Cases, cipramil (celexa) stories,, psychiatry

Kinsella v Rafferty; the effects of Citalopram post-surgery

Dublin's Four Courts

.

.

Kinsella v Rafferty [2012] IEHC 529

.

.

.

This recent Irish Case involves the plaintiff, Cynthia Kinsella, who took an action against Dr Gerry Rafferty, a consultant obstetrician and gynaecologist of Mount Carmel hospital, for Negligence and breach of duty in performing a total abdominal hysterectomy. Section 18 of the Judgment states:

“In the weeks immediately after her discharge from Mount Carmel Hospital, she spent a good deal of time in bed, resting. Up to, three to four weeks post-operatively, she continued to make progress. Then, however, she noticed that she was leaking urine through her vagina. This was not something that was mentioned in the booklet, and as it persisted, it began to cause her great distress.”

Tests later confirmed that a Vesico Vaginal Fistula (VVF) had developed. Later that year Mrs Kinsella was admitted to Mount Carmel Hospital for the repair of the fistula which was a complete success. Although the plaintiff recovered physically, the occurrence of this fistula, the catheterisation of the plaintiff for 2 months and the subsequent correction surgery impacted on her mental health. As a result, this left the plaintiff highly anxious, distressed and somewhat depressed.

In finding for the plaintiff, O ‘Neil J. found that Dr Rafferty’s evidence was unconvincing and further that: “I have come to the conclusion that the plaintiff’s fistula was caused by a failure on the part of the defendant to carry out this procedure with the degree of care to be expected from a consultant gynaecologist.” He awarded Mrs Kinsella the sum of €425,000 plus any agreed special damages.

This is quite an interesting case which can be read in full on Bailii.org, here. The most interesting factor, to me anyway, is what happened after this woman’s surgery. As she remained highly anxious she was referred to a psychiatrist who prescribed Citalopram/Cipramil/Celexa. Leaving aside the awful adverse reactions and the zombie-like effects of Citalopram (as stated by this woman’s husband), it seems that expert testimony (from the professionals in this case) state that for an estimated 50-70% of people, the drugs simply do not work! Yet we spend millions keeping the drug companies happy? The account of her experience with this drug and Justice O ‘Neil’s opinion of the same can also be found in the judgment. Details below:

(1)    All of the psychiatric experts agreed that there was no prospect of the plaintiff’s condition being remedied unless she could undergo an effective therapeutic process which would probably be fairly prolonged. This would consist of the taking of anti-anxiety and depression medication and also probably active intervention in the form of cognitive behavioural therapy.

(2)    Even with adherence to such a programme, for perhaps up to 24 months, the evidence of Dr. Lane was that in at least 50% of cases, perhaps up to 70%, no improvement resulted and there was no return to normal functioning. Dr. Tobin, whilst disagreeing with the higher figure of 70% as being too pessimistic, nonetheless agreed that in cases of severe anxiety disorder, the failure rate in treatment was of the order of 50%. All of the psychiatric experts agreed that the longer the condition persisted the harder it was to treat and the likely outcome correspondingly poorer. All agreed the plaintiff’s condition was and had been for some time in that chronic state.

(3)    Some controversy surrounded the initial treatment undertaken by the plaintiff late in 2008, when she was prescribed a drug called  Cipramil . She was prescribed this drug, first, before she went back to work in October 2008, but postponed starting it at that time because of her return to work. She coped badly at work in the sense that her concentration was poor and her work was frequently called in question by her superiors because of mistakes. Because of the stress of all this, she went out of work again on 4th November 2008, and after that, commenced taking this drug. She attended her GP, Dr. Toomey, in January and again in February 2009, and she reported to him some improvement on this drug and he noted himself some improvement at that time.

(4)    However, her evidence and, in particular, the evidence of her husband, was that she found it extremely difficult to tolerate this drug. Her description, and more particularly, that of her husband, was that whilst she was on it, she was a “zombie” or was constantly “out of it”. Her husband described a variety of minor domestic mishaps resulting from her absent mindedness or forgetfulness or lack of concentration while she was on this drug. Eventually, she could tolerate it no longer and gave it up about March 2009.

