Image: webmd.com
A good friend and fellow advocate recently carried out an experiment at their local Doctor's surgery. The aim of this Q&A session with their Doctor was to highlight just how much Doctor's know about the SSRi's they prescribe, how much they know about the side effects and how much they know about reporting these side effects.
As suspected, this particular Doctor chooses not to prescribe Seroxat any more, you will see why with the following.
The results were startling!
Q: - Do you think depression is caused by a chemical imbalance?
Reply: Yes.
Q: - Can you give me any evidence of this?
Reply: Well it is in the papers that GPs read regarding drugs etc. That is what we are told.
Q: - Who by?
Reply: As I said we look at medical journals etc.
Q: - I don't think so, as there is no scientific evidence to support this theory. Is it what the drug company reps have told you?
Reply: Yes, I suppose so. But I didn't think you were coming here for an arguement.
[I told him it makes me very angry that GPs are prescribing SSRIs on this basis etc.]
Q: - What do you think of the Yellow Card System?
Reply: Well it is quite a good system.
Q: - Why doesn't this surgery advertise the fact that patients can report ADRs themselves?
Reply: Umm Ahh. If I was to report every ADR I would spend the whole day filling out Yellow Cards.
Q: - Yes, but patients can report themselves now. Would you be willing to put up a poster and have Yellow Cards displayed in the surgery?
Reply: Yes, I suppose so.
I answered, "Good, I will bring you a poster and some yellow cards."
He then showed me a yellow card in the back of the BNF and asked if I would like one!
I answered, "No, I have lots at home."
Q: - So what ADRs do you report regarding SSRIs?
Reply: If I reported every ADR such as nausea, vomiting, dizziness etc I would not have the time for anything else. Anyway, the MHRA only ask for serious ADRs to be reported. I only report on Black Triangle drugs.
Q: - Really, so you really believe that you are only supposed to report on Black Triangle Drugs?
Reply: Yes, that's what it says on the Yellow Card in the back of the BNF.
I replied, "I don't think this is what the MHRA are aiming for at at all but I will tell them what you have said, not mentioning your name or the surgery because I appreciate that you have answered my question honestly."
Q: - Do you adhere to the NICE guidelines on SSRIs?
Reply: Well they are always changing the guidelines so not really.
Q: - Have you seen the latest guidelines that came out in October this year? There is a lot of new info about SSRIs, especially withdrawal?
Reply: No. GPs do not generally look at the NICE guidelines.
Q: - Why is that - because they are only guidelines and don't have to be adhered to?
Reply: Well, yes.
He said that the surgery does not prescribe Paroxetine [Seroxat/Paxil] anymore due the controversy in the media etc. They have switched to other drugs such as Citalopram [Cipramil], Prozac and Venleafaxine [Effexor].
----
Let's scrutinise this Doctor's answers.
This Doctor thinks depression is caused by a chemical imbalance, he adds weight to his belief because, "...it is in the papers that GPs read regarding drugs."
The papers that Doctor's read are, in the main, written [or ghost-written] by influential key opinion leaders who are paid by pharmaceutical companies!
Here's how Glaxo promoted Paxil [Seroxat] on TV in 2002. Here they claim that "a chemical imbalance could be to blame" and that "Paxil works to correct this imbalance."
Next, the Doctor lays claim that the Yellow Card System is, "...quite a good system."
He later adds, "...the MHRA only ask for serious ADRs to be reported. I only report on Black Triangle drugs."
This, to my knowledge is NOT true. The MHRA ask for ALL adverse drug reactions to be reported and NOT just the 'serious ones.' Why would a Doctor think otherwise?
He was asked whether or not he adhered to the NICE guidlines with regard to new information about SSRi's. His answer was kind of worrisome. "Well they are always changing the guidelines so not really." He added, "GPs do not generally look at the NICE guidelines."
Finally, the Doctor stated that he did not prescribe Seroxat any more due to the controversy about it in the media. He added that his surgery have switched to other drugs such as Citalopram [Cipramil], Prozac and Venlafaxine [Effexor]
I wonder if this Doctor thinks Cipramil, Prozac and Effexor are more safer than Seroxat?
Although this experiment cannot be classed as 100% proof that Doctor's are being duped and kept in the dark about the safety of these drugs, it does, however, highlight the incompetence of our medicine regulator, the MHRA.
It is plainly obvious, to me at least, that they are NOT promoting drug safety. They are NOT doing enough to educate Doctor's with regard to prescribing this class of drugs and they are clearly misguided about the 'success' of their deeply inaccurate reporting of adverse drug reactions.
With so much effort to stop the sales of online drugs and clamping down on herbal medicines, one would think that the MHRA could spend the money they receive from pharma in a way that actually protected the patient rather than protect the sales of pharmaceutical products.
I wonder if the Doctor who was interviewed is aware that Seroxat is classified as a Class D drug in the United States? [See Fig1] A class by the FDA's Pregnancy Category Definition that states: "Clear evidence of risk in humans. Studies, adequate, well-controlled or observational, in pregnant women have demonstrated a risk to the fetus." [See Fig2]
It would appear that even the UK regulator dispute the FDA's findings.
And MHRA CEO, Kent Woods, wonders why I criticise!
Fig1
Fig2
Fid
ORDER THE PAPERBACK
'THE EVIDENCE, HOWEVER, IS CLEAR...THE SEROXAT SCANDAL' By Bob Fiddaman
SIGNED COPIES HERE OR UNSIGNED FROM CHIPMUNKA PUBLISHING
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