We need to do everything we can to prevent lives being lost to suicide. That is why I want to see anti-depressant medication packets carry warning labels.
This would not replace patient information leaflets, or advice given by the GP or pharmacist, but simply act as another layer of safeguarding for patients. It would highlight how serious withdrawal side effects potentially can be.
My constituent Olivia Russell died aged 25. She was prescribed citalopram – a Selective Serotonin Reuptake Inhibitors (SSRIs) – in November 2020 for anxiety and in June 2021 she began stopping the medication. Olivia suffered extreme withdrawal symptoms which led to her taking her own life in September 2021.
The Royal College of Psychiatrists suggests that between one third and one half of people who take anti-depressant medications will experience withdrawal symptoms to some extent. However, the severity and duration of symptoms, and who they will affect, is not certain (although there have been many reports of SSRIs being particularly bad).
Until recently, guidance from the National Institute for Health and Care Excellence (NICE) suggested that withdrawal symptoms typically only lasted one to two weeks. Thankfully, that has now been updated to reflect the fact that symptoms can be more severe and prolonged.
I met with Olivia’s mum Gina Russell who bravely shared information with me in preparation for a debate I led in Parliament last week on suicide and mental health of young people. The family want to see changes put in place to prevent further deaths and other families suffering the heartbreak they have.
Measures they want include simple warnings on medication packets, improved guidance for medical professionals, and comprehensive advice which could make the process of withdrawal palpably easier and safer, potentially offering better outcomes for patients navigating the complex process of prescription and withdrawal from SSRI medication. I am supporting the family in this and Health Minister Stephen Kinnock has agreed to work with me to see what can be done.
Following Olivia’s death, the coroner took the unusual steps of publishing a Prevention of Future Deaths Report – a report which aims to improve public health, welfare, and safety. The report found no evidence that Olivia was explicitly warned about the risk of relapse, the potential harmful signs of withdrawal or told she might feel worse before feeling better. The report said while advice may have been given, it could not be said with confidence that every GP within Olivia’s practice was discussing the key risks associated with SSRI medication withdrawal.
This is shocking and it is these inconsistencies that need addressing.
The General Medical Council itself acknowledge that the amount of information doctors provide to patients may vary due to time constraints.
If this is common practice across the country, it would mean potentially thousands of patients being left to navigate the complexities of starting medications and understanding the potential seriousness of side effects without support.
That is why we need warnings on every packet of anti-depressant to ensure all patients taking these drugs understand the dangers of stopping the medication. It cannot be left to chance or pot luck depending on how much time a doctor has or if a patient asks their pharmacist for more information. Too much onus is being put on the patient. This simply change could be enough to make the patient read the entirety of the (sometimes lengthy) patient information leaflet, seeking help from a pharmacist or making another call to the doctor. But most importantly it could save lives. Every time someone takes their medication, they would see the warning and be reminded of the dangers of stopping them suddenly and the possible damaging withdrawal symptoms.
This is more important than ever following the closure of the only dedicated antidepressant withdrawal helpline – the Bristol and district tranquiliser project.
The mental health crisis is worsening, and mental health services are under strain. Suicide remains the leading cause of death among young people under 35 in the UK.
Something as simple as warning signs on packaging could make a huge difference at a time when it is needed most.
Olivia’s case is sadly not unique. Just this week an inquest into the death of Thomas Kingston, a friend of Prince William, found he took his life impulsively which is thought to have been due to an adverse reaction suffered from his anti-depressants. Mr Kingston’s wife Lady Gabriella said people needed to be warned of the effects of medication used to treat mental health conditions or more people could die.
No one is disputing that anti-depressants can be lifesaving, life changing and positive for many patients. But we cannot overlook the vulnerability of those navigating withdrawal from them.
