New Tool Streamlines Antidepressants Prescribing

Researchers at King’s College London and the University of Oxford have created a new web application to simplify the prescription of antidepressant and antipsychotic medications, with the intention of empowering patients to play a more active part in choosing the medication that they take. The launch of the Psymatik Treatment Optimizer web tool was accompanied by the publication of an overarching review in Lancet Psychiatry. Researchers combed through all available data on 69 drugs – 32 antipsychotics and 37 antidepressants – to compile a database of adverse effects and effectiveness for each.

Before prescribing antidepressants and antipsychotics, the National Institute for Health and Care Excellence (NICE) recommends that the patient and doctor discuss the effectiveness and side effects of various medications. However, because of the large number of pharmaceuticals available and the vast range of potential adverse effects, meaningful discussions regarding the medications available are challenging and frequently confined to only a few possibilities.

Before deciding which prescription to administer, the doctor and patient meet to discuss the numerous potential side effects that the patient is most concerned about. The doctor enters this information into the Optimizer, which then generates a clear table indicating which antidepressant is least likely to induce that side effect, balanced against its therapeutic effectiveness.

“The Psymatik Treatment Optimizer allows patients and their doctors to easily establish which side effects the patient is most worried about, allowing both parties to quickly highlight which medication is likely to work best.” Dr Toby Pillinger, a Clinical Lecturer at King’s IoPPN

Dr Toby Pillinger, a Clinical Lecturer at King’s IoPPN and the study’s first author explains, “A patient might, for example, feel reluctant to engage with a course of medication due to the significant amount of weight they gained the last time that type of medication was prescribed. Our database takes that information and plots out a series of alternatives, setting the groundwork for a much more transparent conversation about the prescribing process.”

Antidepressants are given to around 13-17% of the adult population in the United States of America (USA) and 1-2% of the adult population in the United Kingdom (UK). While they have shown to be a successful method of symptom management for many people, over 75% of users report adverse effects such as weight gain, drowsiness, and loss of libido, which can impact quality of life and functioning.

Dr Robert McCutcheon, Wellcome Clinical Career Development Fellow at the University of Oxford and the study’s senior author said, “Helping an individual choose a medication that is right for them is absolutely crucial, and optimising the balance of side effects is key to helping people stick with treatments than help their symptoms. We have compiled that most comprehensive side effect database for antidepressants and antipsychotics that streamlines the prescribing process while also empowering patients to make the decisions that are right for them.”

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