Experience of antidepressant use and discontinuation: A qualitative synthesis of the evidence.

WHAT IS KNOWN ON THE SUBJECT?: Rates of antidepressant prescribing have been increasing. Antidepressants are not effective for many people. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Participants described how in order to receive help they had to engage with a medical pathway in which their experiences were constructed as arising from a biochemical deficit. Antidepressant prescribing was identified as being the only option available and was associated with stigma. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses have a role to play in providing treatment options for those experiencing depression. Mental health nurses need to provide evidence-based information about antidepressants support those experiencing depression to make informed choices. ABSTRACT: Introduction There are increased prescribing rates of antidepressants associated with an increase in the diagnosis of depression. However, antidepressants are not effective for many people. There is a gap in the existing literature for a synthesis of the experiences of those with lived experience of antidepressant use to better understand their use and impact given their ubiquitous use in mental health, primary care and other secondary and tertiary care settings. Mental health nurses play direct or indirect roles in both advocating for antidepressant use and monitoring adherence. Aims To identify how people prescribed antidepressants describe their experiences of the medication including its discontinuation? Method A meta-synthesis of qualitative studies examining patients' experiences of antidepressant medication. Ovid MEDLINE, EMBASE, PsychINFO and Cochrane Library databases were searched in May 2021. One reviewer screened titles and abstracts. Two reviewers independently reviewed the retrieved papers for eligibility and data extraction. The data synthesis was conducted using thematic analysis. Two reviewers independently conducted quality appraisals. Results Twenty-seven studies with a total of 2937 participants were identified for inclusion in this review. Four themes were identified across the studies: the only option available; stigma associated with 'biochemical deficit' not myself and the vicious cycle. Implications for practice Those seeking treatment for depression need to be provided with treatment options and evidence-based information about anti-depressants to provide them with the opportunity to make informed choices.