Mental health: A senior Government adviser on mental health has expressed concern that doctors are over-prescribing anti-depressants with little evidence of any public health benefit.
Dr Dermot Walsh, the former Inspector of Mental Hospitals, told The Irish Times the increase in prescription of anti-depressants was also accompanied by a worrying rise in suicide rates.
"There isn't any public health evidence that widespread increase in anti-depressants has resulted in a decrease in the incidence of depression," he said.
"There is no question that prescription rates have increased greatly. But there is no evidence that depression itself has decreased during this period. If anything, the lengths of stay in psychiatric hospitals has increased and, worryingly, the rise in suicide mirrors almost exactly the increased use of anti-depressants."
Figures showing increased admission rates and length of stay in psychiatric hospitals are contained in a report co-written by Dr Walsh on the mental health services and published by the Health Research Board.
Dr Walsh's comments come at a time of increased questioning of the effectiveness and safety of a range of anti-depressant drugs known as SSRIs (selective serotonin reuptake inhibitors).
Official figures suggest around one in 10, or 300,000 patients, are prescribed anti-depressants each year. The State pays out millions of euro for such drugs under the medical card and drugs repayment scheme.
Dr Walsh said there were clear signs that members of the public wanted "more talk and less tablets" when it came to ways of dealing with mental illness or depression.
"There are other ways of dealing with mild and moderate depression. The public is not very happy about the pill culture, and that has come through clearly in a consultation process over the future of the mental health services," he said.
This point was raised by Britain's National Institute for Clinical Excellence last week, which recommended to doctors that anti-depressants should not be used for the initial treatment of mild depression because the risk-benefit ratio was poor.
The Irish Medicines Board, the regulatory body for medicine, said it was participating in an ongoing European review of SSRIs and related anti-depressants.
Dr Walsh said the education of doctors and patients was vital in dealing with the over-prescription and overuse of anti-depressants. However, drug companies were taking over the education role, he said.
"The psychiatric profession is largely educated by the drug firms: they take them away, give them dinner as part of product promotions. The information that is presented at these events is, for the most part, totally unscientific. Naturally, they try to target the young doctors," he said.
