Anti-depressants: Cost, Risks and Ramifications

Lord Patel Excerpts

Wednesday 11th December 2024 Lords Chamber

[Baroness Merron (Lab)]

I extend my deepest sympathies to the family of Thomas Kingston after his very tragic death earlier this year. We await the findings of the inquest and will act on any recommendations by the coroner as appropriate. While there has been an increase in prescribing, as the noble Lord observes, anti-depressants, for example, are often prescribed for a wide range of reasons—not just for the treatment of depression but for migraine, chronic pain, and ME, among other conditions. The other possible reason for the increase is because of the stigma associated with seeking mental health treatment, but prescribing anti-depressants is never the first port of call—it is just one of the tools in the box to assist people. There are no current plans to conduct a review.

[Lord Patel (CB)]

My Lords, the noble Lord, Lord Alton, did not mention whether we were discussing specific anti-depressants, but the case he mentioned does refer to a group of anti-depressants called selective serotonin reuptake inhibitors. They treat the patient by increasing serotonin levels, but they run the risk of patients having suicidal ideation—the feeling of wanting to commit suicide. In a meta-analysis carried out using 29 research reports, it was found that they are beneficial in the early phase of the treatment of depression, but in later phases the data is less reliable. Are the MHRA and the NIHR working together to look at the evidence available and to produce the appropriate guidance? To avoid a high risk of suicide in people using this group of drugs, it is important to have proper monitoring, which means controlled visits to appropriate health specialists.

[Baroness Merron (Lab)]

I assure the noble Lord that NICE keeps all its clinical guidance under active surveillance to ensure that it can respond to any new evidence that is relevant, including relevant clinically related literature, that could possibly impact on its recommendations. More broadly, guidance recommends that suicidal ideation should be monitored in people with depression who are receiving treatment, particularly in the early weeks of treatment. That includes specific recommendations on medication for people at risk of suicide.