Introduction & module overview

In the UK in 2023-24, Department of Health and Social Care (DHSC) figures show that 750,000 people aged over 18 years were diagnosed with depression – that’s roughly 60 per community pharmacy. Most are prescribed an antidepressant.

This module will help pharmacists understand how to have conversations with people over 18 years of age who present with a first prescription for an antidepressant.

It covers ways of asking questions to determine how effective or well tolerated the antidepressant treatment is, how to finish a consultation, and when to escalate concerns about a person’s risks. It concentrates on treatment with selective serotonin reuptake inhibitors (SSRIs), which NICE recommends as first-line therapies.

Pharmacists who want to refresh their clinical knowledge about antidepressants can do so using the NICE guideline, Depression in adults – treatment and management NG222.

People with depression may not regard themselves as ‘patients’, especially where they feel there is a possible cause and they are otherwise well. This is why NICE refers to ‘the person’ in the guideline and this module does the same.

Antidepressants are not recommended by NICE for mild depression “unless that is the person’s preference”, but waiting lists for talking therapy are often long and many people therefore request or agree to an antidepressant.

Talking to a healthcare professional can remove the emotion or worries a person may have had if they were talking to a friend, colleague or family member.

For example, they may be worried about stress at work or are not coping with family dynamics. A conversation where the medicine is the focus has an obvious purpose and shows the pharmacist is there to support them and offers an opportunity for regular contact.

There may be co-diagnoses, such as anxiety, or the person may be experiencing depression after a diagnosis such as cancer or dementia. So before your conversation, it is worth reviewing the PMR for any other newly prescribed medications.