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Oxford study: Anti-depressants should be given at lower doses

Researchers say UK guidelines on prescribing the drugs need updating.

There are calls from Oxford University for anti-depressants to be prescribed at lower doses to restrict the potential adverse side effects.

A study's found current UK guidelines for prescribing the drugs are 'conflicting'.

The research analysed data from nearly 20-thousand patients.  

Professor Andrea Cipriani, co-author of the study, said: "When I see patients in my clinic and we agree on prescribing an antidepressant for their depressive episode, the big challenge is not only to prescribe the right medication but also to find the best dosage for each individual, optimising efficacy and reducing side effects.

"Current practice guidelines provide conflicting recommendations."

The analysis, published in journal The Lancet Psychiatry, focused on the most frequently prescribed antidepressants in the UK, including five selective serotonin reuptake inhibitors (SSRIs), venlafaxine and mirtazapine.

The lower range of licensed doses was found to achieve "optimal balance between efficacy, tolerability, and acceptability in the acute treatment of major depression".

Commenting on the findings, Professor Sir Munir Pirmohamed, from the University of Liverpool, said: "Medicines are developed on a one-dose-fits-all strategy, and typically the dosing instructions state that the dose should be titrated to the maximum tolerated doses, which inevitably ends up as the maximum licensed dose."

He added: "We need to start developing methodology for personalising dosing for patients, not only for drugs used for psychiatry, but also in many other conditions."

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