Previously Tony, a Professor of Primary Care, identified shortcomings in how general practitioners (GPs) diagnosed and treated depression, showing that antidepressant treatment was not targeted accurately to the patients who needed them.
This research informed national guidelines and led to the introduction of depression questionnaires in GP practices that improved the targeting of treatment.
Tony has built on this previous research by developing internet and telephone interventions to safely support people stopping long-term antidepressant use when it is no longer necessary.
Although the diagnosis of depression has subsequently improved, concerns have emerged about prolonged antidepressant use. Public Health England has reported that many adults remain on these medications longer than the recommended two years, despite the risks of side effects such as weight changes, sleep disturbances and ‘emotional blunting.’ More serious complications include heart problems, stroke, and bleeding in older adults.
In response to this, Tony launched the Reviewing Long-Term Antidepressant Use by Careful Monitoring in Everyday Practice (REDUCE) programme that focused on supporting people to safely discontinue long-term antidepressant use.
Funded by the National Institute for Health and Care Research (NIHR), the programme showed that nearly half of long-term users, who were well and willing to stop treatment, could successfully taper off antidepressants with support from their GP.
The REDUCE findings are a critical step towards better managing antidepressant prescribing in the UK and have the potential to alleviate the burden on healthcare systems and improve patient outcomes.
The REDUCE programme is the first large-scale study to demonstrate that antidepressant discontinuation can be effectively managed without costly therapies like Cognitive Behavioural Therapy (CBT) or Mindfulness-Based Cognitive Therapy (MBCT).
In 2024, the research team published a groundbreaking study involving 330 adults that revealed 46% of participants successfully stopped antidepressants with the support of:
During each call, depression symptoms were assessed using the Patient Health Questionnaire. That assisted the GP in monitoring patients’ progress.
The study results gained widespread attention reaching more than 25 million people globally through coverage in newspapers and on TV and radio across the UK, USA, Europe, China, Australia and India.
The research team developed an online digital tool called ADvisor that offers patients accessible, cost-effective support for stopping antidepressant use. They also created another tool called ADvisorHP that provided GPs with advice on tapering off treatment slowly and dealing with withdrawal symptoms.
NHS England’s National Clinical Director for Prescribing Tony Avery has endorsed the idea of linking ADvisor support through the national NHS app, and David Clark, National Clinical and Informatics Advisor for NHS Talking Therapies, supports recommending ADvisor to patients who continue antidepressants after completing successful psychotherapy.
Tony is now seeking additional funding to expand access to the ADvisor online tool. The new grant will focus on creating a mobile-friendly app version as an NHS England resource and getting general practices and NHS Talking Therapies to refer people wanting to stop long-term antidepressants to the app. This will be combined with telephone support from primary care mental health workers.
