Campaigning persuades Royal College of Psychiatrists to change its position on antidepressant withdrawal

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.”



11 Responses to Campaigning persuades Royal College of Psychiatrists to change its position on antidepressant withdrawal

  1. kiwi 30/05/2019 at 4:42 am #

    ” 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.

  2. kiwi 30/05/2019 at 4:52 am #

    “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.

  3. Millie Kieve 30/05/2019 at 7:37 am #

    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 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.

  4. Michael Z Freeman 30/05/2019 at 8:17 am #

    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.

  5. Nuala Sheehan 30/05/2019 at 9:46 am #

    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.

  6. Sonia Milsom 30/05/2019 at 5:25 pm #

    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

  7. Rosemary Knowles 30/05/2019 at 6:36 pm #

    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!

  8. Rosemary Knowles 31/05/2019 at 12:34 pm #

    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.

    • Millie Kieve 31/05/2019 at 7:32 pm #

      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.

  9. Rosemary Knowles 01/06/2019 at 2:12 pm #

    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 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.

  10. Kiwi 01/06/2019 at 8:59 pm #

    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.

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