Dr. Brendan O'Shea:

I think we all get exercised about the use of medication. We often regard it as a failure of therapy, and perhaps it is. The science around it is a little difficult. There are two studies to which we might refer the committee. One, by Tom Fahey et al., concerns the use of antidepressant medication in Irish adolescents. The study ran from around 2010 to 2015. The authors noticed a decrease in the prescribing of antidepressants from in the order of 4.74 per 1,000 of population to 2.61. That is a significant decrease in antidepressant use in adolescents, and the paper is a good scientific study that relates to Ireland. Another question is how much antidepressants we are using in the population as a whole. There is an interesting comparative study entitled, Antidepressant Utilization and Suicide in Europe. These are two very important issues - how much drugs we are putting in and how much suicide we are having. The study looks at these two parameters across 26 countries, and it is evident from the study that suicide rates have begun to decrease while antidepressant usage rates have begun to increase. It is difficult to separate and tease this out, but one figure the authors of the study have is that one needs to treat in the order of 660 people with an antidepressant in order to prevent one suicide. We do not have a right answer to this question but we strongly concur with our colleagues in IACP about having more strands of talking therapy and that it should be diverse and in communities.