Philosophy of The Big Society

David Cameron gets to be God!

Wednesday 25 March 2009

If this is scaremongering then I am scared!!!

Couple of news stories arrived today:

From Times Online March 24, 2009

Hundreds of deaths linked to schizophrenia drug clozapine
David Rose

Fifty people die each year and hundreds more suffer serious side-effects as the result of taking powerful tranquillisers prescribed by the NHS, The Times has learnt.

Data from the medicine watchdogs own reporting scheme suggests that clozapine, a drug taken by schizophrenia patients, has been linked to 950 deaths since being licensed in 1990 equivalent to nearly one fatality a week.
Recent figures record the deaths of 55 people taking the medication in four months, from October to January, despite the drug being prescribed to relatively few people.
The anti-psychotic drug is used as a treatment of last resort for schizophrenia patients but appears to increase the chances of having a heart attack or stroke, or of suffering other long-term health problems that are not adequately monitored by current checks, campaigners say. More than 11,600 adverse reactions linked to clozapine have been reported in 19 years, according to the Yellow Card reporting scheme of the Medicines and Healthcare products Regulatory Agency (MHRA), which is designed to flag up potentially harmful side-effects for licensed drugs.
Related Links

Schizophrenia is the modern leprosy
Children given unlicensed anti-psychotic drugs

Mind, the mental health charity, which analysed the figures, said that the number of deaths associated with the drug was chilling. The MHRA promised to look into the charitys concerns.

The warning comes as the National Institute for Health and Clinical Excellence (NICE) is due to publish guidelines tomorrow on the treatment of schizophrenia, which affects about one in every 100 people in Britain. The watchdog will recommend that oral anti-psychotic medications should be offered to people with newly diagnosed schizophrenia, although patients should take clozapine only after trying at least two other drugs.

The drug, also known by the brand names Clozaril, Denzapine and Zaponex, was prescribed on 7,000 occasions last year many of which will have been repeat prescriptions to help to control delusions and hallucinations.

People who take clozapine must be given regular blood monitoring for the risk of a potentially fatal blood disorder known as agranulocytosis, but at present there is no mandatory requirement to monitor their health in other ways.

NICE will recommend tomorrow that GPs and other primary healthcare professionals should monitor the physical health of people with schizophrenia at least once a year, with a focus on their risks of heart disease.

Alison Cobb, senior policy officer at Mind, said that the drug could be effective for some patients and acknowledged that people with schizophrenia had a higher risk of death than the general population. There are health risks and side-effects associated with all anti-psychotic medications but it is chilling to see this number of deaths associated with clozapine and the month-on-month increases, she said. The figures refer to heart disease, strokes, cancer and other long-term health problems that cannot be explained simply by suicides or an increased overall risk of death.
We want to see the use of clozapine properly reviewed and for people taking it to be offered the full range of health checks and alternative treatment options that might mitigate any harmful effects.

A study published in the British Journal of Psychiatry last month concluded that use of clozapine in patients with severe mental illness was associated with a significantly increased risk of death compared with the general population. However, the author of the study, David Taylor, the chief pharmacist at Maudsley Hospital, South London, defended the use of the drug, which he said had transformed the lives of thousands of people around the world.

Most of the deaths reported could not be said to be a result of clozapine treatment; none could be definitively linked to its use, he said. Clozapine, it is widely agreed, is under-used in this country and in practice its use is delayed for much longer than NICE currently recommend.

The safety of clozapine has been continuously monitored since its launch in 1990, he added. In fact, no other drug has been as closely monitored. Close and intensive physical monitoring should be mandatory for all people with severe mental illness, regardless of treatment.

In a statement, the MHRA added: We are aware of the particular concerns of Mind in relation to clozapine and have already indicated to them that we will look further into the concerns they have raised and consider whether the trends in reporting through the Yellow Card scheme raise any new issues that merit update to the product information or indeed require reminders to prescribers about the need for close monitoring of patients to optimise safe use."

Simon Hough was diagnosed with schizophrenia 14 years ago and still manages his condition with medication. Fellow patients warned him off clozapine, after those taking it compared the effects to like coming off cocaine or heroin.

They described feeling really low and lethargic, and the side-effects such as weight gain and dry mouth were so much worse than other drugs, he said. One guy I knew was average weight, about 10 or 11 stone, and he just ballooned up to about 18 or 19 stone when he started taking the drug. Thats got to have some impact on your long-term health.