(5)    Whilst the plaintiff did report to Dr. Toomey some improvement while on this medication, I am satisfied from her evidence, and particularly from the evidence of her husband, that by March 2009, when one would have expected this medication to be producing a tangible benefit in terms of the plaintiff’s overall wellbeing, the reverse was the case, and the plaintiff found herself no longer able to tolerate it. I think it is probable that in her reporting to Dr. Toomey, her general demeanour of diffidence and apology for her condition may have induced her to present to him a more optimistic picture than was justified.

(6)    All of the psychiatric experts were asked to consider the reasons why the plaintiff gave up this medication. This arose from the fact that in a second report, Dr. Tobin expressed the opinion that if the plaintiff was compliant with this type of medication regime, she was likely to begin to improve after three weeks or so, to be significantly improved after about two months and to be ready to resume employment after about three months.

(7)    Dr. Lane thought this scenario far too optimistic. Both Dr. Lane and, in particular, Dr. Murphy who saw her on several occasions, was of opinion that the precipitating factor causing her to give up the medication was not any wish on the part of the plaintiff to get by without the medication, nor any personal bias against this type of medication, but rather, her state of mind induced by her anxiety condition in the first place. Dr. Lane further explained that the type of medication the plaintiff was on had in it a component which tended, in the initial phase, to increase anxiety, and whilst Dr. Tobin agreed with this, he was of opinion that this could have been counteracted by offering a tranquilising-type drug at the same time until the initial phase was overcome.

(8)    It is unlikely that the plaintiff’s problem with this drug was any initial adverse reaction to an anxiety component in the drug. She persisted with the medication for approximately four to five months, which should have taken her beyond this initial phase, but by that time, she found the effect of it on her intolerable. I have no doubt that given that this medication did not alleviate her anxiety state, it was probable that the continuance of this kind of medication had an exacerbating effect on her anxiety state, in the sense that if the medication was not making her any better and if she felt in many ways worse on the medication, it was inevitable that the continued taking of the medication, or of an alternative substitute for it, was likely to heighten her anxiety state.

(9)    Accordingly, when she saw Dr. Lane who suggested an alternative medication and when the dosage levels were mentioned, which appeared high to the plaintiff but in fact were not, her reaction was, understandably, resistance, no doubt driven by her underlying state of hyper-anxiety. What this suggests is that it is going to be very difficult to establish the plaintiff, having regard to her chronic state of high anxiety, on a regime of medication that she will, in the first instance, be able to accept, and secondly, tolerate to the point of achieving some benefit.

(10) There is then, the rather chilling evidence of Dr. Lane, with which Dr. Tobin agreed, that in any event, in 50% of cases of severe anxiety, even with total compliance by a motivated patient, the treatment  fails.

R v Smallshire

A nation of Zombies

Newspaper and internet articles, psychiatry, Random

Professor David Healy: Time to abandon evidence based medicine?

.

A talk by Prof David Healy from the Institute of Psychological Medicine and Clinical Neurosciences at Cardiff University. The talk was presented at the Cardiff University School of Psychology on 26th November 2012.

Prof Healy makes an interesting point about Sertraline/Zoloft (the drug that Anna Byrne was prescribed in her pregnancy) at 9.40 mins and 48 mins. 80% of Sertraline trials proved negative and yet Sertraline was approved long before it was prescribed to Anna and Nicolas Maguire. So terribly tragic, so very wrong and so avoidable. An article in the Irish Independent regarding Anna’s death stated “Mrs Byrne’s GP had started her on Sertraline – an anti-depressant regularly used during pregnancy – and Dr Sheehan doubled her dosage….” This is the same dangerous drug that the NIMH deem fit to be trialed in children as young as seven…Link.

Anway, for those of you with an attention span like mine, I’ve gone through the video and put the time to the important bits:

.
Ghostwriting at 4 mins

Study 329 at 5.30 mins & 10.45 mins

Pfizer’s Zoloft/Sertraline worst antidepressant (80% of trials proved negative) at 9.40 mins and 48 mins

The truth behind GlaxoSmithKline’s proposal to make data available at 24.30 mins

‘It’s the disease, not the drug’. Heard that one before anyone? at 38 mins

For the seriously depressed, Antidepressants don’t work at 38.10 mins

GSK Seroxat suicide; the way around the problem of Paroxetine/ Paxil/ Seroxat causing suicide at 42.30 mins

Antidepressants in pregnancy at 51.10 mins

Sex in a spray at 51.40 mins

(Shocking) Sacked for not taking flu-vaccine at 54.35 mins

Discussion at 58.12 mins

Weight-gain on Zyprexa at 59 mins

ECT at 62.19

Newspaper and internet articles, Our story., Random, Shanes story.

