Benefits to healthcare professionals

This prescribing guide provides practical structured advice and examples of good practice approaches for health professionals to:

• identify individuals who may benefit from review (see Target groups for review)
• review antidepressant therapy and
• routinely support people in their care

Prescribers have identified and reported that it can be:

‘…easier to start [psychotropic medicines] than to stop [them]’¹⁰

and that

‘…what we’re [prescriber] probably not good enough, at the moment, is sort of the long-term managing and the coming-off part’¹⁴

This may be due to a range of perceived and actual barriers, such as some healthcare professionals lacking confidence, knowledge and skills to support and enable proactive antidepressant review and discontinuation.^{10,13,14,16,19} Lack of knowledge may include time to onset of action,⁵ as antidepressants demonstrate their effects within one to two weeks of use.^18,20 Despite this, some prescribers wait eight weeks or more before optimising doses or switching antidepressant treatments in poor or non-responders.^5,21

Identifying individuals for review can be limited by some of the electronic clinical systems routinely used in clinical practice. However, the Scottish Therapeutics Utility (STU) has been developed for use in general practice in Scotland, to identify people who may benefit from a medication review. General practice staff can routinely use STU to identify and plan antidepressant review work. While there is no consensus on the optimal method for antidepressant withdrawal,^22,23 this guidance provides a range of options for reducing and withdrawing antidepressants. More detail is available in Reducing and stopping antidepressants.