Interview with Dr Kerryn Phelps, Federal President, AMA: Anti-depressant Drugs, Sky News,
Wednesday 31 January 2001

And joining me now on the line is the federal president of the Australian Medical Association, Dr Kerryn Phelps.

Now Dr Phelps, I find these figures somewhat alarming, that we should be writing 500 prescriptions for anti-depressants for every 1,000 Australians over the age of 15, if only because that many Australians should be suffering from depression. Do you find those figures alarming?

Dr Phelps: I find those figures alarming but not surprising. We know that depression has been under-diagnosed for many years and in fact it's taken quite a long time for GPs to become satisfied with the development of new anti-depressant agents, to be comfortable about prescribing them more widely. And there's no question that these medications properly prescribed and in conjunction with counselling are tremendously effective in helping to treat depression.

Compere: So it is quite appropriate then?

Dr Phelps: Well it is. A recent survey of 17,000 Australian women found that 52 percent of women had felt that they had been significantly depressed at some stage in their lives or were currently depressed.

I think that really we need to look at what are the underlying reasons for that depression and I don't think we're even close to understanding that yet.

But I think that the Depression Initiatives need to look at those causes and not just at ways of treating them.

Compere: Because otherwise, we're going to become a nation of people very much dependent on pills.

Dr Phelps: Yes, I think that the really important issues here are that people have access not only to medication for management of depression but I think that this is also a reflection of the fact that we've seen a shrinking back of community-based services for people who are needing support. You know things like family support and I mean that in terms of community counselling services, substance abuse counselling services.

These sorts of things have become very, very hard to access. I'm in general practice and, when we need to be able to refer somebody for psychological counselling or psychiatry, then we find it's actually very difficult. There are long waiting times, if those services indeed are available in the areas.

Compere: Well as you say, you are in general practice. How many people suffering from depression do you come across and how often do you prescribe drugs such as Prozac?

Dr Phelps: Well it is a common illness. It is quite often transient. But in some people it become more chronic and longer term. And I think it's just important that, whatever practice you're in, that you're able to spend some time with people sorting out ways of them being able to cope, and I think that's where the counselling issue comes in; ways of them being able to perhaps modify the way they think and the way they behave so that they can in fact get through difficult times.

Compere: But do you have any reluctance yourself in prescribing drugs?

Dr Phelps: It's always a matter of judgment. People with more severe illness, if they're not sleeping, if they're not eating, if they're losing weight, if they are thinking of harming themselves, these are signs that the depression is severe and needs to be treated quite often with medication.

You have to be able to judge clinically whether it's a mild, moderate or severe depression and manage that accordingly. And if somebody is just not getting any sleep and their life is a misery and they're not coping, then they certainly do need assistance not only with counselling but sometimes also with medication. And it's a matter of appropriate prescribing.

And I would have to echo Professor Hickey's comments in that the increase we've seen in the prescribing of anti-depressant medication is in line with what we're hearing about the rates of depression.

I do believe, however, that the rates of depression in men are under-diagnosed and that's why we're seeing higher levels of substance abuse in men who are looking to, in inverted commas, 'drown their sorrows' if you like by drinking too much or by taking medication that is not so much in their interests.

Compere: Well it certainly sounds like the national initiative to tackle depression is long overdue then.

Dr Phelps: No question about that, and I think that one of the focuses that I'd like to see is in looking at improving community based counselling and support services for people who are in difficulties or who are having trouble coping.

Compere: Kerryn Phelps, thank you very much.

Compere: Thank you, John.