Mr Hough, 42, who now works for Making Space, a mental health charity in Northwich, Cheshire, took part in the CUtLASS study, a large-scale trial comparing the effects of modern antipsychotic drugs with those of older treatments.
I was offered clozapine but after all that Id heard about it I preferred to be in the group that took quetiapine [an alternative drug] instead.


Psychiatrist over-prescribed lithium


3/23/2009 8:30 AM
By Justin Anderson -Cabell Bureau


http://www.wvrecord.com/news/217993-psychiatrist-over-prescribed-lithium-man-says

HUNTINGTON - A Huntington man is suing his former psychiatrist for allegedly over-prescribing lithium that caused end stage renal disease.

Troy L. Robinson filed a lawsuit against Deleno H. Webb III and Area Psychiatric and Psychotherapy Group in Cabell Circuit Court on Feb. 17.

Robinson says he was a patient of Webb's from Feb. 12, 1997, to April 23, 2008. Robinson sought Webb's services because he had feelings of depression and anxiety.

The complaint says Webb diagnosed Robinson with bi-polar disorder and began prescribing him lithium -- Eskalith -- in September 1998. The dosage was 450 milligrams twice a day.

By November 2001, Robinson's lithium level was recorded in the therapeutic range and the creatinine was elevated at 1.7, but he claims Webb did not changes the dosage. In October 2004, Robinson claims his lithium level had grown to 2.4 and the amount of creatinine in his blood had risen to 3.3, a level described in the complaint as "dangerous.

"Despite these dangerous blood levels, Dr. Webb continued to prescribe lithium to this patient until it was discontinued in January of 2007," the complaint says.

On March 16, 2007, Robinson was diagnosed with end stage renal disease as a result of lithium toxicity, the complaint says. Nevertheless, Robinson continued to see Webb until April 2008.

Robinson claims Webb was negligent in his prescribing lithium and that Webb did not warn him of the possible dangerous side effects of the drug.

Robinson says he's sustained physical and emotional injuries, medical costs, loss of earning capacity and earnings, loss of household services, pain and suffering and other damages. He claims the company, Area Psychiatric and Psychotherapy Group was negligent in hiring and retaining Webb.

The plaintiff seeks various compensatory and punitive damages as well as pre- and post-judgment interest and legal fees.

Timothy L. Eves is representing Robinson. Cabell Circuit Court Judge David Pancake has been assigned the case

6 comments:

  1. Hi Mandy Have just scanned todays post and are appauled at Mind and NICE suggesting there should be yearly health checks as this was written into the new GP contract 5 years ago and they have been being paid unchecked to do it since then.
    "East coast comment"

    ReplyDelete
  2. Hi Anon

    So that up to £200,000 (performance related pay) for GP's hasn't led to them doing anything more then?

    Are regular checks are legal requirement or is more 'guidance' from NICE. What point guidance if it nobody pays attention to it?

    Having spoken to my STR worker yesterday I said I am the sort of person that needs to know what is going on and I sense it will be down to me to be asking questions rather than any 'planned programme' being put in place by services.

    Perhaps that is why the chap was over prescribed Lithium. Because medical services were not carrying out regular blood tests. Although 900 mg of a potentially toxic substance seems an awful lot for the body to absorb and deal with in one day and then continually over a period of time.

    Once my blood tests are done, I will be making appointment to talk to my GP about how blood tests are organised, dosages of meds etc. There is no way I am going to be taking large doses of anything. I don't give a cobblers about 'therapeutic norms'. They mean fekk all to me.

    As for Mind, seems they put their finger on the pulse long after rigor mortis had set in.

    ReplyDelete
  3. Clozapine kills one person a week

    http://www.ic.nhs.uk/webfiles/publications/PCA%20publication/PCA%202007%20complete%20V2.pdf

    ReplyDelete
  4. Hi Rocket Ron

    'Kill or cure' comes to mind. Bit exreme maybe but again it seems to come back to monitoring.

    Like where is it?

    ReplyDelete
  5. Clozaril Patient Monitoring Service

    http://www.google.com/search?q=Clozaril+Patient+Monitoring+Service&rls=com.microsoft:en-gb:IE-SearchBox&ie=UTF-8&oe=UTF-8&sourceid=ie7&rlz=1I7GZEZ_en-GB

    ReplyDelete
  6. Hi Anon

    Was that link your way of saying it all comes back to the self?

    Clever in it's simplicity! ha!

    ReplyDelete