Finally somebody is asking for changes in the way that SSRI’s are being prescribed by medical professionals in Ireland.
I wrote many letters and e-mails in the last 2 years regarding the care (or lack thereof) that Shane received from the medical professionals in the last month of his existence. I wrote e-mails and letters to, among others, the EMA, FDA, IMB, Lundbeck, Brian Cowan, Kathleen Lynch, Bertie Ahern, James Rielly, Dick Roche, Jan O’Sullivan, Liz McManus (before I found out she was previously married to John Mc’Manus, the GP in Bray who prescribed Shane a months supply of Cipramil), Barack Obama (always an optimist), the college of Psychiatry of Ireland and Mary McAleese.
Most of the replies I received were the usual apologetic but automated response apart from the IHRC.
After reviewing Shane’s medical records, Citalopram PIL’s, Professor Healy’s report, the statements from the doctors, my correspondence with the Irish Medical Council and their subsequent decision, the IHRC have decided to take some action…
The IHRC have written to the Medical Council requesting that, among other things, patients are informed of the potential side effect of suicide ideation with SSRI’s and for closer monitoring and ongoing supervision when SSRI’s are initially prescribed.
Discussion of alternate therapies
Referrals for counselling/psychiatric review
Within medical practices seek to ensure the same doctor deals with the person at all stages if at all possible;
Oral explanation of risks/side-effects of SSRI’s in advance of prescription, together with relevant written information;
Guidelines regarding prescribing SSRI’s from initial stage through ongoing treatment;
Level of monitoring and ongoing supervision required when SSRI’s are initially prescribed
Maintenance of adequate consultation notes; and
The necessity to obtain a full patient history before prescribing SSRI’s
Though quite why the Medical Council have not done this already is beyond my comprehension! Then again, considering that the IMC see no harm in doctors prescribing a months supply of potentially lethal medication to a depressed person, would seem to show their level of understanding/misunderstanding of the dangers of these drugs.
The Irish Medical Council is a statutory body set up by the state; On their website it states “Our statutory role, as outlined in the Medical Practitioners Act 2007, is to protect the public by promoting and better ensuring high standards of professional conduct and professional education, training and competence among registered medical practitioners”.
Protect the public?
By allowing doctors to prescribe a months supply of potentially lethal SSRI’s with known suicidal side-effects to a first time patient; How are they protecting the next poor vulnerable patient who gets a months prescription of SSRI’s from their GP?
Whether the IMC will implement these changes remains to be seen, but the next time that some other unfortunate family raises this issue, the IMC won’t be getting off quite so lightly, as there will be a record of the IHRC’s letter recommending that changes are introduced.
“A medical practitioner who establishes that he followed a practice which was general and approved by his colleagues of similar specialisation and skill is nevertheless negligent if the plaintiff thereupon establishes that such practice has inherent defects which ought to be obvious to any person giving the matter due consideration” (Dunne (an inf.) v. National Maternity Hospital  IR 91.)