Quality Prescribing for Antidepressants: A Guide for Improvement 2024-2027

Appendix 4. Patient information leaflet

Background

Antidepressants can be effective for the treatment of moderate to severe depression, moderate to severe anxiety disorders and nerve pain caused by diabetes and other conditions. However, there are concerns that some individuals may experience dependence and withdrawal associated with antidepressant use. Effective non-pharmacological treatments and lifestyle changes are also an important consideration. It is also known that some individuals may receive an appropriate course of treatment, while others may continue antidepressants inappropriately due to a lack of routine review.

What is the purpose of the antidepressant quality prescribing guide?

It is intended to:

• Empower and help people who receive antidepressants and prescribers to review antidepressants and get the best out of the medicines for individuals.
• Improve the support available from the healthcare system for people experiencing dependence on, or withdrawal from, prescribed medicines.
• Help prescribers identify people who may benefit from an antidepressant review, and support routine antidepressant reviews.
• Provide a range of options, where appropriate, for people who have completed their course of antidepressant treatment, and/or are appropriate to reduce and stop their antidepressants.

Do I need to have my antidepressant reviewed?

• Antidepressants are no different to any other medicines. It is important to have your medicines routinely reviewed. For some individuals once a year review may be enough, for others more regular review will be needed.
• Having medicines reviewed regularly creates an opportunity to discuss if a medicine needs to continue. Consider effective non-pharmacological treatments and lifestyle changes that may help.
• Prior to your medicines review you may wish to complete the questions for your review section on the manage medicines app or website, to help you prepare for your review and identify ‘what matters to you’ about your treatment.

Do I need to stop my antidepressant?

• It may be appropriate for some individuals to stop their antidepressant, but not for others.
• Continuing your antidepressant may be appropriate because there are more benefits to continuing than risks of stopping e.g. recurrence of severe depression.
• Reducing and/or stopping your antidepressant may be necessary to reduce the risk of avoidable adverse drug effects and harms e.g. falls, confusion, sedation. Or where you have completed your course of antidepressant treatment and recovered e.g. six months of antidepressant treatment due to a single episode of depression.

How should I stop my antidepressant?

If you are ready to stop your antidepressant:

• Arrange a review with your general practice doctor, pharmacist or nurse.
• Complete the questions for my review section on the manage medicines app or website to help you prepare for your review and identify “what matters to you”
• Discuss stopping your antidepressant and agree if this is appropriate.
• If appropriate to stop, then plan and agree the best way to do this for you, considering the options outlined in the antidepressant quality prescribing guide.