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NHS suggest alternative treatments to antidepressants

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The NHS has suggested patients suffering from mild depression should be offered exercise, mindfulness, meditation or therapy before being prescribed antidepressants.

A draft guidance from the National Institute for Health and Care Excellence (Nice) suggests a “menu of treatments” should be available to people with the condition before they are put on medication.

At the moment patients with mild depression are offered high-intensity psychological intervention such as cognitive behavioural therapy (CBT) or antidepressants.

A study compiled by the Office for National Statistics (ONS) suggests one in six adults suffered a form of depression this summer with the condition more common in younger adults and women.

In 2017-18 it was reported 17 per cent of adults in England (7.3 million people) were prescribed antidepressants.

Dr Paul Chrisp, director of the centre for guidelines at Nice, said: “The Covid-19 pandemic has shown us the impact depression has had on the nation’s mental health. People with depression need these evidence-based guideline recommendations available to the NHS, without delay.”

If the proposed changes go ahead people with “less severe depression” should have conversations with their GPs about the treatment which would be more suitable for them and CBT should be offered as the first form of medication because it “focuses on how thoughts, beliefs, attitudes, feelings and behaviour interact, and teaches coping skills to deal with things in life differently”.

After CBT the NHS guidelines suggest CBT, self-help or meditation before being prescribed antidepressants.

Other options suggested by the NHS are three hour sessions of group therapy a week over a 10-week period or eight weekly two-hour sessions of group mindfulness or meditation which focus on “concentrating on the present, observing and sitting with thoughts and feelings and bodily sensations, and breathing exercises”.

The guidelines state: “Do not routinely offer antidepressant medication as first-line treatment for less severe depression, unless that is the person’s preference.”

Psychological interventions with the option of antidepressant medication should be considered for patients suffering from “more severe depression”.

Nav Kapur, professor of psychiatry and population health at the University of Manchester and chair of the guideline committee, said: “As a committee we have drawn up recommendations that we hope will have a real impact on people who are suffering from depression and their carers. In particular we’ve emphasised the role of patient choice – suggesting that practitioners should offer people a choice of evidence-based treatments and understanding that not every treatment will suit every person.”

Patients wishing to stop their antidepressants are advised to speak to a healthcare professional before doing so to understand the process could take weeks or months to ensure the process is safe and successful.

More than 20m antidepressants were prescribed between October and December in 2020, a 6% increase compared to the same three months in 2019.