be able to really help people to recover. There are other treatments where drugs are use the minimum possible as is the case of “Dialog” method which is from a Nordic country. A lot of “mental” problems that we are experiencing may well be resolved with a society who may focus in a spiritual and economical balance life for their members….general evolution of humanity has been converted in involution only for economical gains for a few and this is a big part of the problem
This is great news. Congratulations to all involved. I self weaned off venlafaxine and it took me 8 months. After a previous failed attempt under a gp‘s ‘guidance’ years before, I tapered at an approximate rate of 10% and stayed there between 4 and 6 weeks each stage. I thought I was dying was I finally stopped in march this year. Even after such a slow tapering I still went through discontinuation syndrome for 3 weeks. The whole antidepressant experience has ruined my life in many ways.
Thank you to CEP and other organisations and individuals for you hard work on this issue. This shows that the pressure works and it needs to be kept on. I have found it especially revealing reading the work of Peter Levine (Waking the Tiger). Somatic Experiencing offers such a totally different model of trauma that genuinely helps people, whereas the drugs are grossly ineffective and are based on an outdated understanding of trauma.
Well done, great to know and thank you so much.
Now everywhere we must create support for people in the long and difficult journey of ‘coming off’ ..
For myself I never go to doctors when depressed, rather to nature and to poetry – or both together, as in
The Peace of Wild Things
When despair for the world grows in me
and I wake in the night at the least sound
in fear of what my life and my children’s lives may be,
I go and lie down where the wood drake
rests in his beauty on the water, and the great heron feeds.
I come into the peace of wild things
who do not tax their lives with forethought
of grief. I come into the presence of still water.
And I feel above me the day-blind stars
waiting with their light. For a time
I rest in the grace of the world, and am free.
Wendell Berry
Very many thanks and congratulations to CEP for this great achievement.
Would it be possible now to focus attention on the harm being caused by long term neuroleptic drug prescription? I witness the harm being caused to my son by these drugs to the extent that his condition has clearly deteriorated rather than improved. My concerns are not taken seriously by a succession of psychiatrists who are embedded in the biomedical model and prefer to interpret the obvious harmful effects of these drugs as signs of his illness. My son and I are powerless in this situation.
Maybe researching in your country or others you can find a health professional willing to change the drugs or at least reduce them
Heartfelt congratulations on this very positive development.My own gradual withdrawal from benzodiazepines lasted approximately twelve months.Had I not been aware of some of the withdrawal symptoms mimicking classical mental health problems, I would have returned to the GP and asked from more medication, thus being caught in an endless cycle of withdrawal attempts and re-prescription. I was fortunate in that I had done my research and was familiar not only with Professor Heather Ashton’s protocol, but also the other research that was being done on benzo addiction and withdrawal in the nineteen eighties (huge thanks to Esther Rantzen and her ‘That’s Life TV programme). I agree wholeheartedly with a previous comment about the need to include safe withdrawal protocols in the advice sheets given out with the pills an also for the commissioing of withdrawal support groups/clinics in GPs surgeries. issue.Hopefully, a more holisitic approach to withdrawal including talking therapies, CBT, Mindfulness, diet and exercise will be recognised as a healthy way to man age one’s symptoms. I wish your organisation all strength in continuing to campaign and raise awareness amongst the medics and politicians of this long standing medication issue.
Congratulations YES,
I agree with Nuala, however I have three adult children and cannot have them together in one house. All are on multiple interacting drugs forced on them by MH services, all for very different reasons. I have no time to add more atm but many on the Prescribed Harm group are well aware of my complex position, I will add more info ASAP
Thank you again
Sonia Milsom
This is good news and hopefully people who need help to withdraw and remove themselves from mindbending, toxic, prescribed chemicals will receive it in the best way that fits for them as the individuals they undoubtedly are.
I believe however that we as a race need to put the resources we currently plough into MH pharmaceuticals into a different type of provision. We need to provide places of comfort, warmth and safety to help us care for people who are suffering mental and emotional distress. And when that person/those people are ready to express what’s happening for them we need to be prepared to listen…and continue to listen. As beneath mental distress lays a trauma and being calm and caring with and around people suffering distress can help them enable themselves to begin the healing they need and deserve.
In my view this is where we need to focus our care, attention and resources.
Shirley Smith
Soteria Network UK
Yes Shirley that is what needs to be done in order to offer a person the chance to fully recover and not to be tortured and harm the rest of her,/his life. THIS IS NOW URGENT and needs to be in the agenda to anyone that wants to stop this genocide, xxi century holocaust in our own face and day to day life. Without the creation not safe places like a, Soteria the drugs and who is promoting them will never stop!
Thanks cepuk and the APPG Review for getting this far. Too late unfortunately for my poor son who is still withdrawing after two and a half years, as well as suffering PTSD from the court case thrust upon him as a result of the Adverse Effects of taking an SSRI and added Tricyclic, which caused serotonin syndrome, and hypomania. Stupid and ignorant Judge did not have any knowledge of the effects of such negligent prescribing by equally ignorant GPs. His whole life is ruined, and as a result the lives of his parents. He survives to keep loving his precious sons who were used as weapons against him, forcing him to prove he was no risk to them.
