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Headline

One in four adults prescribed addictive medicines, says PHE review

Comment

This review from P.H.E concludes with: "Further Research" - 5.1 "Isolating withdrawal effects (especially of antidepressants) from the original disorder and its return. Surely this will require greater awareness and understanding of SSRI/SNRI and "Atypical"antidepressant induced akathisia and its potentially fatal sequelae? Induction, dose increase, A.D. change all can trigger akathisia and the akathisic patient is then at risk of misdiagnosis of this condition, and its overwhelming suffering, as emergent serious mental illness. Akathisia is also a life-threatening component of AD withdrawal syndromes and carries the same risk of misdiagnosis and exacerbation by increasing the dose or by "augmented" psychotropic medication. Agitation is mentioned in the summary of clinical features of AD withdrawal syndromes, but agitation is a key indicator of akathisia. (Alongside adverse changes in feelings, emotions, behaviour, ceaseless pacing, bizarre abnormal movement (dyskinesia) - in addition to overwhelming agitation). 5.2 "Better understanding the incidence, duration, nature and severity of withdrawal from antidepressants, including long-term and enduring side effects". A commitment to address the long term and life changing syndrome of post SSRI sexual dysfunction - (as an ADR and not a feature of "the underlying disorder") - might restore some hope to those in despair. For a class of drugs advocated as a component of chemical castration, denial of PSSD seems a remarkable response to a common outcome of taking, and for some, long after ceasing antidepressant Rx. AD/SSRI induced akathisia has been described in published scientific literature for some thirty years, some would state 40 years. Terms such as "hyperkinesis" and "emotional lability" have decreased the visibility of akathisia in sponsored clinical trials. "Depressive psychosis is vanishingly rare compared to treatment induced akathisia". Sad indeed to see the latter misdiagnosed as the former. Sad indeed that committed G.P.s feel the discomfort induced by this P.H.E. Report. Prescribers can only follow the evidence base available to them via CME. The same, industry funded C.M.E evidence base used by Regulators and promoted by Key Opinion Leaders.

Posted date

10 Sep 2019

Posted time

2:42pm

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