§ Dr. NaysmithTo ask the Secretary of State for Health what assessment he has made of the World Health Organisation figures relating to SSRI antidepressants and benzodiazepines; and if he will issue further guidance to GPs on the prescribing of these drugs. [2955]
§ Ms BlearsThe Medicines Control Agency (MCA) has on-line access to the World Health Organisation (WHO) data on adverse drug reactions (ADRs) and routinely evaluates these data. MCA contributes all United Kingdom suspected ADR reports to the WHO database. Prescribing information on selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines in the UK is consistent with the known safety profiles of these medicines.
111W Guidance on how to prescribe SSRIs and benzodiazepines, including information on dose and duration of treatment and possible adverse effects, is available in the authorised summary of product characteristics for these medicines. Guidance is also provided to general practitioners in the British National Formulary.
§ Paul FlynnTo ask the Secretary of State for Health what his assessment is of the therapeutic value of antidepressants compared with placebos. [2377]
§ Ms Blears[holding answer 9 July 2001]:There is a large scientific literature that indicates that antidepressant medication is superior in efficacy to placebo. This is particularly the case where depression is more severe. Placebos have been noted to be of some benefit and there is a range of so-called non-specific factors (care, interest and attention from the clinician) which are relevant.
An example is the National Institute of Mental Health Treatment of Depression Research Program in the United States reported in the mid 1990s. They compared two forms of psychotherapy, antidepressant medication (imipramine) and placebo. The latter two treatments also involved "clinical management" which included a weekly meeting with the clinician to discuss symptoms, side effects and progress. For mild depression no significant differences were found between the treatment groups. However for the more severely affected patients the antidepressant treatment was the most effective.
Early studies with tricyclic antidepressant drugs showed that 60 per cent. to 70 per cent. of patients with depression will respond to antidepressant drug treatment as compared with 15 per cent. to 30 per cent. of those treated with placebo. The response to antidepressant medication will take at least two weeks but in some cases up to four weeks or more. The newer antidepressant drugs have been shown to have similar, but not greater, efficacy to the older style medications. The advantage of the newer drugs lies in lower toxicity and different side effects.