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947067

registered interest
date	23/07/2018
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Antidepressants
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government how many anti-depressants have been dispensed by the NHS in each of the past ten years; and what was the total cost to the NHS.
tabling member printed	Lord Alton of Liverpool
uin	HL9757
answer	answer is ministerial correction date of answer 25/07/2018 answer text <p>The information is not available in the requested format. The following table shows the number of prescription items and the Net Ingredient Cost.</p><table><tbody><tr><td colspan="3"><p>British National Formulary 4.3 Antidepressants dispensed in the community in England</p></td></tr><tr><td><p>Year</p></td><td><p>Prescription Items</p></td><td><p>Net Ingredient Cost</p></td></tr><tr><td><p>2007</p></td><td><p>33,839,594</p></td><td><p>£276,107,573</p></td></tr><tr><td><p>2008</p></td><td><p>35,960,539</p></td><td><p>£247,355,066</p></td></tr><tr><td><p>2009</p></td><td><p>39,140,459</p></td><td><p>£230,062,853</p></td></tr><tr><td><p>2010</p></td><td><p>42,787,966</p></td><td><p>£220,372,789</p></td></tr><tr><td><p>2011</p></td><td><p>46,677,813</p></td><td><p>£270,177,163</p></td></tr><tr><td><p>2012</p></td><td><p>50,167,201</p></td><td><p>£211,145,435</p></td></tr><tr><td><p>2013</p></td><td><p>53,326,550</p></td><td><p>£282,121,595</p></td></tr><tr><td><p>2014</p></td><td><p>57,147,928</p></td><td><p>£265,003,747</p></td></tr><tr><td><p>2015</p></td><td><p>61,021,611</p></td><td><p>£284,745,611</p></td></tr><tr><td><p>2016</p></td><td><p>64,703,568</p></td><td><p>£266,560,175</p></td></tr><tr><td><p>2017</p></td><td><p>67,530,375</p></td><td><p>£235,074,205</p></td></tr><tr><td><p>Total</p></td><td><p>552,303,604</p></td><td><p>£2,788,726,212</p></td></tr></tbody></table><p><em>Source</em>: Prescription Cost Analysis</p><p> </p> answering member printed Lord O'Shaughnessy question first answered 25/07/2018 11:44:59 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	738 label Biography information for Lord Alton of Liverpool

947070

registered interest
date	23/07/2018
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Antidepressants
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what assessment they have made of the side effects of anti-depressants; and for how long on average anti-depressants are taken by patients.
tabling member printed	Lord Alton of Liverpool
uin	HL9760
answer	answer is ministerial correction date of answer 25/07/2018 answer text <p>Antidepressants are an important group of medicines which help patients who suffer depressive illness and anxiety disorders. As with all medicines, anti-depressants may be associated with side effects in some individuals, and information on side effects is included in the product information for prescribers (the Summary of Product Characteristics) and patients (the Patient Information Leaflet).</p><p>The safety of the use of anti-depressants in routine clinical practice is continually monitored by the Medicines and Healthcare products Regulatory Agency (MHRA). The MHRA monitors all data including reports of suspected adverse drug reactions submitted by healthcare professionals, patients and carers through the Yellow Card scheme, as well as published and unpublished data. As new data emerges it is carefully evaluated and, where appropriate, product information for prescribers and patients is updated and advice issued.</p><p>It is not possible to estimate how long on average patients receive antidepressants. The British National Formulary recommends that patients should be reviewed every 1–2 weeks at the start of antidepressant treatment. Treatment should be continued for at least four weeks (six weeks in the elderly) before considering whether to switch an antidepressant due to lack of an adequate response. In cases of partial response, the guidance is to continue for a further 2–4 weeks, and elderly patients may take longer to respond.</p><p>Following remission, antidepressant treatment should be continued at the same dose for at least six months (about 12 months in the elderly), or for at least 12 months in patients receiving treatment for generalised anxiety disorder as the likelihood of relapse is high. Current guidance advises that patients with a history of recurrent depression should receive maintenance treatment for at least two years.</p> answering member printed Lord O'Shaughnessy question first answered 25/07/2018 15:56:50 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	738 label Biography information for Lord Alton of Liverpool

857584

registered interest
date	07/03/2018
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Antidepressants
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government whether they classify SSRI drugs as dependence forming; and if so, what time frame constitutes dependence forming.
tabling member printed	Lord Hunt of Kings Heath
uin	HL6156
answer	answer is ministerial correction date of answer 14/03/2018 answer text <p>Selective Serotonin Reuptake Inhibitors (SSRIs) are authorised for the treatment of depression and anxiety disorders. A comprehensive assessment of all available data by the Expert Working Group of the Committee on Safety of Medicines in 2004 found that there was no clear evidence that SSRIs and related antidepressants have a significant dependence liability or show development of a dependence syndrome according to internationally accepted criteria. All SSRIs may be associated with withdrawal reactions on stopping or reducing treatment and product information for healthcare professionals and patients includes advice on gradual withdrawal of treatment and management of symptoms. The safety of SSRIs is continually monitored by the Medicines and Healthcare products Regulatory Agency.</p> answering member printed Lord O'Shaughnessy question first answered 14/03/2018 13:12:39 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

