Can a GP prescribe ADs for a 17 year old?

[Izearle]

Just that really.

DD has been struggling more and more in the last 2 years. We went to the GP and got a CAMHS referral, where she was offered 30 minute talking therapies which didn’t help at all. DD is now reluctant to try a different therapist because hers was so poor!

I think she needs medication but I have no idea how to go about it - does it need a psychiatrist to prescribe? Will a GP do anything else now she’s been discharged from CAMHS (she refused to go to any more sessions as she thought they were a waste of time)

She clearly has anxiety or depression - feeling of dread every day, constantly stressed, overwhelmed at the slightest thing, horrible mood swings, falling behind at school, no motivation to do anything and chronic insomnia.

Any help would be appreciated.

From experience they can and will, with or without your consent.

Yes. I had to request them on DD1's behalf (with her permission) as she wasn't in a fit state, but there was no argument from the GP.
She was coming up to 17.

Yes I think they will. I think they can prescribe them for 14 upwards or something like that.

Yes, get dd to ask. Or go with her, and firmly politely request.

Yes, you should definitely discuss with them. I hope you get what your dc needs

NICE guidance is for under 18s to be referred to psychiatrist for medication and for any drugs to be accompanied by talking therapy. Doesn't mean that always happens though
www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/antidepressants/considerations

My 17 yo got them via a psychiatrist. She had a CAMHS therapist who referred her. Not the magic answer though - prescribed a higher dose today.

You could also ask for melatonin. My dd struggles to sleep at night and it has helped. But they prescribe quite low doses for under 18s.

In my area you need a psychiatrist to prescribe and monitor either via camhs or privately. GPs won't prescribe to under 18s. I think there might be a bit of a grey area when they're 17 nearly 18 though, as waiting lists will mean they will turn 18 before they reach the top of the list. So it may be worth asking.

I'm going through exactly the same thing. Went to GP in October with 17yo DD, he said only camhs can prescribe but by the time she gets an appointment she will be 18 (Sept 23) - his words. We are in no mans land. Going back to see GP tomorrow - I need action, she's not getting better and when she says she doesnt want to be here anymore - I can't cope

Our GP was adamant they coukd not prescribe AD's under 18 without a psychiatrist referral. Sounds like some GP's are willing to though?

We paid privately (which was difficult) but after 2 months of private prescription the Psychiatrist wrote to the GP and he agreed a shared case? Whatever and now we get the meds on the NHS.
We still pay for 6 monthly meetings as part of the private due diligance patient care etc which are useful if there is a set back or meds need tweaking.

@WOZZA1 I’m sorry to hear you’re going through it with your DD too. It does feel like everyone is reluctant to help - GP told me I had to go through her school, and her school said I had to go through the GP!! When the GP eventually agreed to a CAMHS referral it only took a few weeks here, it was very quick, but sadly not helpful at all.

@ilovebagpuss I would happily pay for a private referral if it got her help. CAMHS here were not very good and she wouldn’t go back to talking therapy.

I managed to get her a GP appointment for Friday having explained the issue to the receptionist so hoping that’s a good sign and they might be able to prescribe something!

@Izearle Camhs were rubbish and CBT did not help at all. School was useless so she didnt attend Y11 at all but in college now. Just want my little girl back to be honest. The waiting list for camhs referral is about 12 months here so we're just in no mans land - appointment tomorrow though so fingers crossed!! @ilovebagpuss good luck for Friday, hope you get a good response!

All antidepressants now have be initiated by a psychiatrist or paediatrician to under 18s. Once established gp can take over prescribing... it changed about 10-15 years ago. Some GPs might do it but they would be in serious shit without a leg to stand on if things went wrong which they can and do. Antidepressants can affect adolescent brains differently to adults which is why they should only be started by clinicians specialised in this area.

@Didiplanthis can you elaborate on the shit they would be in if things went wrong? I think it’s us as parents that don’t have a leg to stand on.
mine was prescribed antidepressants on the basis of a telephone appointment at 17. I was really concerned and called the gp/ practice manager about the bad reaction my child had to them ( and the prescribing via telephone appointment).my child was informed that I’d complained and advised to have me removed from accessing their medical info. Which they did because they saw me as interfering.

This was last year and no psychiatrist or paediatrician involved. Ad’s given for anxiety, as advised as a good idea by college counsellor.

If a GP prescribed and there was a serious adverse effect they would have no legal defense of their actions in initiating an antidepressant to an individual under 18 ( different if initiated by a specialist ). Anyone over age of 16 is supposed to give formal consent for a parent to discuss their medical care, and at 13 they need to consent to parental access to records and be aware of parental input.

Just an update in case anyone happens across this thread.

Booked a face to face appointment with a GP who was very helpful and agreed medication could be beneficial as the talking therapy hadn’t helped. On the basis that DD is 17.5 and it would take months to get a referral, at which point she would likely be 18 anyway, and also that she has discussed it so openly with me and understood what effect SSRIs had, he thought she was a good candidate.

So no referral required and she has started medication now. The beta blockers are already having a positive effect on her ability to function properly in the mornings. Whether the citalopram helps too remains to be seen but I think it’s a positive next step for her.

Ds had to wait until he was 18 despite seeing a psychologist & being under Camhs. He had an appointment booked for his 18th birthday at our doctors at least a month before because he was so desperate & walked out with a prescription.

Good news ! My DH’s Citalopram took 4 weeks before we noticed a difference, and he was better still by 6 months.

I'd see if you can source a private psychiatrist if you can afford it and get her seen privately if your really worried about her. ❤️ my dd saw one for adhd and was diagnosed in less than month and on meds. It's expensive for adhd care as it's a rolling care for 6 months but one appt should've
Be less than £300 for a general consult if you can stretch to that.

Read the update, she’s got the medication.

Please do keep a close eye on your dd. There is a reason most GPs are reluctant to prescribe. My dc had them from CAHMS at 17 and it was honestly the worst thing ever. He got almost every side effect, suicidal, eating disorder, insomnia, they definitely don’t fix all. Instead of addressing his growing problems, they kept upping the dose higher and higher, which made him worse every time. To be honest, he was ok on the lowest dose but there seems to be a requirement to continuously increase the dose once on them.
I hope you dd has a better experience, they destroyed my son.

Thank you, and I’m so sorry you went through that, it must have been horrendous.

I have warned DD that she will likely feel worse before she feels better and to keep talking to me (I hope she will).

DD already has bad insomnia but no suicidal thoughts or thoughts of self harm so I’m hopeful these will work, but I will bear in mind what you have said. She has another appointment in 4 weeks to review so if things are worse then at that point I will mention this if things are worse.

I hope your son is doing much better now.