9.1 million patients in England received 96 million antidepressant prescriptions in 2025/26 – the highest figures ever recorded – continuing an almost unbroken upward trend stretching back a quarter of a century.
The figures, published in the NHS Business Services Authority (NHSBSA) annual Medicines Used in Mental Health report, also reveal stark inequalities in who receives these drugs. Four out of five categories of mental health medicine tracked by the report, including antidepressants, antipsychotics and drugs for anxiety, had higher numbers of patients in England’s most deprived areas than in its least deprived. Dementia drugs were the only exception. What’s more, women, and particularly teenage girls, remain far more likely to be prescribed antidepressants than men.
The gaps in prescribing are widening
Our medical system’s dependence on these drugs stretches far back. In 1999, England dispensed 20.1 million antidepressant items. By 2017, that figure had more than tripled to 67.5 million, according to NHS Digital figures. This year’s 96 million marks nearly a fivefold increase in a quarter century.
It isn’t just the sheer volume of antidepressant prescribing that is shocking; behind the headline figure lies a growing inequality gap. Forty-four per cent more patients were prescribed antidepressants in England’s most deprived areas than in its least deprived, while the same pattern held for antipsychotics, ADHD medication and hypnotics and anti-anxiety drugs – only dementia treatments buck the trend, being more common in wealthier areas, likely reflecting longer life expectancy and its link to wealth.
This phenomenon isn’t new either. A study published in the journal BJGP Open found that antidepressant prescribing levels correlated with the government’s official measure of deprivation across the country. The CSJ’s own analysis of nine years of NHSBSA data found the number of patients taking antidepressants in the most deprived fifth of areas has consistently and substantially outstripped the least deprived fifth every year since 2015/16.
The pattern repeats as conditions get worse. People detained under the Mental Health Act are almost 3.5 times more likely to come from England’s most deprived areas than its least deprived, according to the Centre for Social Justice (CSJ).
Gender differences are equally pronounced. Of the 9.1 million people prescribed antidepressants in 2025/26, 65% were women. Among 15- to 19-year-olds prescribed antidepressants, 71% (124,434 people) were female.
Younger people more broadly have seen the sharpest rise in probable mental health disorders of any group. Among children aged 8 to 16, the proportion with a probable mental disorder rose from 12.5% in 2017 to 20.3% in 2023, NHS England surveys found, while for 17 to 19-year-olds it rose from 10.1% to 23.3% over the same period. Hospital admissions for self-harm among girls aged 8 to 17 nearly quadrupled between 2007/08 and 2021/22, rising from 29 to 108 per 100,000 population.
The cost of coping
All of this comes with a staggering cost. Mental ill health costs England £300 billion a year according to the Centre for Mental Health – a figure that includes £6.5 billion in sickness absence and £5.7 billion in lost tax revenue from unemployment and economic inactivity linked to mental health conditions.
The human cost is harder to quantify but no less real. Antidepressants help many people, particularly those with moderate to severe depression, but they are not without risk. Between 27% and 86% of people who attempt to stop taking an antidepressant experience some form of discontinuation syndrome, with symptoms ranging from dizziness and flu-like effects to mood swings and, in some cases, suicidal thoughts. For patients who respond poorly or partially, the reality is often years cycling through different medications, adjusting doses, and managing side effects.
GPs know the system isn’t working. Polling of 1,001 GPs commissioned by the CSJ found 83% were concerned that antidepressants are prescribed when non-drug interventions would be more suitable, and 85% worried they prescribe them simply because alternatives aren’t available quickly enough. The number of people in contact with NHS mental health services climbed from 1.2 million to nearly two million between 2016 and 2024 – a 70% increase – but waiting lists for NHS Talking Therapies mean GPs often reach for the prescription pad not because it’s the best option, but because it’s the only one to hand.
Hard to access alternatives
Against this backdrop, the case for exploring cannabis and psychedelic therapies as alternatives or adjuncts to antidepressants has grown louder, and the evidence base, while still developing, is no longer trivial.
If even a small fraction of the 9.1 million people currently prescribed antidepressants could be effectively treated with cannabis-based medicines or psychedelic-assisted therapy instead, the implications for NHS workload would be significant. And data suggests many GPs are open to trying something other than antidepressants. A 2025 survey of 250 practising UK doctors has revealed that most would be willing to prescribe medical cannabis if it were part of the NHS toolkit. Yet despite the scale of the problem, there is no NHS-commissioned modelling of whether expanding access to these treatments could reduce prescribing or ease service pressure – and no active NICE review of cannabis for any qualifying condition, despite depression being the UK’s most common mental health condition.
Yet study results frequently show that a genuine clinical need can be met by cannabis. Data from the UK Medical Cannabis Registry tracked 698 patients with treatment-resistant depression over 24 months and found statistically and clinically significant improvements in depression, anxiety, sleep quality and quality of life, most pronounced in the first three months of treatment, according to a study published in the Journal of Affective Disorders earlier this year. Real-world patient surveys tell a similar story: a multi-clinic survey found that 98% of UK mental health patients report improvement from medical cannabis.
