Medical community must ensure that those needing support to come off antidepressants can get it - Wendy Burn (BMJ Opinion) 2020

[MSEsperanza]

Wendy Burn: Medical community must ensure that those needing support to come off antidepressants can get it (BMJ Blog)

The BMJ Opinion, September 25, 2020

In 2018, while I was still President of the Royal College of Psychiatrists (RCPsych), I co-signed a letter to The Times which stated that “in the vast majority of patients, any unpleasant symptoms experienced on discontinuing antidepressants have resolved within two weeks of stopping treatment.”

To my astonishment the letter sparked a furore. A group of psychologists, psychiatrists and patients complained publicly. They were unhappy as they had found stopping antidepressants led to symptoms in patients that were often misinterpreted as a relapse of depression, which in turn led to taking medication for longer periods of time.

Formal complaints were made to RCPsych and to the General Medical Council. I was widely and upsettingly trolled on social media, as were several of my colleagues.

It became clear that I had underestimated the number of people experiencing difficulties in stopping antidepressants and that the problem was widely under-recognised across healthcare.

I spoke to people who reported feeling abandoned with little or no support for symptoms after stopping their antidepressants. Meanwhile, I feared that heated and often polarised arguments were deterring people with mental illness from speaking about their experiences and seeking support.

The College’s position in 2018 had not been right.

We worked together with patients, GPs, psychiatrists, stakeholders, campaigners, NICE and PHE to produce a statement on antidepressants and depression which changed our position and gave clear recognition to the difficulties that can arise for some people when coming off antidepressants.

With this position statement we put patients at the centre of our work, listening to critics with an open mind and using this to inform our practice—a significant step in the right direction.

https://blogs.bmj.com/bmj/2020/09/2...port-to-come-off-anti-depressants-can-get-it/

 

[hinterland]

Mea culpa. Never an easy admission for those in positions of power, so well done, Wendy Burn. Let’s hope other past presidents of the RCPsych are paying attention.

 

[MSEsperanza]

Just wanted to check which format the BMJ used to publish this mea culpa.

Not an editorial.

 

[MSEsperanza]

Something just reminded if of this.

 

[MSEsperanza]

Again was reminded of that.

I think that's a strong hint that in an illnesses that hasn't an established biomarker yet, patients' reports of harms from a certain treatment can easily be misinterpreted as being minor or transient, not caused by the treatment etc -- so not a relevant side effect / adverse reaction.

Especially if you depend on assessment by the same people involved in setting up trials or otherwise hold strong beliefs that there treatment works and does no harm.