Me a cynic? Absolutely!


Cynical: Believing that people are motivated by self-interest; distrustful of human sincerity or integrity. Me a cynic? Absolutely!

Isn’t it strange how ‘professionals’ are nice as long as you go with the flow and until you step away from the ‘norm’? As long as I accept that Shane was a homicidal/suicidal maniac and was just extremely good at hiding it for 22 years, I could be tolerated. As long as I accept that the drugs he was prescribed in his last 17 days were coincidental and accept what the Irish College of Psychiatry say ‘that the drugs do not cause suicide or violence’, that’s ok. As long as I don’t believe what the other experts say ‘that the drugs CAN cause suicide and Homicide’; then I’ll get the sympathy vote. That’s nice! Shane attended 2 doctor’s surgeries in the last few weeks of his life and there is a few points I would like to make that just don’t sit well:

i. When I first rang the Carlton Clinic in Bray after Shane’s death, I spoke to the doctor who prescribed Shane the drug (John McManus). He couldn’t have been nicer and said if I had any queries that we could arrange a meeting with him. When it became clear that I was bringing the issue of the adverse effects of antidepressants into the public domain, his attitude changed; he said if I had any queries, it would be advisable to put them in writing.

ii. I then spoke to our family GP in Ashford (husband and wife team, Dan McCarthy and Orla McAndrews). Shane’s last doctor’s visit was with their locum (Dr Buys/aka Dr Coatzee). Firstly, a few weeks after my son’s death I went to collect his medical records; Dr Orla came out with the envelope and said (and I quote) “there’s not much here as he was only here once.” (He only died once too.) That’s it! No “sorry for your loss” Nothing! I spoke to her husband Dan by telephone a few times and he seemed to be a tad more understanding. He assured me that the Inquest would ‘find’ whether the antidepressant Cipramil (which his locum prescribed) was involved in Shane’s death and he would talk to me then; It did and he didn’t!

iii. It also appears that their locum Dr Coatzee was in a bit of a hurry to hightail it back to her homeland of South Africa. Wonder was it something I said? Furniture for sale, urgent.

Newspaper and internet articles, Random

Claire Peake; Another victim of ‘unhappy’ pills?

You know, some of the stories I read are way too close to home. This one in particular is about a young mother and it reminds me so much of my sister when she had her first baby, a little girl. She was besotted with her beautiful baby as most new mothers are and the thoughts of going back to work and leaving her daughter filled her with dread. No-one could mention the W word (work) without the floodgates opening, so we learned to dance around the subject, and referred any questions to her long-suffering husband instead. Anyway she was feeling terrible, so dispatched herself off to the local doctor who promptly, after about 10 minutes, told her she needed to go on antidepressants. My sister explained what had happened to Shane, her nephew, and the terrible consequences because of these drugs, to no avail. The doctor seemed to ignore her protestations and insisted that she needed antidepressants. She left without a prescription, feeling much worse than she had when she went in. As she was leaving my sister asked the doctor if she thought she “would get better?” The doctor’s response was.. not without the tablets!! She hasn’t been back since!

Needless to say, she’s back at work, albeit part-time, and herself and her gorgeous daughter are none the worse for it, still hoping to win the lotto though so she can give up work!

Yesterday in the ‘Mail Online’, there was an article published about a young mother and teacher who died by suicide. The article stated that Claire Peake, a ‘fantastic teacher’, had stopped taking antidepressant medication while she was pregnant but started taking it again in December. An earlier article said she was taking Mirtazapine, an antidepressant. Similar to SSRI’s which can exacerbate some patients’ depression and cause suicidal ideation (Wiki), Mirtazapine is also believed to be capable of this, hence the black-box warning in the U.S.

This woman had stopped taking the antidepressant (Mirtazapine) while she was pregnant probably for fear that these drugs can cause birth defects. She went back on the drug in December when her daughter was 3 months old.

