单项选择题

Family doctors routinely prescribe antidepressants to patients who may not need them, according to an exclusive survey for The Times. GPs are ignoring official guidelines by hastily prescribing pills rather than waiting to see if symptoms improve, the survey suggests. It also provides evidence that it is GPs and psychiatrists who are likely to propose medication as a treatment, rather than patients demanding pills to make them feel better. In addition, the findings raise questions about the efficacy of reviews of medication, required to make sure that patients are still receiving appropriate treatment. Some who took part in the survey claimed that their medication had not been reviewed for years. And there is evidence that GPs are reluctant to discuss options for ending medication, fuelling concerns that too many patients are condemned to take antidepressants for the rest of their lives regardless of improvements.
The survey, which was carried out by the mental health charity Mind, does contain positive news, however, with 84 percent of patients saying that their antidepressants were effective. Access to talking therapies appeared to be improving, and most patients said that they were able to taper off their medication without suffering harsh side-effects. Last week The Times revealed that more than one million men and women are addicted to benzodiazepine tranquillisers, drugs that include Valium and which should be prescribed for no more than four weeks for a severely restricted number of conditions.
The online survey proved to be one of the most popular ever held by Mind, attracting almost 1,500 responses from people who are on antidepressants or who have stopped taking them within the past two years. Paul Farmer, the charity"s chief executive, said: "Many people are being prescribed antidepressants too quickly and taking antidepressants for longer and longer periods without review. We must not demonise drugs and put people off taking something that might help them. But we need also to remember that antidepressants are powerful drugs and as such should be prescribed with caution."
More than 46 million prescriptions for antidepressants such as Seroxat and citalopram were written last year, a rise of 9 percent over the previous 12 months. Experts have expressed concern that doctors are prescribing drugs too casually, while GPs claim that patients expect to be given pills to help them through even relatively minor upsets. The Royal College of Psychiatry estimates that between 50 percent and 65 percent of people treated with an antidepressant for depression will benefit. Clare Gerada, a GP and president of the Royal College of General Practitioners, said: "I prescribe antidepressants because they work." The length of time people take antidepressants is a key issue. Of those who took part in our survey 37 percent had been on medication for more than five years and 20 percent for more than ten years.
Two thirds said that their GP or psychiatrist had prescribed antidepressants straight away rather than waiting to see if the symptoms improved as recommended in guidelines set by the National Institute for Health and Clinical Excellence (NICE). Four out of five said that it was their GP or psychiatrist who suggested medication in the first place. Of those, 51 percent said that they agreed that it was the right course of action but 42 percent were not in agreement. Forty-five percent of respondents felt that they were not given enough information about the medication they were prescribed, although this fell to 39 percent among those who were prescribed antidepressants more recently.
More than half said that they experienced ongoing side-effects. 27 percent said that antidepressants affected their ability to work or study; 24 percent their social lives; 21 percent their relationships with family, friends or partners; and 44 percent their sex lives. Only half of respondents have their drugs monitored every three months, and 72 percent at least every six months. Alarmingly, 6 percent never have their drugs monitored. A total of 25 people who took part in the survey had been taking drugs for more than five years without being monitored, and ten people for more than ten years.
GPs and psychiatrists appear reluctant to discuss coming off drugs with their patients: 71 percent said that they had not talked about discontinuing medication. Even those who had been on antidepressants for a significant amount of time had not had a discussion about coming off. More than a quarter said that they expected to be on antidepressants for life.
Only 7 percent of respondents who had come off medication within the past two years said this had been at the suggestion of their GP or psychiatrist. Since stopping medication 17 percent believed that they have recovered from their mental health problems, and 44 percent said that they could manage their mental health without drugs. More than half of the respondents of this online survey reported that they experienced ongoing side-effects, which affected all of the following aspects EXCEPT ______.