Ireland’s over-prescribing disaster.

Ali Bracken
Ali Bracken

In 2009 following Shane’s death, a ‘Tribune’ journalist ‘Ali Bracken’ decided to find out whether antidepressants were being over-prescribed in Ireland. She presented to 5 doctors with symptoms of mild-depression and was shocked when 4 out of 5 prescribed her an antidepressant. The article ‘A Pill For Every Ill’ can be viewed here. So what has happened in the last 4 years. Has the over-prescribing of potentially dangerous drugs been curtailed in any way? Nope, in fact it’s actually got much, much worse.

In the last few weeks, a young journalism student ‘Niamh Drohan’ posed as a mildly depressed student in Waterford. This time sheNiamh Drohan visited 7 GPs as part of her investigation; all near Waterford city. Sadly, all 7 prescribed her an antidepressant. Her article ‘Depressing Truth about Treating Depression In The Young’ can be viewed here. What is all the more shocking this time around, is that 3 prescriptions were issued for one month supply, 1 was for two months, 1 was for three months and 2 were for six months. Can you believe that? Two doctors prescribed a 6 months supply of a potentially fatal amount of drug, to a depressed person that they had only just met? Why not just give her a gun and play some Russian Roulette with a young girl’s life? Idiots!

So why are Irish doctor’s prescribing so recklessly? The National Institute for Health and Clinical Excellence (NICE) guidelines  recommend that doctors “Do not use antidepressants routinely to treat mild depression because the risk–benefit ratio is poor…” Another NICE review stated that the benefit of antidepressant medication compared with placebo in mild to moderate depression may be minimal or nonexistent.

What about the Irish Human Rights Commission who recommended, among other things, that doctors/psychiatrists are to give an ‘oral explanation of risks/side-effects of SSRI’s in advance of prescription, together with relevant written information’ and that a ‘level of monitoring and ongoing supervision is required when SSRI’s are initially prescribed’. I don’t think that equates to ‘here’s a script, now have a nice day young lady and don’t take them all at once’.

Considering Shane had access to 6 weeks of poison Citalopram and had a toxic-to-fatal level of same in his system when he died, how many horses could a 6 month supply kill? This dangerous over-prescribing is heading for disaster. As Dr Phil would say; how’s that working for ya professor? Rising suicides and increased prescribing… sometimes 2+2 really does equal 4.

IHRC Recommendations.

NICE guidelines.

NICE Review Consultation Doc.


8 thoughts on “Ireland’s over-prescribing disaster.

  1. When the public do trials of their own they will either be ridiculed or dismissed as ‘uncontrolled’. When pharma do trials they merely hide the negative results [such as those found by these two women in your story] and promote the ‘good’ results… that are normally pooled from 20 or more studies.

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  2. Perhaps I’m naïve, but I found this article astonishing. After all that has been learned about antidepressants since the beginning of this century, doctors are still going straight to the prescription pad. Both Niamh and the Irish Examiner should be congratulated on the quality of the article.
    I have also listened to the hideous Dr Kelly commenting on the article on an Irish Radio Show, trying to defend the indefensible. She glossed over the fact that not one of the doctors told Niamh of the serious side effects.
    GPs practising in the UK are duty bound to adhere to what is in the British National Formulary from which they prescribe. This contains the paragraph: “The use of antidepressants has been linked with suicidal thoughts and behaviour. Where necessary patients should be monitored for suicidal behaviour, self-harm or hostility, particularly at the beginning of treatment or if the dose is changed.”
    The UK Department of Health states that “Doctors have an ethical responsibility to inform patients about the treatment proposed, including any possible side effects of prescribed medicines.”
    So if these doctors were practising in the UK, every one of them would be officially considered as both negligent and unethical. I don’t think it would be unfair to attach these labels to the Waterford Seven.

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  3. Another NICE review stated that the benefit of antidepressant medication compared with placebo in mild to moderate depression may be minimal or nonexistent.

    I think this statement may have led our GP to prescribe Cipramil for my 17yr old daughter and assure us that it was very safe and if she wasn’t depressed it would do nothing.
    It did. It led to her suicide just over 3 years later. There was no information or guidance, there was some follow up as in “Well how are you feeling today? How have you been? Let’s increase the dosage etc” There was no suggestion of it being a short term fix. My daughter was taking Cipramil for a year before being asked if she would like to come off it, she preferred to wait 2 months until after her exams. From pharmacy records it appears to have been a sudden stop. She was back on within 2 months for what I now believe were withdrawal symptoms and not the return of depression. Medication continued for 2 years before another ill advised tapering method led to withdrawal symptoms which again were classed as a return of depression and Cipramil 20mg was prescribed. My daughter died by hanging the next day.

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    1. Hi Sarah,
      I have no doubt your daughter would be alive today without the intervention of an uninformed doctor’s prescription for Citalopram. You might find this interesting but equally tragic; the NICE guidelines have a ‘DO NOT DO’ section. Here it states “Antidepressant medication should not be used for the initial treatment of children and young people with mild depression.” This is because of lack of efficacy, as you said, and also because of the increased risk of suicide. So all of the 7 doctors above and your daughter’s doctor were wrongly prescribing. In your daughter’s case this tragically led to her death.
      Leonie

      NICE ‘DO NOT DO’: http://www.nice.org.uk/usingguidance/donotdorecommendations/detail.jsp?action=details&dndid=747

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