Two days before her death her dosage was increased after she visited her GP in a tearful and distressed state. Was the doctor aware or was Claire told, that the dangerous period with these drugs is upon starting, discontinuing or changing the dosage (up or down). The article also states that Claire was clearly devoted to her 5 month old daughter. It seems that Claire was not as lucky as my sister, who, without the intervention of an antidepressant, returned to her normal happy self without the doctor’s intervention of a prescribed antidepressant.

Was Claire’s suicide caused by her depression or the very drugs that she was taking to make her feel better? Interestingly, there is another Mail Online article today entitled “They sold us ‘happy pills’ – but all we got was suicide and misery”. Article here.


Mail Online Full Article on Claire Peake.

lundbeck, Newspaper and internet articles, psychiatry, Random

Excerpt from Professor Healy’s Pharmageddon and his dad’s experience with Irish healthcare.

Myself and the poor husband went into the High Court a few weeks ago, just to observe (ha got ye there, Yep, would dearly love a day in Court with Lundbeck). Anyway as we do, we stumbled into a case where a doctor was in the dock. He performed a hip replacement on a woman who alleged that after the operation, one of her legs was shorter than the other. The doctor proceeded to tell the Court how, despite sending a letter to her GP recommending a shoe with a built up heal, it was all in the womans head. In my humble opinion ‘the God complex’ is a huge issue in the medical hierarchy and that’s why I thought people might like a look at the first page of Professor Healy’s book. It’s a great read and as you can see from this excerpt, he doesn’t hold back.

 

Click on the Pharmageddon picture to have a look at the Amazon page.

Introduction

My father smoked all his adult life. He had a number of physical disorders, including ulcerative colitis, ironically one of the few conditions for which smoking is beneficial. In 1974, when he was in hospital for colitis, a routine chest x-ray revealed a shadow on his lung. Dr. Neligan, the surgeon called in, advised my mother on the importance of an operation.

Our general practitioner at the time was Dr. Lapin whom I remembered from childhood as being tall, silver-haired, and distinguished, often wearing a bow tie. He had spent time, I was told, as a doctor in the British army, a very unusual occurrence then in Ireland. To a child, Dr. Lapin had appeared effortlessly wise and seemed to transcend the boundaries of religion, politics, and division I saw elsewhere.

When my mother developed problems in the early 1960s after giving birth, Dr. Lapin had suggested she come to see him once a week, but at the time she felt the arrangement was too open-ended, and she could not afford it. She was seen instead by another doctor, diagnosed with an ulcer and ultimately received the standard operation of the day, which involved cutting the vagus nerve and removal of stomach. This left her with bowel problems for the rest of her life, and regrets for not having taken Dr. Lapin’s offer of treatment for what she later regarded as postnatal depression.

When my mother consulted him about the wisdom of an operation for my father, Dr. Lapin was slow to comment. But when pressed, he pointed out that my father had a number of illnesses, any of which could kill him before the tumor would. Many people, he said, went to their graves with cancers, heart disease, or other problems, but these were not what killed them. An operation would take a heavy toll on him.

My mother relayed this perspective to my father and suggested that he take six months to build himself up and then have an operation if he felt stronger; he agreed. When this plan was mentioned to the surgeon, he responded, “That’s fine, but have him out of the hospital within 48 hours.” When my mother revealed that my father still didn’t know he had cancer, the surgeon went straight from the phone to tell him. Without an operation my father would be dead within months, Dr. Neligan indicated, but an operation offered the prospect of a cure. My father, alarmed, agreed and the operation took place two days later. Dr. Neligan afterwards said there was little they could do about my father’s tumor when they opened him up. He died six months later, his life almost certainly shortened by the operation.

If there had been progress to speak of in the treatment of lung cancer in the years since my father’s death, his medical care might be viewed as one of those sacrifices that at least ultimately benefits others. But there has been little progress, even though advances on almost all medical fronts are trumpeted daily. Genuine progress has been made in some areas, but far less in most areas than many people have been led to believe. More importantly, when it comes to pharmaceuticals in particular, many of these apparent advances underpin and contribute to what in recent decades has become a relentless degradation in medical care, a replacement of Lapins with Neligans, a quickening march toward Pharmageddon. While drugs played no part in what happened to my father, they have played a huge role in fostering a surgical attitude to medical care, a kind of fast healthcare.