New GPs and psychiatrists are still proffering him more of these harmful drugs – to cure his withdrawal symptoms. Fortunately he does not “comply” to their treatment. Far more needs to be done to ban these drugs that do more harm than good. Whenever he does not answer his phone, I worry that he might have ended his life – So, Wendy Burn, Matt Hancock, and GPs everywhere – get your acts together – drugs that have side effects such as suicide ideation should be banned NOW!
Further to my previous reply regarding suicide ideation – When trialling outcomes of withdrawal sufferers, we should absolutely essentially include the numbers of suicides, as we should also with patients still taking these psychoactive drugs. The only person I know of who does that is Brian, of AntiDepAware who follows up on coroners reports and puts them on his website. Our NHS system seems to be totally indifferent to these poor non-survivors of antidepressants. Certainly The Royal College of Psychiatry is totally in denial or dismissive of these victims. Some official body should collate these numbers of deaths, and they should be factored into the percentages of those harmed by these immoral destructive drugs. Someone has to speak for them, not just their family members, but the medical profession, and especially the psychiatric fraternity. If this is not done – this is meaningless. The NHS needs to be forced to keep this record compulsorily – or we live in a failed state.
Which of course we do ….instead of leading the world in this matter. Life must not be cheap, especially in thrall to the Big Pharma companies with their corruption.
Totally agree Rosemary.. it’s time that something is seriously done about this medication. I know there are many who are trying right now but we all need to get together and build a bigger and stronger army against pharma’s, against gp’s and doctors and all that are advocating antidepressants whilst hiding the truth behind them. I’m a suicidal survivor. I completely trusted the doctors who continued to up my dosage when I wasn’t feeling better. My own research opened my eyes. I weaned myself off over 8 months and it’s the best thing I’ve ever done. Now I want to fight for others. CEP’s victory is one step closer.
Completely agree Rosemary.
I have twice submitted to Coroner’s Inquiries with the suggestion that for all sudden deaths, a record of prescribed drugs used, stopped or started withing say 6 – 9 months of the death could be placed on a data base. So a ‘no blame’ analysis could highlight significant data.
A Coroner can ask for medical information and can record this but currently there is no, or was no data sharing between Coroners. When I went to the Coroner’s office where the data for my daughter was held, as I wished to add the information about the medicines, I had discovered long after the inquest, to the file in case anyone did research. The receptionist said ” We just had our first Ritalin death!”.
This kind of information is lost and one Coroner may find the medicines significant, while another will brush it under the carpet, to get a quick verdict out of the way and move on to the next case.
I have witnessed this with a girl who was prescribed by different doctors, Prozac, Dianette, Roaccutane and Zopiclone, all linked to suicide risk. The train driver stated, she ‘staggered and fell’ the coroner told the jury – the girl jumped. The verdict was suicide and no mention of the fact the doctors had never spoken to each other about a vulnerable girl. The Coroner used the medical names for the drugs so the jury would not have found significance or understood what they were.
I am getting old and have spent over 20 years trying to make changes, had some result with medical education which is a disgrace currently, failing the doctors who are not expected to know anything about psychiatric ADRs or withdrawal effects. There may be a call for a patient group to help a Professor of Clinical Pharmacology to move in the area of CPD for the already qualified doctors. At last there is an exam for medical students to test ‘Competence to Prescribe’ – only there for the past 3 years and it is not mandatory.
Clinical Pharmacology and Therapeutics was withdraw around 1992 by the GMC from ‘Tomorrow’s Doctors, the official guide for medical schools curriculum. I had to nag and nag and got them to add ‘side effects’ to the guide in 2001 or 2002.
If the consultants would not prescribe these drugs pharma will not benefit, psychiatris, doctors, nurses, judges, social workers are all taking economical benefits and deciding to ignore so many tortures, and destroyed life’s…
Congratulations CEPUK!
An amazining milestone ! The world is watching. We have the same debates here in Norway. Your work is inspiring. And your welcome to Norway any day! Please keep up the good work.
Best regards
Dr Mohammad Yousaf
Chief Psychiatrist
Hurdalsjøen Recoverysenter
Norway
Millie Kieve – brave and dogged of you to fight for acknowledgement by the Medical Profession that education in this area of prescribing of dangerous drugs is sorely lacking. It is in fact shocking. I for my part will write to my son’s old GP surgery who were responsible for his poisoning , advising them to refer to the cepuk.org website and read all the articles, and the comments too, on this vital subject. I would love to name and shame them, and sue them for damages – but then – was it really their fault? Is that why no lawyers will take on a negligence claim on the basis of antidepressant drugs – because the drugs were regulated by MHRA and passed, and NICE’s guidelines were too limited in scope, because of their own ignorance? Whose fault was it ultimately that these drugs passed safety limits. Health and Safety rules have become somewhat silly in so many areas of our everyday life, yet here in this most important area of mental health treatment, they have got away with murder, – literally. Who ? Psychiatry and the Pharmaceutical companies. But we must now demand of the Health Secretary and the NHS that they reverse this state of affairs.
