New guidance from BACP and our partners gives psychological therapists information to help clients struggling with side effects and withdrawal issues which have resulted from an increase in the prescription of psychiatric drugs.

Guidance for Psychological Therapists: Enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs has been published following Public Health England’s acknowledgement of the growing problem of prescribed drug dependency and withdrawal.

The guidance is endorsed by us as well as British Psychological Society, UK Council for Psychotherapy and National Counselling Society, which represent more than 80,000 UK counsellors, psychotherapists and psychologists.

The guidance means clients will be better supported to understand the difference between emotional distress, relapse and the side and withdrawal effects of psychiatric drugs. We have produced a Q&A to answer your queries about the guidance.

Most psychological therapists now work with clients who have taken, or are taking, psychiatric drugs. Currently fewer than one in ten feel their training equipped them to deal adequately with client’s questions.

Guidance

Dr James Davies, Roehampton University academic, qualified psychotherapist and guidance co-editor and author, said: “PHE and NICE have finally acknowledged that antidepressant withdrawal can be severe and protracted – lasting for many weeks, and in some cases, months and beyond.

"Many such reactions have been misread as relapse by doctors, with drugs being reinstated, and little or no withdrawal support offered. This guidance indicates how therapists can identify withdrawal and support their clients. It is gratifying that our national therapeutic organisations, through this guidance, are taking their share of responsibility for addressing this nationwide problem.

“In addition to offering such support, we now need to address our over-prescribing problem; significantly increasing our provision for social and psychological alternatives, including longer-term therapies."

Paul Sams, a service user who was prescribed psychiatric medications, said: “For 10 years I was often required to withdraw to start new medication, this was always with little to no support or advice.

Informed

"I am pleased this guidance is an opportunity to support sharing of relevant information that promotes informed choice through collaborative decision making. I am hopeful the move will support those following me on their recovery journey to have a better experience than I encountered.”

The guidance, facilitated by the All-Party Parliamentary Group for Prescribed Drug Dependence in the last parliament, has been steered and endorsed by four psychological therapy organisations that represent 80,000 of the UK’s psychological therapists, and by senior clinicians and researchers in the field.

Dr John Read, professor of clinical psychology, University of East London, and co-author said: “After being involved with these issues for 40 years I am delighted to finally see psychologists, therapists and counsellors being urged to get properly involved, in an informed, ethical, evidence-based manner, in what is a central issue in the lives of so many of our clients."

Dr Anne Guy, accredited psychotherapist, co-editor and author, added: “It provides psychological therapists with key questions to consider in how information about medications relates to therapeutic work, such as how to navigate key ethical considerations and how to help support clients experiencing withdrawal effects, while remaining supportive of relationships with prescribers.”

In the UK, it is now widely acknowledged that the incidence, severity and duration of withdrawal effects, and the extent to which those people affected need support, was underestimated.

Relevant organisations are, therefore, now considering how best to support people who have suffered harm. Public Health England has recommended a helpline, better training for doctors on appropriate withdrawal management, and more support for GPs; recommendations now supported by the Royal College of General Practitioners, the Royal College of Psychiatrists, the British Medical Association and all the organisations involved in the creation of the guidance published today.

Guidance for Psychological Therapists: Enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs is available online at www.prescribeddrug.info/

Notes for Editors

About Public Health England (PHE):

In a recent report, Public Health England (PHE) found that, for the last 10 years, more people are being prescribed more of these medicines and often for longer. The prescribing of some of these medicines (like benzodiazepines and opioids) has fallen recently but others (such as gabapentin, pregabalin and antidepressants) are being prescribed more and for longer. This means more people are at risk of becoming addicted to them or having problems when they stop using them. It also costs the NHS significant amounts of money, some of which is wasted because the medicines do not work for everyone all the time, especially if they are used for too long. Full link to the report: https://www.gov.uk/government/publications/prescribed-medicines-review-report/prescribed-medicines-review-what-this-report-means-for-patients

About the All-Party Parliamentary Group for Prescribed Drug Dependence in the last parliament:

It was formed in 2015 to address the growing problem of prescribed drug dependence (PDD). Chaired by Oliver Letwin MP, the APPG’s aim was to demand appropriate services for those affected, proper training for medical professionals, reduced prescribing through adherence to new and existing guidelines, better data regarding the prevalence of PDD and more research into long-term harms associated with PDD. See link: http://prescribeddrug.org

Data sources:

  • Department of Health and Social Care (DHSC) (2018) statistics care of Hansard: Prescriptions drugs – written question – 128871.
  • Proportion of the UK on prescription drugs: Kendrick, T. (2015). Long-term antidepressant treatment: Time for a review? Prescriber, 26(19), 7–8.
  • A survey of 1,200 practising therapists in 2019 revealed that the majority felt ill-equipped to manage such issues in the therapeutic setting, with 93.1% reporting they would find it ‘useful’ or ‘very useful’ to have guidance to help them work more confidently with people either taking or withdrawing from psychiatric drugs.