Sixways Clinic acknowledges the level of risk involved when prescribing Selective Serotonin Reuptake Inhibitors (SSRI’s) for young adults.
This policy has been created to ensure safe prescribing and consistency for patients who fall into this category.
NICE guidance recommends that children and young people presenting with moderate to severe depression (or mild depression unresponsive to 2-3 months of psychological therapy) should be reviewed by a CAMHS team. It also advises Initiation of medication should not take place in primary care – if an antidepressant is to be prescribed, this should only be following an assessment and diagnosis by a child and adolescent psychiatrist.
The NHS advises (see link: https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/antidepressants/considerations/) that use of antidepressants is not usually recommended in children and young people under the age of 18. This is because there is some evidence that, in rare cases, they can trigger thoughts about suicide and acts of self-harm in this age group. For moderate to severe depression, antidepressants may be used if both the following apply:
– the person being treated will also receive talking therapies in combination with antidepressants
– the treatment is supervised by a child and adolescent psychiatrist (a doctor who specialises in treating mental health conditions in children)
Guidance
Patients who are under the NHS CAMHS service have their condition monitored through the CAMHS team. Their medication is issued (by CAMHS) dependent on such reviews. The surgery will not prescribe medications for patients under the care of CAMHS and patients should ensure they allow plenty of time to make their requests to the CAMHS teams.
In-keeping with local guidance (on transfer of private healthcare professional recommended prescribing into the NHS – attached) the practice will also not take over the prescribing of SSRI’s initiated in under 18’s in the private sector. The surgery also recommends patients should ensure they allow plenty of time to make medication requests to the private child psychiatry services.
In line with national guidance the practice will not initiate prescription of SSRI’s for those under the age of 18.
Patients who are prescribed SSRI’s at the age of <18 will not have these medications added to their repeat medications list. This is to ensure proper oversight of these medications.
Further Support
Further information on local service available for Cheltenham mental health please visit https://www.onyourmindglos.nhs.uk/ where you can search for services available at specific ages.
This policy is reviewed on a regular basis in line with local and national guidance. Should you wish to raise any concerns with the content or guidance within this policy please contact the practice manager.