Antidepressants; a GP ponders the urban myths…

I’m writing this blog purely as a GP who, every day, sees patients who take antidepressants. So these are my thoughts, based on experience, as well as evidence.

I also see patients every day who should consider taking antidepressants, because they clearly have all the signs and symptoms of significant clinical depression, anxiety, obsessive compulsive disorder or social phobia. Up to one in three of my consultations is for a mental health problem, and I suspect most of these people have finally come to see a doctor because they have reached a crisis point, or no longer know how to cope. They do not come lightly, and I understand that. They will often have already tried sensible measures, though we usually discuss those anyway, such as minimising alcohol or drug use, better sleep and eating routines, and exercise.

I always suggest counselling or other talking therapies, though again, many have had unsuccessful experiences of these. I will probably mention giving them another go…a different approach or technique perhaps?

But finally we come to medication, always approaching the subject gently, knowing that everyone comes with preconceptions and concerns.

“But they’re addictive”

“I don’t want to feel like a failure, needing medication”

“They’ll make me fat”

“They’ll make my acne worse”

“My parents won’t approve”

“I’ll be on them forever”


I have heard all of these, and many more, hundreds of times in the 15 years I’ve been a GP.

And it takes time and patience to pick my way through the concerns, which are mainly based on hearsay/myth (especially because they are NOT addictive or dependency inducing, and only one specific antidepressant is classically associated with possible weight gain. They have no effect on acne!).


But it’s worth the time, and listening to the concerns, because often a patient will then agree that it might be worth ‘giving them a go’, and that there is little to lose by trying them. Side effects are usually minimal for most people, especially if started at a half or low dose, and we always like to review how things are going at 2-3 weeks. And then when they have given them a go, and they return 4-6 weeks later, I have lost count of the number of people, but it is the vast majority, who have noticed an improvement, and as time goes on, at 8-12 weeks, say “I wish I’d tried these sooner”.


So all I would say is this; if you’re struggling and unsure about medication, then talk to a GP, sooner rather than later, and discuss your concerns, so we can see if antidepressants might help you too. And if they’re not right for you, we will still support you, and meet with you, to discuss other options and therapies.

You are not alone, and we are here to help.


Antidepressants; friend or foe?

Antidepressants; friend or foe

 Two (unrelated) students asked me to write this blog. Independently they mentioned at the end of their consultations that there was a lack of positive stories about using antidepressant medication, and that other students might like to hear about some success stories such as theirs. They felt that these ‘good news’ tales might balance some of the very negative opinions that they and their peers were reading online.

Well I have worked at the Students’ Health Service for over 10 years and it has certainly been my experience that the vast majority of students that I treat with antidepressants get better. Treatment times vary, as does the need to try more than one type of pill before finding that one that works for an individual, but alongside psychological therapies, medication is usually successful in helping students return to normality.

Of course we must consider possible side effects (minimised by starting with a half dose for the first week in many cases), and appropriate length of treatment (6 months for a first episode, 2 years or more for recurrences ). It is also vital to withdraw the medication very slowly tailored to an individual’s response. The GPs at SHS are fastidious in planning regular follow up for patients on antidepressants and strive to have continuity of care to allow us to get to know each student as best we can, therefore giving a better overview of treatment response.

Evidence suggests that medication is most appropriate in cases of moderate to severe depression, so we are much less likely to prescribe it for mild cases, and we always encourage other supportive treatments such as increased exercise, counselling and psychological input as necessary.

Six million people are thought to suffer from depression in the UK, and in the last few years the NHS has noted a significant (26%) rise in the prescription of antidepressant medication. Much has been written and theorised on the reasons for this, but it is a phenomenon noted throughout the population, and students are no exception unfortunately. In the face of rising numbers of people with mental health issues it is good to have a treatment that works to offer them, and which shows benefit within usually 4 to 6 weeks. Sometimes people need to take something just to be able to get back to a point of functioning well enough to start talking therapies, of which there is steadily increasing availability on the NHS.

Antidepressants work for the majority of students that we treat, though it needs to be the right one for the individual. They can be life changing, and should always be considered and discussed as an option, though decisions should be made on a case by case basis of course.

I am confident in stating that antidepressants are an important option to be considered in the consultation between the GP and any student who is feeling depressed, and we see significant positive effects on an almost daily basis in our population. It is true that these good news stories don’t excite the media in the same way as negative stories, but that’s no great surprise.

If you are worried about your moods, or feeling low, please do come and talk to us, we really do want to know and help you, in whatever way suits you best.