When antidepressants are prescribed, the clinician responsible for the patient’s care should explain the medicine clearly. This should include a discussion with the patient about the possible benefits, risks, and side effects of treatment. Patients are also given a patient information leaflet (PIL) with each medicine. This explains possible side effects. The National Health Service website also has information on antidepressants, including possible side effects.

Patients and families raised concerns with the Medicines and Healthcare products Regulatory Agency (MHRA) that the current warnings about some risks of antidepressants were not clear enough. In response, an Expert Working Group of the Commission on Human Medicines (CHM) was set up to give independent advice to the MHRA on how risks could be explained more clearly to patients. This review has concluded and the MHRA is taking forward several recommendations with the marketing authorisation holders, including strengthened wording in the PIL, so that risks such as suicidal behaviour are clearer and easier for patients and their support network to understand. This work has been informed by a group of patients with a range of mental health conditions in line with CHM advice.

In 2022, the National Institute for Health and Care Excellence published guidelines entitled Medicines associated with dependence or withdrawal symptoms: safe prescribing and withdrawal management for adults to assist clinicians in supporting patients prescribed medicines with the potential for withdrawal-related adverse effects, including information on how to safely reduce and withdraw the prescribing of these medicines. The guidelines are available at the following link:

https://www.nice.org.uk/guidance/ng215

The following table the number of National Health Service prescription items classified as antidepressants prescribed in England that are then dispensed in the community in England, Scotland, Wales, the Isle of Man, or the Channel Islands by age group for each year from 2015/16 to December 2025:

Note: data for 2025/26 is from April to December, or nine months.

The NHS Business Services Authority does not hold data on the clinical indication of a prescription and therefore does not know which prescriptions were prescribed for depression. Many drugs have multiple uses, for example, some drugs that are classified as antidepressants can be issued to treat migraine, chronic pain, myalgic encephalomyelitis, and a range of other conditions.

The following table shows the number of National Health Service prescription items classified as antidepressants by age group for each year from 2015/16 to 2024/25:

Note: data for 2025/26 is from April to September.

The NHS Business Services Authority does not hold data on the clinical indication of a prescription and therefore does not know which prescriptions were prescribed for depression. Many drugs have multiple uses, for example, some drugs that are classified as antidepressants can be issued to treat migraine, chronic pain, myalgic encephalomyelitis, and a range of other conditions.

The Department through its research delivery arm, the National Institute for Health and Care Research (NIHR), has funded research into this topic. Examples of relevant research include a study exploring antidepressant use during pregnancy to assess the benefits to mothers and long-term neurodevelopmental risks to children, and a project which aimed to create a computerised decision support tool to guide discussions between doctors and pregnant women about medication risks and benefits, ensuring a balance between maternal health and foetal protection.

In addition, the NIHR has supported research which investigated Neonatal Adaptation Syndrome, a cluster of symptoms like jitteriness and feeding difficulties, in babies exposed to selective serotonin reuptake inhibitors or selective noradrenaline reuptake inhibitors antidepressants in utero. This research aimed to understand the experiences of mothers and monitoring practices.

The Medicines and Healthcare products Regulatory Agency (MHRA) is an executive agency of the Department with responsibility for the regulation of medicinal products in the United Kingdom. The MHRA ensures that medicines are efficacious and acceptably safe, and that information to aid the safe use of a medicine, including possible side effects, is appropriately described in the authorised product information.

The MHRA’s approved patient information leaflets for the most commonly prescribed antidepressants contain warnings about sexual side effects whilst taking the drug, and for some antidepressants there is a warning about sexual side effects which may continue after stopping the medicine. These warnings are under review by an expert working group of the Commission on Human Medicines, and the findings of this review are due to report in the Autumn.

Persistent genital arousal disorder (PGAD) is not specifically listed as a possible side effect in the patient information leaflets for any antidepressants. PGAD remains poorly defined and requires research into several proposed causal factors.

A total of 13 reports that describe PGAD suspected to be associated with an antidepressant have been received through the Yellow Cared scheme. The reports were received between 2017 and 2025 for sertraline, with six reports, citalopram, with three reports, fluoxetine, with three reports, and reboxetine, with one report.

The MHRA continuously monitors the safety of these medicines. However, the data currently available is considered insufficient to list PGAD as a possible side effect of antidepressants. Any emerging data will be carefully considered and regulatory action taken as needed.

A public assessment report will be published following the advice of the Commission on Human Medicines (CHM) to the Medicines and Healthcare products Regulatory Agency (MHRA) after the next meeting of the Antidepressant Risk Minimisation Expert Working Group (EWG) in July 2025. The public assessment report will contain the minutes of all EWG meetings and the outcome of the CHM’s advice. It is anticipated that the public assessment report will be published by the MHRA in Autumn 2025.

The Medicines and Healthcare products Regulatory Agency (MHRA) will seek the advice of the independent Commission on Human Medicines (CHM) on the final recommendations of the Antidepressant Risk Minimisation Expert Working Group, following the next meeting in July 2025.

If the CHM advises the MHRA to request changes to the antidepressant product information, the MHRA will write to all of the pharmaceutical companies affected in accordance with standard timelines and procedures for requesting variations to product information.

The NHS Business Services Authority (NHSBSA) holds data going back to April 2015, but not prior to this date. The following table shows the total number of patients aged 17 years old and under that were prescribed antidepressants for the financial years 2015/16 to 2023/24:

Source: NHSBSA Statistical Collections, available at the following link:
https://www.nhsbsa.nhs.uk/statistical-collections/medicines-used-mental-health-england

These cover antidepressants prescribed in England that are then dispensed in the community in England, Scotland, Wales, Isle of Man, or the Channel Islands.

