Sunday 19 November 2017

Proper use of medications cuts suicide risk

Ted Dinan, Professor of Psychiatry at University College Cork
Ted Dinan, Professor of Psychiatry at University College Cork

'Ivor is a charismatic, controversial individual who is loved by the Irish media, and he has been for decades.

He is a caring, compassionate clinician. That is fundamental to the practice of medicine - and it would not be true about everyone. But he is profoundly misguided in his attitudes to medication.

To say that nobody should take antidepressants is an extremely dangerous statement to make. It is most unwise and injudicious.

There is unequivocal evidence that in countries where they have good health services, suicide rates have dropped where antidepressants are prescribed appropriately.

The question you have to ask is this: Is Professor Browne a major academic psychiatrist in international terms? He is not.

He has not been engaged in pharmacological research and I don't think his opinion is worth an awful lot.

I believe antidepressants do work. A new report by the British House of Commons Select Committee concludes that judicious use of antidepressants reduces suicide rates and are effective. I would go along with that.

I would not deny that there are inappropriate prescriptions, and nobody is going to stand over them.

I work in Cork University Hospital with people who have severe forms of depression. They have usually been prescribed antidepressants by their GPs appropriately.

Anybody who looks at the science objectively knows that there are major international placebo trials that show antidepressants are effective. To says that they do not work is nonsensical.

In my treatment of depression I use a combination of cognitive behavioural therapy and antidepressants. In my opinion that combination is the most effective.

When Ivor talks of antidepressants making treatment more difficult, I assume he is talking about psycho-dynamic forms of psychotherapy. I regard these type of treatments as mumbo-jumbo with no science behind them.

There is very little evidence that regression (where patients explore subconscious memories for past traumas) as a form of therapy works. You could summarise the evidence in favour of it on the back of a postage stamp.

The idea that everybody who is depressed suffered a trauma in childhood and needs to regress is simply not true.

I have patients who come to me and their depressive illness may have emanated from major financial breakdown or marital breakdown.

It hasn't resulted from trauma in childhood. Regression isn't going to solve their financial difficulties, and neither will antidepressants.

Antidepressants may not solve the financial problems, but they will help to relieve the depression. When you are not depressed you are in a better condition to deal with the problems in your environment."

Ted Dinan, Professor of ­Psychiatry at University College Cork

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