Experiences of antidepressants

Reviewing antidepressant use

People should have regular reviews with their doctor after being prescribed a new antidepressant medicine. They should also have review appointments with their doctor when they have been taking antidepressants on a regular basis so that he or she can find out how they are feeling, and also for the opportunity to ask questions and talk through any concerns. It can take a while to find an antidepressant that works as everyone responds differently to them, so keeping in regular touch with the doctor whilst you get used to taking one, and to monitor your progress on an ongoing basis is good practice. You may also be offered a medicines use review by your pharmacist. These reviews concentrate mainly around the use of medicines. People we spoke to who saw their doctor on a regular basis to talk about their medicines and how they were feeling appreciated the opportunity to talk things through, and having somebody to give them advice and support. 
Doctors should arrange follow up appointments as a matter of course For people starting on antidepressants who are not considered to be at increased risk, the GP should see them after 2 weeks initially, and then at intervals of 2 – 4 weeks in the first 3 months. In our interviews people said the time between follow up appointments varied. Tim valued his doctors clear advice about when he should return to monitor his progress on the antidepressant he had been prescribed. Some people took the initiative to book regular appointments for themselves. Emily arranged monthly appointments to see her GP. I wanted the reassurance that I was doing the right thing, that I should still be on it.’ Andrew’s doctor had left it to him to decide whether to make an appointment. ‘Basically he said come back whenever you want and I’ll be more than happy to see you’. A face to face appointment isn’t always necessary, these days doctors often provide advice and support by phone. Victoria had regular telephone consultations with her GP to monitor her progress. 
Review appointments can provide an opportunity for people to discuss different aspects about their illness and treatment, and can help them to make decisions. Lou used follow up appointments to plan when she might stop taking the antidepressant. Sonia’s medicines were sometimes changed or the dose adjusted when she returned to see her psychiatrist every 6 months. Steve felt it could be helpful if the doctor asked you questions for example, ‘is it affecting your sleeping, is it affecting your eating?’ because it can sometimes be difficult to make connections between changes in the way you feel, and the medicines you are taking. 

People sometimes had difficulties arranging appointments to see their doctor and some felt that there was not enough time during a regular ten minute appointment to have a full discussion. 
Sometimes the way the GP practice is organised can make it difficult to see the same doctor each time. Several people stressed the importance of having a relationship with a GP who knows you so that he or she is more able to assess how things are going. Melanie found it frustrating to have to keep telling her story to different doctors, and wanted the doctor to be able to observe her progress by knowing her better. Lou felt strongly that a review appointment should be not just be about medicine use, and that doctors should regularly discuss the possibility of alternative treatments such as counselling or therapy with patients. Stuart would like doctors to offer lifestyle advice and give more information and support about other ways to alleviate depression. 
Not everyone had a clear idea about when or whether they should make a follow up appointment with the doctor. Some said their doctor had left it up to them, and that they felt they had been left to ‘get on with things’ without sufficient support. Sharon felt annoyed when she phoned to ask her doctor about her prescription and had been given advice by a receptionist. 
Often people who are taking an antidepressant on an ongoing basis are issued with a regular repeat prescription to collect from the surgery or pharmacy. Some said they rarely saw the doctor for a review and it could feel as though their progress was not being monitored. Some said they only went to see their doctor if they had a specific question to ask or an issue they wanted to discuss, for example if they felt the antidepressant had lost it effectiveness. Sometimes the doctor reviewed people’s use of an antidepressant when they went to see him or her about another matter, as well as checking to make sure that other prescribed medicines could be safely combined with the antidepressant they were taking. Jenny has been on a number of medicines for acute asthma and other related health conditions and now checks things for herself using the British National Formulary (BNF). People who were under the care of other specialists for other conditions stressed the importance for their all their medicines to be reviewed together at the same time, (see ‘Managing other illnesses’). 
Sometimes the doctor will want to carry out more frequent reviews, for example where somebody has been having suicidal thoughts or has previously taken an overdose. Sonia and Thomas were only allowed a limited supply of their medicines at a time, and the doctor would not re-issue a further prescription without seeing them regularly. Whilst Sonia found this reassuring, Thomas felt resentful at being forced to go each week. He found it difficult to arrange so much time away from work, especially as it he did not want to reveal details about his mental health status to his employer. 
(See also ‘Stopping taking antidepressants’ and ‘Changing antidepressants’).

Last reviewed June 2016.
​Last updated June 2016.


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