In 2022, the National Institute for Health and Care Excellence (NICE) published the guideline Medicines associated with dependence or withdrawal symptoms: safe prescribing and withdrawal management for adults, which makes recommendations on discontinuing antidepressant medication. This is also addressed in Depression in adults: treatment and management. Further information on the guidelines on medicines associated with dependence or withdrawal symptoms and depression in adults is available, respectively, at the following two links:

https://www.nice.org.uk/guidance/ng215

https://www.nice.org.uk/guidance/ng222/chapter/Recommendations

In 2023, NHS England published Optimising personalised care for adults prescribed medicines associated with dependence or withdrawal symptoms: Framework for action for integrated care boards (ICBs) and primary care. The framework includes five actions, resources, and case studies to help develop plans that can support people who are taking medicines associated with dependence and withdrawal symptoms. The framework is available at the following link:

https://www.england.nhs.uk/long-read/optimising-personalised-care-for-adults-prescribed-medicines-associated-with-dependence-or-withdrawal-symptoms/

NHS England is also encouraging ICBs to address inappropriate antidepressant prescribing and to consider commissioning services for patients wishing to reduce or stop prescribed medicines that can cause dependence and withdrawal. Further information is available at the following link:

https://www.england.nhs.uk/long-read/national-medicines-optimisation-opportunities-2023-24/

The Government recognises that too many people with mental health issues are not getting the support or care they need, and we know that waits for mental health services are far too long. This is why we are committed to ensuring we give mental health the same attention and focus as physical health, so that people can be confident in accessing high quality mental health support when they need it.

The New Medicine Service (NMS) is an advanced service offered by community pharmacies, providing patients with advice to address any possible side effects, issues, or questions that patients who are prescribed a new medicine may have. The service focuses on treatments for long-term conditions, including asthma and hypertension.

Early interventions of this type can improve medication adherence, patient outcomes, and can reduce pressure on the wider National Health Service. From October 2025, the NMS will expand to introduce depression as a further therapeutic area for which patients can receive support.

The New Medicine Service (NMS) is an advanced service offered by community pharmacies, providing patients with advice to address any possible side effects, issues, or questions that patients who are prescribed a new medicine may have. The service focuses on treatments for long-term conditions, including asthma and hypertension.

Early interventions of this type can improve medication adherence, patient outcomes, and can reduce pressure on the wider National Health Service. From October 2025, the NMS will expand to introduce depression as a further therapeutic area for which patients can receive support.

Antidepressants can be an effective treatment option for depression when prescribed safely and in alignment with patient preferences. They are also used in anxiety and chronic pain.

It is for the responsible clinician to work with their patient to decide on the best course of treatment, with the provision of the most clinically appropriate care for the patient always being the primary consideration. It is important for patients to be able to make informed choices about whether to take antidepressants, and NHS England has recently published a Patient Decision Aid on this topic, produced by the National Institute for Health and Care Excellence (NICE).

It is also important for clinicians to recognise that, while antidepressants may be helpful for some patients, non-drug options are likely to be a better option for most people who present with less severe mental health conditions. These include NHS Talking Therapies for anxiety and depression, and social prescribing.

To ensure antidepressant drugs are made available to patients only where the benefits outweigh the potential harms, NHS England is encouraging the integrated care boards to address inappropriate antidepressant prescribing and to consider commissioning services for patients wishing to reduce or stop using antidepressants.

The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for ensuring medicines, medical devices and blood components for transfusion meet applicable standards of safety, quality and efficacy. The MHRA rigorously assesses available data, including from the Yellow Card scheme, and seeks advice from the Commission on Human Medicines, the MHRA’s independent advisory committee, where appropriate, to inform regulatory decisions including amending the product information.

The MHRA has received a total of 112 reports through the Yellow Card scheme for all antidepressant medications of reports of completed suicide which have been received between 1 January 2015 and 25 February 2025. The following table shows a yearly breakdown thereof:

Source: MHRA

Note: List of antidepressant medications included in the search were: escitalopram, citalopram, paroxetine, fluoxetine, fluvoxamine, sertraline, venlafaxine, duloxetine, reboxetine, amitriptyline, clomipramine, dosulepin, dothiepin, doxepin, imipramine, lofepramine, nortryptiline, trimipramine, trazodone Isocarboxazid, tranylcypromine, moclobemide, phenelzine, agomelatine, vortioxetine, L-tryptophan, esketamine, mianserin, mirtazapine.

It is important to note that anyone can report to the MHRA’s Yellow Card scheme and the recording of these reports in the Yellow Card database does not necessarily mean that the adverse reactions have been caused by the suspect drug. Many factors must be considered in assessing causal relationships, including temporal association, the possible contribution of concomitant medication, and the underlying disease. We encourage reporters to report suspected adverse reaction reports, the reporter does not have to be sure of a causal association between the drug and the reactions; a suspicion will suffice.

The number of reports received cannot be used as a basis for determining the incidence of a reaction, as neither the total number of reactions occurring, nor the number of patients using the drug, is known. All fatal reports including those reporting completed suicide are assessed by the MHRA and cumulative information is reviewed at regular intervals. Warnings about the risk of suicidal behaviours are contained in the product information for all licensed antidepressants and these warnings are based on causality assessments of individual case reports and the totality of evidence from clinical trials and the scientific literature.