830410

registered interest
date	25/01/2018
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Antidepressants
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health and Social Care, how many incidents the NHS has recorded of Citalopram leading to the deterioration of a patient's health in 2016-17.
tabling member constituency	Witney
tabling member printed	Robert Courts
uin	124976
answer	answer is ministerial correction date of answer 01/02/2018 answer text <p>Reports of suspected adverse drug reactions (ADRs) are collected by the Medicines and Healthcare products Regulatory Agency (MHRA) and Commission for Human Medicines (CHM) through the spontaneous reporting scheme, the Yellow Card Scheme. The MHRA continuously monitors the safety of all medicines on the market in the United Kingdom and seeks independent expert advice from the CHM on important new safety issues.</p><p> </p><p>The Yellow Card Scheme collects information relating to suspected adverse drug reactions, which include both serious and non-serious effects which a doctor or patient suspects may have been due to a medicine. The MHRA has received a total of 593 suspected spontaneous ADR reports in association with citalopram between 1 January 2016 and 31 December 2017. This number includes reports received directly from healthcare professionals, patients and indirectly through pharmaceutical companies which have a legal obligation to report suspected ADRs. The number of reports received directly from the National Health Service cannot be determined.</p><p> </p><p>The MHRA does not hold information on deterioration of health. Each ADR report contains information on an ADR at a specific point in time, rather than a deterioration of health over a period of time, and should therefore not be interpreted as a report of a deterioration of a patient's health.</p><p> </p><p>The inclusion of a particular ADR in a report does not necessarily mean it has been caused by the drug, only that the reporter had a suspicion it may have, or it had a close temporal relationship to the administration of the suspect drug. The fact that symptoms occur after a treatment does not necessarily mean that they have been caused by the drug itself, as underlying illnesses and other conditions may be responsible.</p><p> </p><p>Citalopram is an antidepressant belonging to the class of medicines known as selective serotonin reuptake inhibitors. Citalopram is an effective medicine for the treatment of depression. Information about possible side-effects associated with treatment are provided in the product information which is available to all prescribers and patients. Data is evaluated as it emerges and where necessary regulatory action is taken and communicated to healthcare professionals and the information for patients is updated.</p> answering member constituency Thurrock answering member printed Jackie Doyle-Price grouped question UIN 124977 question first answered 01/02/2018 16:12:40 answering member 4065 label Biography information for Dame Jackie Doyle-Price
tabling member	4589 label Biography information for Robert Courts

731876

registered interest
date	22/06/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Antidepressants
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, how many prescriptions for anti-depressants were issued in each year for which data is available.
tabling member constituency	Vale of Clwyd
tabling member printed	Chris Ruane
uin	838
answer	answer is ministerial correction date of answer 27/06/2017 answer text <p>Information is not collected centrally on the number of prescriptions issued. However, information is available on the number of prescription items dispensed for antidepressants and is given in the attached table.</p> answering member constituency Winchester answering member printed Steve Brine question first answered 27/06/2017 15:27:46 answering member 4067 label Biography information for Steve Brine attachment 1 file name PQ838 attached document.docx title PQ838 attached table
tabling member	534 label Biography information for Chris Ruane

718198

registered interest
date	06/04/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Antidepressants
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government how many NHS prescriptions for anti-depressants were written in (1) 2010, and (2) 2015; and what was their estimated cost.
tabling member printed	Lord Brooke of Alverthorpe
uin	HL6699
answer	answer is ministerial correction date of answer 20/04/2017 answer text <p>Information from the Prescription Cost Analysis system regarding the number of antidepressant prescription items written in the United Kingdom and dispensed in the community in England, for the years 2010 and 2015 is shown in the following table.</p><p> </p><p>Total number and Net Ingredient Cost (NIC) of antidepressant prescription items written in the UK and dispensed in the community in England in 2010 and 2015 for British National Formulary Section 4.3 antidepressants.</p><p> </p><table><tbody><tr><td><p>Year</p></td><td><p>Items</p></td><td><p>NIC (£)</p></td></tr><tr><td><p>2010</p></td><td><p>42,787,966</p></td><td><p>220,372,789</p></td></tr><tr><td><p>2015</p></td><td><p>61,021,611</p></td><td><p>284,745,611</p></td></tr></tbody></table><p> </p><p>Source: Prescription Cost Analysis.</p><p> </p><p> </p> answering member printed Lord O'Shaughnessy question first answered 20/04/2017 15:04:01 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	3335 label Biography information for Lord Brooke of Alverthorpe