The picture for psychedelics is more contested, but shows promise. Early trials of psilocybin, the active compound in magic mushrooms, run by researchers at Imperial College London, found large and sustained reductions in depression and anxiety among participants. But a landmark meta-analysis published in JAMA Psychiatry in March 2026 complicated that narrative. Because patients in psychedelic trials can usually tell whether they’ve received the real drug or a placebo, given how unmistakable its effects are, earlier studies may have overstated its benefits relative to antidepressants. When researchers compared psychedelic-assisted therapy against antidepressants prescribed openly – with both groups aware of what they were taking – the two performed almost identically.
“Psychedelics may still be a valuable treatment option,” said Balázs Szigeti, a clinical data scientist at the University of California, San Francisco and co-author of the study. The findings of that study don’t mean psychedelic therapy doesn’t work, only that it may not clearly outperform existing antidepressants once the playing field is levelled – a genuinely useful, if less headline-grabbing, piece of the evidence picture. Surely people deserve the right to choose?
Legal, but out of reach
Whatever the strength of the evidence, access is the more immediate concern for many people suffering with poor mental health. Cannabis-based medicinal products were rescheduled on 1 November 2018, following a review commissioned by the then health secretary Matt Hancock. The change allowed specialist doctors to prescribe cannabis for the first time.
Yet almost eight years on, NHS prescribing remains rare. Licensed cannabis medicines can only be prescribed on the NHS for a narrow set of conditions – severe treatment-resistant epilepsy, nausea from chemotherapy and muscle spasms caused by multiple sclerosis – and even within those, uptake has been minimal. Unlicensed cannabis medicines, which cover a far wider range of conditions including chronic pain and mental health conditions, are almost never funded by the NHS.
Private prescribing has grown to fill the gap instead. Industry experts estimate that between 100,000 and 150,000 people will have been prescribed medical cannabis privately at some point during 2026, up from around 100,000 the year before – all through private clinics rather than the NHS, at a typical cost of £150 to £500 a month for prescription items and consultation fees. Patients and campaign groups argue this two-tier system restricts access to those who can afford to pay.
For psychedelics, there is no legal access route at all outside a clinical trial. Psilocybin and MDMA remain Class A, Schedule 1 substances – the category reserved for drugs deemed to have no recognised medical use – meaning there is no prescription or compassionate-access pathway of any kind, legal or otherwise, in the UK. Researchers can run trials, but the only legal route to psychedelic therapy is ketamine, available through a small number of private clinics at £300 to £800 a session on an off-label basis; the NHS medicine derived from it, esketamine, was rejected for NHS funding in England and Wales by the National Institute for Health and Care Excellence (NICE) in 2025, but is available through NHS Scotland via a patient access scheme.
Where next?
The public support for change is strong. A YouGov poll of the British public and 106 sitting MPs, published in January 2025, found 73% of the public believe doctors should be able to prescribe cannabis for medical use – a view shared by 83% of MPs.
Support runs even higher for psychedelic therapy. A separate YouGov poll of 2,148 UK adults, commissioned by the campaign group Psilocybin Access Rights (PAR), found 68% back the medical use of psilocybin-assisted therapy for people facing the end of their lives, against just 8% opposed, while 53% support its use for serious mental health conditions including depression, anxiety and PTSD.
“These figures should reshape the political conversation in Westminster,” said Timmy Davis, co-founder of PAR, arguing there is no remaining case for keeping psilocybin trapped in Schedule 1.
Whether Westminster agrees with the public remains an open question.
There seems little appetite, either politically or within the NHS and NICE, to trial cannabis and psychedelics as alternatives to antidepressants. The most concrete near-term development is an upcoming review by the 2025 Advisory Council on the Misuse of Drugs (ACMD) into the impact of the 2018 cannabis rescheduling – described by industry observers as the most comprehensive assessment since the law changed. The ACMD’s chair, Professor David Wood, said in March 2026 that the working group’s report was in progress and expected to be completed by the summer. While the industry and patients wait for the outcome, many hope it could help make medical cannabis more accessible for those seeking treatment.
“It’s important that the ACMD review considers the lived experiences of patients who rely on their medical cannabis treatments, plus the financial barriers that still prevent many people from accessing them,” Mike Morgan-Giles, CEO of the Cannabis Industry Council, told leafie.
“It should also consider some of the shortcomings that have persisted since 2018. It’s our and the industry’s hope that the review will offer and act on recommendations that improve access to medical cannabis. This will provide patients and healthcare professionals a genuine choice in the treatments that are available to them, particularly as medical cannabis treatments can offer a viable alternative to SSRIs.”
Sadly, no equivalent review of psilocybin’s legal status is currently scheduled, despite pressure from PAR and other groups. For now, the options facing someone who wants to try cannabis or psychedelic therapy instead of another antidepressant prescription remain the same as they have been for years: pay privately, join a research trial, or break the law.
Meanwhile, NHS antidepressant prescriptions climb to record highs, and the mental health crisis deepens for those who can’t pay their way out.
