Coping with coming off exposes serious difficulties in doctor-patient relationsh

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Sun, 18 Sep 2005 19:50:14 -0400

[sSRI-Research] Coping with coming off exposes serious

difficulties in doctor-patient relationship

 

 

 

 

 

Mind releases latest drugs report:

 

 

Coping with coming off exposes serious difficulties in doctor-patient

relationship

 

http://www.mind.org.uk/News+policy+and+campaigns/Press/CWCO0905.htm

 

" Next time I won't go to the doctor, I'll go down to Waterstones. "

 

" I found his (my psychiatrist's) attitude extremely depressing. He

never gave me any grounds for hope of optimism (of coming off

successfully). "

 

Today mental health charity Mind releases its groundbreaking new

findings from the Coping with coming off report about the experience

of coming off psychiatric drugs, revealing serious problems in the

doctor-patient relationship.

 

Of patients interviewed, 40 per cent saw their GPs as " not helpful " in

the process, making them the least helpful source of advice and

support, with 10 per cent stating that GPs " made things worse " .

Internet and email groups came out top - 94 per cent found them

helpful. Doctors were also unable to predict who could come off

successfully - those who came off against doctors' advice/didn't

inform doctors were more likely to succeed: 53 per cent, compared to

44 per cent of those whose doctors agreed they should come off.

 

Following recent awareness of lack of information on harmful

side-effects of drugs such as Seroxat and Vioxx, the report delivers

insight into traumatic experiences of harsh withdrawal symptoms, and

the worrying lack of support in trying to come off medication, despite

the benefit, need and/or desire for some people to come off.

 

Sixty eight per cent experienced problems in coming off SSRIs, 60 per

cent psychiatric drugs in general. Of grave concern is the lack of

patient choice in taking drugs. Interviewees were able to give more

than one answer, reflecting different experiences on different

occasions: 30 per cent had been compelled (under Mental Health Act),

52 per cent had felt under threat of compulsion, and 70 per cent had

felt pressured to take drugs.

 

Antidepressant issues

 

On antidepressant issues such as addiction and links with suicide

rates, and some drug companies' apparent 'profit before patient'

approach, Mind has been campaigning for some years.

 

In 2004, there were 29 million prescriptions for antidepressants in

England, of which some 18.5 million were SSRIs and related drugs (a

rise from 8.2 million SSRIs/related in 1999). Recent Norwegian

analysis showed a clear link between Seroxat and significantly higher

rates of suicide attempts.

 

Concerns are widespread - in April 2005, a significant negative

correlation between antidepressant prescription and national suicide

rates was reported from Sweden, Denmark, Finland and Norway, and the

US Food and Drug Administration is continuously monitoring

antidepressants' links to worsening depression or suicidal behaviour.

On 26-28 September, drug consumers from across the US and Canada will

join forces to protest at GlaxoSmithKline HQ (Philadelphia) over Paxil

(US name for Seroxat) - 5,000 US citizens have filed lawsuits against

GSK over lack of warning about Paxil's addictive nature and withdrawal

symptoms.

 

But last week the Government rejected Health Committee recommendations

for independent publication of full clinical trial data, despite proof

that the MHRA has been far too slow to act on information affecting

consumers in the past. Hesitation that may have cost lives. Last year,

Mind Chief Executive Richard Brook resigned from the MHRA expert group

over its failure to protect patients from unsafe dosage levels of

Seroxat, fearing the influence of large drugs companies. The Norwegian

survey was based on clinical data previously available to drugs

regulators.

 

The research process

 

There were two phases, developed and carried out by service

user/survivor consultants. In the first, 204 people were interviewed

over the phone using a questionnaire. This was followed up by

interviews with 45 of those, exploring their experience in more depth,

and being asked to gauge how helpful different kinds of people,

resources or activities were.

 

There were positive comments about mental health professionals -

showing the helpful effect of professional guidance. As doctors

prescribe psychiatric drugs, it is reasonable to expect them to be the

best source of advice and support about coming off them. These results

will be used to produce information for service users, good practice

guidelines for mental health professionals, and policy recommendations.

 

Alison Cobb, Mind Policy Officer and Coping with coming off Project

Manager, said:

 

" This study shows that it is vital for doctors to listen to their

patients, and so have a better understanding of patients' perspectives

of their medication, and of the difficulties of coming off.

 

People who want to come off their drugs must have their decision

respected, and be practically supported even by professionals who may

not agree with them. When the GP-patient relationship works, it works

well, but there are clear limitations of relying on medical help, and

value in a much wider range of resources. There is also an urgent

responsibility for doctors to be provided with the fullest information

on the drugs that they prescribe, from the MHRA and other sources.

 

" Mind's hope is that this research will be informative for

professionals as much as service users and that we can work with the

professions to make medication choices a reality for people taking

psychiatric drugs. "

 

Reference material

 

The Coping with coming off report (£5.50 inc p and p) is available

from Mind Publications

T: 0844 448 4448, E: publications, W: www.mind.org.uk Mind

will publish Making sense of coming off psychiatric drugs (£3.50 p and

p) booklet in October.