718199

registered interest
date	06/04/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Antidepressants
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government what is NHS policy for general practitioners prescribing anti-depressants to patients whose depression relates to the effects of alcohol.
tabling member printed	Lord Brooke of Alverthorpe
uin	HL6700
answer	answer is ministerial correction date of answer 20/04/2017 answer text <p>There is no single National Health Service policy for the prescribing of antidepressants to those individuals whose depression is linked to the effects of alcohol. However, clinicians are expected to prescribe such medication in accordance with best practice and any available guidance.</p><p> </p><p>Under the terms of their contract with NHS England, general practitioners (GPs) are required to identify any patient, over the age of 16, who is drinking alcohol at increasing or higher risk levels by using either of two of the World Health Organization’s Alcohol Use Disorders Identification questionnaires.</p><p> </p><p>Where a patient is identified as such, GPs must also ensure the patient is assessed for anxiety and depression, is offered screening for anxiety and depression and where this is diagnosed, ensure the patient is provided with any treatment or support which may be required – including referral for specialist mental health treatment.</p><p> </p><p>It is a clinical decision of the individual GP to decide what treatment is most appropriate taking into account any relevant National Institute of Health and Care Excellence guidance and professional advice from the Royal Colleges.</p> answering member printed Lord O'Shaughnessy question first answered 20/04/2017 15:03:49 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	3335 label Biography information for Lord Brooke of Alverthorpe

718200

registered interest
date	06/04/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Antidepressants
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty’s Government how many anti-depressants were prescribed to patients in 2015 who continued to consume alcohol; and at what cost.
tabling member printed	Lord Brooke of Alverthorpe
uin	HL6701
answer	answer is ministerial correction date of answer 21/04/2017 answer text <p>This information is not held centrally.</p> answering member printed Lord O'Shaughnessy question first answered 21/04/2017 11:46:15 answering member 4545 label Biography information for Lord O'Shaughnessy
tabling member	3335 label Biography information for Lord Brooke of Alverthorpe

691948

registered interest
date	20/02/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Antidepressants
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, what recent assessment he has made of the side effects of long-term use of anti-depressants.
tabling member constituency	East Worthing and Shoreham
tabling member printed	Tim Loughton
uin	64673
answer	answer is ministerial correction date of answer 23/02/2017 answer text <p>Antidepressants are an important group of medicines which help patients who suffer depressive illness and anxiety disorders. As with all medicines, antidepressants may cause side effects in some individuals and information on side effects is included in the product information for prescribers (the Summary of Product Characteristics) and patients (the Patient Information Leaflet).</p><p> </p><p>The safety of the use of antidepressants in routine clinical practice, including in long term use, is continually monitored by the Medicines and Healthcare products Regulatory Agency (MHRA). The MHRA monitors all data including reports of suspected adverse drug reactions submitted by health professionals, patients and carers through the Yellow Card scheme as well as published and unpublished data. As new data emerges it is carefully evaluated and, where appropriate, product information for prescribers and patients is updated and advice issued. There have been no recent changes to product information in relation to the long term safety of antidepressants.</p> answering member constituency Oxford West and Abingdon answering member printed Nicola Blackwood question first answered 23/02/2017 15:03:15 answering member 4019 label Biography information for Baroness Blackwood of North Oxford
tabling member	114 label Biography information for Tim Loughton

691949

registered interest
date	20/02/2017
answering body	Department of Health
answering dept id	17
answering dept short name	Health
answering dept sort name	Health
hansard heading	Antidepressants
house id	1
legislature	25259 pref label House of Commons
question text	To ask the Secretary of State for Health, how many prescriptions for anti-depressant medication were issued in England in each of the last 10 years to (a) adults and (b) children.
tabling member constituency	East Worthing and Shoreham
tabling member printed	Tim Loughton
uin	64672
answer	answer is ministerial correction date of answer 23/02/2017 answer text <p>The data available has no patient level information; therefore the breakdown of prescriptions for adults and children is not available.</p><p> </p><p>Antidepressant drugs are classified in the British National Formulary (BNF) section 4.3 antidepressant drugs using the classification system prior to edition 70.</p><p> </p><p>Data on the number of prescription items for antidepressants is provided below.</p><p><strong> </strong></p><p>Total number of antidepressant prescription items written in the United Kingdom and dispensed in the community in England, 2006 to 2015, for BNF Section 4.3 antidepressants.</p><table><tbody><tr><td><p>Year</p></td><td><p>Prescription Items (000s)</p></td></tr><tr><td><p>2006</p></td><td><p>31,038.0</p></td></tr><tr><td><p>2007</p></td><td><p>33,839.6</p></td></tr><tr><td><p>2008</p></td><td><p>35,960.5</p></td></tr><tr><td><p>2009</p></td><td><p>39,140.5</p></td></tr><tr><td><p>2010</p></td><td><p>42,788.0</p></td></tr><tr><td><p>2011</p></td><td><p>46,677.8</p></td></tr><tr><td><p>2012</p></td><td><p>50,167.2</p></td></tr><tr><td><p>2013</p></td><td><p>53,326.6</p></td></tr><tr><td><p>2014</p></td><td><p>57,147.9</p></td></tr><tr><td><p>2015</p></td><td><p>61,021.6</p></td></tr></tbody></table><p> </p><p><em>Source: Prescription Cost Analysis provided by NHS Digital.</em></p> answering member constituency Warrington South answering member printed David Mowat question first answered 23/02/2017 10:22:23 answering member 4080 label Biography information for David Mowat
tabling member	114 label Biography information for Tim Loughton