Anti-depressants are being prescribed too readily by doctors treating patients with mild symptoms of depression and stress, British and Irish experts agreed yesterday.
Their comments came as new guidelines for the treatment of patients with depression and anxiety were issued in the UK.
The National Institute for Clinical Excellence (NICE) recommended that anti-depressants should not be used for the initial treatment of mild depression because it said the risk-benefit ratio was poor.
Furthermore it stressed that for mild and moderate depression, psychological treatments such as counselling can be as effective as drug treatments and should be offered as options.
Prof Patricia Casey, consultant psychiatrist at the Mater Hospital in Dublin, said she believed anti-depressants were being given too readily to patients with mild symptoms in the Republic.
"Anti-depressants are very useful for the treatment of depressive illness, but it's often confused with stress reactions and with low periods people have in their lives when things are not going well for them, and there has been a tendency to prescribe in those circumstances and it's my belief that that is wrong because they are not necessary and do not help," she said.
She added, however, that anti-depressants were an excellent treatment for full-blown depressive illness in which the mood change has its own momentum and doesn't respond when pleasant things happen.
Meanwhile, NICE advised that where anti-depressants were prescribed for moderate or severe depression, SSRIs (selective serotonin reuptake inhibitors) should be used but patients should be informed they could suffer withdrawal symptoms when they stopped taking them.
The Medicines and Healthcare products Regulatory Agency in the UK (the equivalent of the Irish Medicines Board) wrote to doctors yesterday advising them that there was "no clear evidence of an increased risk of self-harm and suicidal thoughts in young adults of 18 years or over" taking SSRIs.
Patients, however, should be given the lowest dose possible and should be monitored frequently. Young adults on the drugs, in particular, should be closely monitored, it said.
It also advised that Efexor (Venlafaxine) from Wyeth should only be prescribed by specialist mental health practitioners because of concerns about "cardio-toxicity and toxicity in overdose". It said it should not be given to patients with heart disease.
The Irish Medicines Board said it was continuing to actively participate in an ongoing European review of SSRIs and related anti-depressants.
Common types of SSRIs would include Prozac and Seroxat.