Cases, cipramil (celexa) stories,

R v Smallshire…influenced by Citalopram!

R v Smallshire [2008] All ER (D) 186 (Dec)

This is an English Appeal Case appealing the Length of sentence imposed upon the defendant (Ronald Smallshire).

The background to the Case…

The victim, 23, and his three step-sisters were walking their two dogs. One of the dogs attacked the defendant, his wife and one of the defendant’s dogs. The defendant, Mr Smallshire, 56, who had consumed alcohol, went into his house, got a steak knife and emerged wearing a coat with the hood pulled over his head. He hit the victim to the head and back, causing him to fall to the ground. Mr Smallshire then straddled the victim and stabbed him 19 times, also to the head and back. The victim suffered a pneumothorax (collapsed lung) and stab wounds. He stayed in hospital overnight. He made a good recovery but he and his stepsisters suffered psychological effects.

The Defendant Mr Smallshire had no previous convictions and was described by the Court as ‘a man of impeccably good character’. The Court further stated that it was quite apparent that his conduct was out of character. So what could make a person behave in such an uncharacteristic fashion? Ah yes, Citalopram again!

The appeal centered around the side-effects of the medication he was prescribed. 11 days before the incident, Mr Smallshire was prescribed Citalopram. Mr Smallshire said, upon starting the medication, he felt agitated, unreal and confused.

Excerpt;

Mr Smallshire relies, in support of his challenge to conviction, upon evidence of Dr Andrew Herxheimer, a consultant clinical pharmacologist, experienced in the investigation and evaluation of the adverse effects of drug therapy and who in recent years has studied a large number of reports of effects relating to SSRI (Select Seroxat Inhibitors) antidepressant drugs, of which Citalopram is one.

Dr Herxheimer wrote a report for the Court where he concluded:

“. . . citalopram very likely contributed decisively to Mr Smallshire’s actions on 16 December 2005. He had started taking this antidepressant medication 11 days earlier; its concentration in his brain would have been steadily increasing from about seven days. It is highly probable that alcohol augmented the effect of the drug: on its own alcohol would not account for his behaviour.”

In allowing the appeal, the Court reduced Mr Smallshire’s sentence from six-and-a-half years to four-and-a-half years.  Full Judgment R v Smallshire

cipramil (celexa) stories,, lundbeck, Newspaper and internet articles, Random

Charlie Suen: Another Citalopram victim.

This is just so sad; another Newspaper report today and another young man has hanged himself because of Citalopram. Another young man’s parents raising concerns about the depressant/antidepressant Citalopram.

Charlie Suen, 18, a popular teenager, killed himself after failing to make the grades for university and splitting from his girlfriend, an inquest heard. Former Tiffin School student Charles Suen wanted to retake some of his A-levels after he struggled with school and missed out on his first choice of Edinburgh University the previous year.

During the inquest, concerns were raised about the delay in Charlie’s referral for psychological therapy and over the prescription of anti-depressant citalopram.

11 days after starting citalopram, Charlie hung himself from his bunk bed at his home.

His GP Michael Desouza felt it was appropriate to prescribe Citalopram for Charlie. Citalopram is used to treat a variety of mental health problems and can improve symptoms such as depression and anxiety. Although, just not efficacious in Charlies Case and many, many other unfortunate cases?

In the early stages of treatment citalopram may intensify depression and suicidal feelings, increasing the risk of self-harm or suicide, but as the drug starts to work the risks decrease. (That is the spin usually used by the company doctors but it is also very very wrong; if you are having an adverse reaction to the drug, staying on the same drug will never make it better and most probably cause death)

Mr and Mrs Suen raised concerns over its prescription to their son and the lack of communication and involvement they had in his treatment.

Mr Suen said: “Although he was 18, just 18, shouldn’t they be asking him ‘Do you want your parents to come? Shouldn’t they be co-ordinating, communicating between us?”

HOW MANY MORE?

Full Article

cipramil (celexa) stories,, lundbeck, Newspaper and internet articles

Another two Inquests this month; Citalopram involved in both.

Two Inquests this month concerned two young women who were both suffering from anorexia. Both had been prescribed Citalopram shortly before their death.

