APRIL's third Conference Accredited by the Royal College of Physicians
Adverse Psychiatric Side Effects of Medicines:
What's our Responsibility?
Thursday 6 November 2008
at Friends' House, 173 Euston Road, London NW1 2BJ
main conference flyer with details of the speakers
Breakout session: 'Coming Off Medicines' sessions - programme
Biographies of the Speakers
Speakers were:
Professor Munir Pirmohamed Link to NHS Chair of Pharmacogenetics talk and presentation at our conference.
He has published important statistics on Adverse Drug Reactions:
Adverse drug reactions as cause of admission to hospital: prospective analysis of 18 820 patients
http://www.bmj.com/cgi/reprint/329/7456/15.pdf
Professor Munir Pirmohamed and the research team found 6.5% of the emergency admissions were due to ADRs with a median bed stay of 8 days (4% of hospital bed capacity) costing in the region of £466m or $847m. Most reactions being avoidable.
The team concluded the burden of ADRs on the NHS is high, accounting for considerable morbidity (iatrogenic illness), mortality (deaths) and extra costs.
The ADR admission statistics in the above study excluded paediatric, psychiatric and maternity emergency admissions.
Psychiatric adverse drug reactions (ADRs) are distressing for patients and have important public health implications. We identified the drugs with the most frequent spontaneous reports of depression, and fatal and non-fatal suicidal behaviour to the UK’s Yellow Card Scheme from 1998 to 2011.
There were 110 different drugs with ≥ 20 reports of depression, 58 with ≥10 reports of non-fatal suicidal behaviour and 33 with ≥5 reports of fatal suicidal behaviour in the time period. The top five drugs with the most frequent reports of depression were the smoking cessation medicines varenicline and bupropion, followed by paroxetine (a selective serotonin reuptake inhibitor), isotretinoin (used in acne treatment) and rimonabant (a weight loss drug). Selective serotonin reuptake inhibitors, varenicline and the antipsychotic medicine clozapine were included in the top five medicines with the most frequent reports of fatal and non-fatal suicidal behaviour. Medicines with the highest reliably measured reporting rates of psychiatric ADRs per million prescriptions dispensed in the community included rimonabant, isotretinoin, mefloquine (an antimalarial), varenicline and bupropion. Robust denominators for community prescribing were not available for two drugs with five or more suicide reports, efavirenz (an antiretroviral medicine) and clozapine.
Charles Medawar
For years he has done in depth research into the serious and life threatening side effects, first of benzodiazepines and then of SSRI antidepressants and recorded patients' own experiences.
Charles Medawar and his organisation Social Audit (www.socialaudit.org.uk) have recently been exploring the concept of pharmageddon with eminent researchers. Details are on the Social Audit web site. (sadly since our conference Charles has withdrawn his web site due to ill health and the link now goes to the Archived site on WaybackMachine web site.
Andrew Herxheimer and Charles Medawar appeared in BBC Panorama documentaries about Seroxat / Paxil (paroxetine).
They reviewed the Medicines and Healthcare Products Regulatory Agency (MHRA) handling and analysis of ADR Yellow Card reports and the thousands of reports of ADRs and distressing withdrawal symptoms sent to the Panorama team.
Journalist Lynn Eaton wrote in the British Medical Journal about an apparent attempt by the UK government to distract from MHRA incompetence and a system, that in Dr Andrew Herxheimer's words, was chaotic and misconceived
Professor David Healy has devised a withdrawal protocol for SSRI and similar antidepressants which is widely used, has made studies and published papers on the risk of suicide for people taking SSRIs.
David Healy is Professor of psychological medicine at the University of Wales. More information on Professor Healy's attempts to draw attention to suicide and dependency problems caused to some people by SSRI and other antidepressants is on the web site:
There were many more speakers, panel members and chairs worthy of mention and more details of these amazing and ethical doctors, clinicians and academics will be put on to the web site when time allows, in the meantime try to google for more information for those above and for the following speakers:
Dr Ben Goldacre is a GP who writes a column and has published a book entitled Bad Science.
Dr Joanna Moncrieff Sen.lecturer, psychiatrist member of Critical Psychiatry Group.
Joanna Moncrieff is author of The myth of the chemical cure interview with Joanna on BBC radio4 http://news.bbc.co.uk/today/hi/today/newsid_8151000/8151332.stm
Dr Bob Johnson psychiatrist/author does not support the use of medication in dealing with mental illness. He believes by unravelling childhood trauma, many people can be helped back to living normal lives without drugs. His organisation the James Naylor Foundation publishes reviews of their conferences and debates held in London. They will be setting up a centre in London during 2009.
Dr Anita Holdcroft anaesthetist author on paper evaluating anaesthetic ADRs.
Professor Heather Ashton Emeritus Professor clinical pharmacology ran the benzodiazepine withdrawal clinic in Newcastle, produced a benzodiazepine and z drug withdrawal protocol which is used world wide,
Dr Simon Maxwell, Senior lecturer Clinical Pharmacology Edinburgh, paper on medical education and member of Medical Schools Council Safe Prescribing Working Group,
Dr John Halliday, Senior lecturer pharmacology and therapeutics.
Dr Hugh Middleton, psychiatrist and social scientist.
Nigel Meadows, HM Coroner Manchester City believes many of the sudden deaths are linked to medication and wants more help for Coroners to find information among the mine field of adverse drug reactions.