With World Mental Health Day 2021 upon us, Comment Central examines the latest research into the impact of the global pandemic on mental health in the UK as well as the thoughts and concerns of healthcare professionals surrounding frontline antidepressant treatment options. 

The Pandemic and Mental Health

The rise in rates of depression and the devastating toll Coronavirus and lockdown had on the nation's mental health is well documented. The ONS estimates rates doubled from 2019 to 2020. But, for the first time, a new study by specialist digital healthcare insights and consulting firm, CREATION.co, offers us greater understanding of the drivers behind the rise in rates of mental illness.

Published to coincide with World Mental Health Day 2021, they show how successive lockdowns, exam results, and the start of the new academic year triggered spikes of activity among doctors and other experts in the treatment of rising rates of depression and the prescription of frontline antidepressants known as Selective Serotonin Reuptake Inhibitors (SSRIs) during the pandemic.

The findings show the impact of COVID-19 and how this triggered conversations among healthcare professionals regarding the impact of repeated lockdowns, the economic recession, social distancing, and other restrictions, on rates of depression and an increase in the use of antidepressants.

It also highlights the impact of exam results, including GCSEs and A-Levels, the start of the new academic year and how these drove rates of depression and an increase in the use of antidepressants among young people.

The findings are based on an analysis of almost 6,000 online posts by 2,000 UK healthcare professionals discussing the use of commonly prescribed antidepressants (Selective Serotonin Reuptake Inhibitors) in the treatment of clinical depression from January to December last year.

Commenting on the findings, Daniel Ghinn, CEO and Founder of CREATION.co explained that: "While the impact of successive lockdowns and self-isolation on rates of depression and the prescription of antidepressants is well documented, the findings of this study offer greater granularity to our understanding of what drove this. Less well documented is the negative impact upon young people of uncertainty surrounding exam results ? a knock on effect of their diminished capacity to learn and study due to lockdown.

"The study offers insight into the valuable role social media can play in helping us to understand the needs and behaviours of groups. Online analysis of the views and sentiments of healthcare professionals offers huge potential for collecting real-world evidence for an array of different areas of public health. It can range from what's driving greater demand (as in this case) to other areas, such as lesser-known side effects of drugs and unknown interactions. It represents a fast-growing tool in public health analysis whose significance is likely to grow in the coming decades."

Antidepressants: Effective, but Beware the Side Effects

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The same study also examined sentiment among healthcare professionals toward frontline treatment options, specifically Selective Serotonin Reuptake Inhibitors (SSRIs) antidepressants. It found that while the majority speak positively surrounding their efficacy, side effects remain a key concern with one in six (16 per cent) arguing these outweigh the positives.

Of the stigma-contributing conversations expressed by healthcare professionals online, the study found the primary factors were negative side effects or adverse events associated with their use (48 per cent); the possible worsening of other illnesses, such as self-harm (13 per cent); dependency (11 per cent); and inefficacy (15 per cent).

The authors of the survey also explored sentiment among healthcare professionals towards the eight prescribed SSRIs in the UK. It found that Eli Lilly's Prozac (fluoxetine) is spoken about the most by healthcare professionals online, followed by Pfizer's Lustral (sertraline) and Lundbeck's Cipramil (citalopram). The positive mentions are mostly in relation to discussions surrounding the efficacy of the drugs. Negative sentiment typically reflected issues, such as side effects and dependency. The positive-negative ratio suggests most of those surveyed think that the good efficacy and positive aspects of the products outweigh the negatives.

In terms of the conversation topics discussed online regarding SSRIs, the most common were good efficacy and adolescent usage. Good efficacy was most spoken about in relation to almost all SSRIs, but especially Prozac. Inefficacy is spoken about the most regarding GSK's Seroxat (paroxetine), which does not feature in good efficacy conversations. Notably, Pfizer's Lustral (sertraline) contributed little to online conversations surrounding good efficacy, yet was the main product spoken about in relation to side effects.

There was also significant conversation about the youth and young adult demographic using SSRIs, particularly with regards to taking Lustral and Prozac, which are FDA approved for treating OCD and depression in children.

Commenting, Daniel Ghinn from CREATION.co, added: "On the one hand, the findings of this research are very positive. They show that HCPs consider SSRIs to be a safe and highly effective class of medication that provides respite to millions of sufferers around the world struggling with debilitating depression and other affective mood disorders. But the study offers greater granularity regarding the shortcomings of these medications as reported by patients, their clinician and other healthcare professionals. Of note is the contrasting ratios in terms of positive, neutral, and negative sentiment regarding seven of the SSRIs available in the UK.

At CREATION.co, we are excited to be at the forefront of this exciting and growing wave of digital insight and analysis that is promoting better understanding of pharmaceuticals and public health."

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