An inquest at Southwark Coroner’s Court yesterday dealt with a paediatrician, Dr Melanie Spooner, 30. Dr Spooner had battled an eating disorder since the age of 13. She was found dead by her parents in her London flat on September 25 2011, after suffering heart failure. “Sudden cardiac deaths are recognised in anorexia, so I think that’s the most likely cause of her death,” said pathologist Dr Peter Jerreat.

A report from her GP surgery said she had been prescribed citalopram, an anti-depressant, shortly before her death.

Did anyone acknowledge or voice concerns that Citalopram has recently been found to cause sudden cardiac deaths?  Citalopram heart risk.

According to the FDA, Celexa “can cause abnormal changes to the electrical activity of the heart.” These changes, known as prolongation of the QT interval, can lead to fatal changes in the heart’s rhythm. Link.

At another Inquest this month, Katie Lumb, 23, a promising medical student who also battled with an eating disorder, died when her severely-emaciated body failed to cope with anti-depressants prescribed by her GP mother. Recording a narrative verdict, West Yorkshire coroner David Hinchliff said: ‘A post mortem examination shows the cause of death to be citalopram toxicity. Link.

How many more deaths will occur before the IMB or the EMA will do their job?

https://leoniefennell.wordpress.com/2012/01/28/how-many-deaths-this-week-from-citalopram/

cipramil (celexa) stories,, lundbeck, Newspaper and internet articles

How many deaths this week from Citalopram?

 How many more people will this drug kill before someone puts a stop to this madness?

Here’s another four stories I have come across lately. Citalopram seems to be increasingly effective as a depressant.

How many people has it killed today and why is the IMB allowed to pass the blame with ridiculous statements like “the risk outweigh the benefits”? You think…

May 13, 2011. Katie Lumb, 23, A promising medical student who battled with an eating disorder died when her severely-emaciated body failed to cope with anti-depressants prescribed by her GP mother, a Leeds inquest has heard. Recording a narrative verdict, West Yorkshire coroner David Hinchliff said: ‘A post mortem examination shows the cause of death to be citalopram toxicity. Link.

February 2010, Martin Boyle, 40, soaked himself in petrol and threatened to ignite the fumes during a siege at his home. He later fell unconscious and was pronounced dead on arrival at hospital. Home Office pathologist Dr Naomi Carter gave the cause of death as ‘acute alcohol toxicity enhanced by citalopram’. Link.

September 22, 2011. John Eyre, 47, a Former Royal Navy officer died after choking on his own vomit following a heavy drinking session. Coroner, Geoffrey Saul, said: “He [John Russell Eyre] died following aspiration of gastric contents due to alcoholic intoxication and the effects of citalopram.” Link.

October 15 2008, Cyril Aldridge, 59, a dad of four, took a fatal overdose of his anti-depressant drug Citalopram before hanging himself from the loft space of his home in Noake Road, Hucclecote. Pathologist Dr John McCarthy said death was due to hanging. Blood and urine samples revealed he had two-and-a-half times the alcohol limit for a driver in his body and a toxic level of his Citalopram medication. Link.

Probably should add these people to the hall of shame. https://leoniefennell.wordpress.com/2012/01/08/lundbecks-hall-of-shame/

cipramil (celexa) stories,, Newspaper and internet articles, Our story.

IHRC Recommendations on SSRI Prescribing

IHRC (Irish Human Rights Commission)

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.

.

Recommended IHRC Guidelines:

(i)

Discussion of alternate therapies

(ii)

Referrals for counselling/psychiatric review

(iii)

Within medical practices seek to ensure the same doctor deals with the person at all stages if at all possible;

(iv) 

Oral explanation of risks/side-effects of SSRI’s in advance of prescription, together with relevant written information;

(v)

Guidelines regarding prescribing SSRI’s from initial stage through ongoing treatment;

(vi)

Level of monitoring and ongoing supervision required when SSRI’s are initially prescribed

(vii)  

Maintenance of adequate consultation notes; and

(viii)  

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 [1989] IR 91.)

https://leoniefennell.wordpress.com/2011/10/22/medical-negligence-in-ireland/

https://leoniefennell.wordpress.com/2011/10/10/update-on-our-complaint-to-the-irish-medical-council/