1 in 7 Taking Antidepressants Despite Increased Access To Psychological Therapy

Maybe the antidepressants and/or psychological therapy  are  not making a real-world difference? Is it more likely than not, that one or other of these treatments works? I do not think that I could prove either to a Court’s satisfaction. Attempts to deliver them are taking a terrible toll, with a focus on Key Performance Indicators (KPI’s) rather than the client’s story. Taking these treatments in turn:

 

Antidepressants. There has been a doubling of the prescription of antidepressants  from 2006 to 2016, followed by increases in the prescription of antidepressants for 6 years [BBC News, July 9th 2022]. The BBC News  confidently asserted that a major study proved antidepressants work, citing a link to a study published by Cipriani et al in (2018) in the Lancet. But it was only in a footnote that the BBC reporter acknowledged that the meta analysis covered, predominantly studies that looked at the effects of taking the medication for 8 weeks. There is no evidence that antidepressants alter the course of a persons mental health. Journalists like to give a human angle, and so the BBC presented an individual who had benefitted from antidepressants. But equally, I could have furnished an example of a guy I saw recently with depression as a consequence of being unable to do his manual job, because of a physical injury, who has been prescribed various SSRI’s and he has lost his libido, with a deleterious effect on his long term relationship and no loss of diagnostic status. One cannot rely on anecdotes to bolster the claim for either antidepressants or psychological therapy.

Psychological Therapy.  Billions of £’s have been spent on the Improving Access to Psychological Therapies (IAPT) Programme over the last decade.  But there has been no publicly funded independent audit of IAPT. Why? Vested interests and a deep desire to believe that antidepressants and IAPT ‘must’ be making a difference. I examined the effectiveness of CBT in routine practice for 90 IAPT clients in the course of my work as an Expert Witness to the Court Scott (2018) and found that only the tip of the iceberg recovered (i.e lost their diagnostic status) using a ‘gold standard’ semi-structured interview. Further it mattered not whether they were treated before or after their personal injury. It has been said that human beings can only take so much reality, if so, following the scientific edict to ‘follow the data’ is likely to prove more aspirational than actual.  

I cannot see any Expert Witness clearing an, on the balance of probability threshold, with regard to either of these interventions, as delivered in routine practice, in a British Court. 

 

Dr Mike Scott

 

 

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