Thalidomide, Valproate, infected blood transfusions – and next antidepressants! Let us not stop yet …. research into long-term effects must come soon. Alistair Campbell was such a sad figure when he featured on the BBC’s 3 part TV series on depression – and how I squirmed every time we were shown him popping his Sertraline pills. To no effect in all honesty.
Until now if you bear to speak up or discusse the harmful and ineffective result from this drugs to a psychiatrist or social worker , you may be ban from seen/contact your relative, displace as near relative that you are not involve in his her care, they may try to tag you as well as if you are suffering mental illness and many other unbelievable situations…even GP seem sometimes defenseless
It is a major victory for the Mail, which for the past two years has been working with campaigners to highlight the plight of those left struggling to come off prescription drugs.
The Royal College has changed its position after hearing countless patients’ stories highlighting the devastating impact of withdrawal – with the worst-hit experiencing nausea, anxiety, insomnia and agitation.
“Psychotherapist Dr James Davies of the University of Roehampton, an outspoken critic of the overuse of antidepressants, said last night: ‘This is a huge, dramatic shift in position by the Royal College.
‘It’s a real step forward in trying to stop the widespread harms that have been experienced by people trying to come off these drugs.
‘We have been working very hard to persuade the Royal College to change its position and it has been the Daily Mail that has been giving voice to the research community that has called for a change.’
Totally agree ….thankyou Daily Mail.
And let’s not forget The Times …
Two organisations which refused to be gagged.
The RCP would have gotten away with it too, if it weren’t for you meddling patients!
Reminds me of the other areas of campaigning where groups patients ask for the same standards of science that are deemed necessary in other fields (for example the need for blinding or objective measures of functioning/disability in clinical trials! Or withholding data and cherry-picking outcome measures).
Yet this is being met not only with stubborn resistance, but the patients are being told they are the ones being unscientific and their complaints are considered harassment.
RCP are still getting away with it; 2 and a half months since this post appeared on cepuk.org website, and i jumped for joy. Three days ago my son saw yet another Psychiatrist as he has to to qualify for Benefits now he can no longer work. She listened to his horror story of adverse effects which destroyed his life, and was sympathetic, then proffered him several different antidepressants, 2 mood stabilizers, Pregabalin again and finally Benzodiazepines. He joked that he could start his own pharmacy – but he refuses to take the pills. Nothing has changed – psychiatrists in Hospitals remain as wicked as ever. He understands better – that he is a survivor, and so improves a bit. The injustice never gets dealt with, so the sense of it always remains.
As the concerned mother of a man who has been a service user for 18 years I have become very involved in campaigning for mental health reform and I am heartened to be witnessing a genuine interest in change. However, I fear it will take years for this enlightenment to influence the practice of consultant psychiatrists who adhere relentlessly to the biomedical model and its hierarchical structure.
I am witnessing my son being harmed by a cocktail of drugs and denial of the dire side effects, which are regarded by his current psychiatrist as part of his illness. She tells me she takes a holistic view and uses a biopsychosocial approach, however I see no evidence of the psycho and social bits. My son has been in a well resourced unit for 3 years at a cost, I am told, of £3500 a week. He is in a much worse condition now than when he was admitted. Despite the triangle of care and Carers’ Toolkit, I feel marginalised and powerless, as is my son. I have the ear of senior managers in the hospital and the Trust who share my concerns but it appears not possible to intervene clinically as ultimate power rests with the consultant.
I used to say my son was being damaged, I have now started to say he is being destroyed. My fear is that the good changes underway will be so slow to effect change at ward level in this hospital that it will be too late for my son. It is tragic that approaches which could really help him to recover, such as Open Dialogue, do exist, yet the clearly harmful biomedical model persists.
Hello Nuala I am horrified of how long is taking for real help for our love ones to become a reality. Provoke death or harm to a human being in a western world knowingly is consider murder.
There is too much evidence of how damaging is the actual psychotropic treatment is doing to humans and the psychiatrist responsibility would be to be the first ones to support a straight away change by now urgently creating the real places where the victims can at least improve their lives, and where other in need of emotional support can be helped instead of use for other humans interests.
We need to push the creation of that places NOW.
There is not enough to write only people needs to get together in unison at countries level, specially young people needs to be aware and informed of this situation.
The only way is to put together the families, friends and health professionals and start pilot places like Soteria, not the only one.
There will come a time when psychiatrist will sit in court to be judged as it happened with the Holocaust, too many lives destroyed for no need still they continue doing the same.
I would like to think that this argument may help those psychiatrist to accept that there is a need for a radical change in treatment and to start at looking how to go ahead… before is too late for themselves!
I experienced the symptoms of withdrawal for roughly 4 weeks. I was prescribed to take Luvox after getting treatment a telepsychiatry. When I got well and was advised to stop taking the pill, the symptoms became evident. I was fortunate enough that the telepsychiatrist who treated me helped me alleviate the symptoms through constant communication. A year later, I now work for them on patient screenings 🙂