Adverse Psychiatric Reactions Information Link
Promoting awareness of medicines that can harm mental health

Medicines

Many prescribed  medicines  CAN CAUSES DEPRESSION AND EVEN LEAD TO SUICIDE.

DOCTORS - NURSES - PSYCHIATRISTS & Non Medical Prescribers  should be aware of IMPORTANT INFORMATION
about iatrogenic (treatment induced) psychiatric adverse drug reactions.

Anaesthetics combined with pre and post surgical medication can cause mental health issues too. 

Read about this here: Confusion and Delirium following general anaesthesia.

 

Professor Munir Pirmohamed and other researchers stated " In recent years there has been growing concern that certain prescribed medicines may be associated with psychiatric adverse drug reactions such as depression, non-fatal self-harm and suicide" Click on the heading for the published research.

 

Professor Sir Munir Pirmohamed with research colleagues published the following and you can click here for the full paper:

Reporting of drug induced depression and fatal and non-fatal suicidal behaviour in the UK from 1998 to 2011
Kyla H Thomas, Richard M Martin, John Potokar, Munir Pirmohamed and David Gunnell

In the above research information there is a table showing: Rates of Yellow Card adverse reports per million prescriptions dispensed for the top 20 drugs with the highest number of adverse reports for depressive disorders, non-fatal suicidal behaviour and suicide

Prescribed pharmaceutical medicines include:

Rimonabant Isotretinoin Mefloquine Etonogestrel Sibutramine Levonorgestrel Desogestrel Levetiracetam
Paroxetine Venlafaxine Fluoxetine Citalopram Rimonabant
Isotretinoin Clozapine Atomoxetine Varenicline Duloxetine Paroxetine Levetiracetam Topiramate
Pregabalin Escitalopram Risperidone Mirtazapine Olanzapine Sertraline
Paracetamol Efavirenz Varenicline Duloxetine Aripiprazole  Risperidone  Venlafaxine Olanzapine
Escitalopram Quetiapine Zopiclone Diazepam Amitryptiline

Please read the Royal College of Anaethetists information about 'Delirium and Confusion after Anaesthesia'

 

The Imperial College study as published in the Royal Society of Medicine journal may have escaped your notice.

ADR hospital admission statistics to 2010 (as published by the Royal Society of Medicine)

  • Increase in ADR related hospital deaths 10%
  • Emergency admissions in hospitals due to ADRs increased by 76.8% 

Professor Munir Pirmohamed and other researchers stated 

In recent years there has been growing concern that certain prescribed medicines may be associated with psychiatric adverse drug reactions such as depression, non-fatal self-harm and suicide" Click on the heading for the published research.

Reporting of drug induced depression and fatal and non-fatal suicidal behaviour in the UK from 1998 to 2011
Kyla H Thomas1,4*, Richard M Martin1, John Potokar2, Munir Pirmohamed3 and David

 The Maudsley Hospital psychiatric adverse drug reactions (ADRs) data used in the hospital, in their prescribing guidelines, as compiled by McConnell and Duffy is interesting.

The list of medicines on left should be in alphabetical order but  you will find BENZOs are at the bottom of the list .

Please also refer to the topics listed across the headings on the home page.

qualitative study for Dianette known as co-cyprindiol, is produced from reports received by APRIL from women who found the hormone pill affected their mood adversely. Grateful thanks to Kathy Piccolo BSc(Hon) Human Physiology, RNC for compiling the data.

We hope you will find information that is of help to you, 

All medicines have effects but some are unwanted and can be harmful. Adverse Drug Reactions (ADRs) or Adverse Effects (AEs) may occur after a drug is licensed. If they occur during a clinical trial they should be recorded as a Serious Adverse Event (SAE)

What is an Adverse Drug Reaction (ADR) ?

The definition of an ADR or AE is defined by the British Medical Association (BMA) as:

"unwanted or unintended effects of a medicine which occurs during proper use."

The British Medical Association policy document titled "Reporting adverse drug reactions". was published by the BMA Board of Science and Education. 

In the conclusions section of the BMA document mentionded above, is stated "The subject of adverse drug reaction reporting should be included in both undergraduate and continuing medical education provision for general practitioners and hospital doctors."

However the above recommendation was not heeded. The General Medical Council's (GMC) guidelines on medical education publication, "Tomorrow's Doctors", contained no reference to adverse drug reactions or withdrawal effects for many years. Clinical Pharmacology and Therapeutics was not a required subject for medical students, according to the GMC under their policy of "integrated medicine".

 

Could my symptoms be an adverse reaction?

If medication is involved and you are concerned about yourself or another person, due to an unusual change in mood, a rash, or any other sudden or gradual difference in mental or physical condition

  • Read the Patient Information Leaflet (PIL) carefully
  • For more details about the medication find the Summary of Product Characteristics on the Pharmaceutical manufacurer's data sheet (SmPC or SPC) on www.medicines.org.uk
  • Speak to your local pharmacist or call the pharmacy in your local hospital with a list of other medicines, drugs or herbal products that may possibly be interacting with the new medication.

The focus of APRIL is mainly on drugs prescribed for physical conditions and drugs used around surgical procedures. Information about a few of the specific drugs or drug groups with known psychiatric ADRs , are listed in the left hand menu.

 

Could adverse reactions occur following surgery or anaesthetics used for local anaesthesia?"

Incidents of psychosis or depression or sucidal thoughts have been reported following surgery, either immediately or several days following the procedure. This may be due to the anaesthetics or drugs used pre and post surgery or a combination.

The important message is to stay with a person who is having unusual mood swings or seems not to be their usual self. Do not leave them alone.

The list on the left side on computers or maybe below on a mobile phone ,contains some of the medicines we know can cause psychiatric side effects. However, there are many more drugs implicated in the onset of mental distress.

 

Useful web sites to find more information about drug side-effects

Rxisk is an independent data base set up by doctors. They provide information and welcome your reports of ADRs  www.rxisk.org

The Association of British Pharmaceutical Industry (ABPI) electronic medicines compendium (emc), contains pharmaceutical data sheets known as Summary of product characteristics (SPCs or SmPCs) www.medicines.org.uk  on this site will be the latest  Patient Information Leaflet (PIL) too.

The data from the pharmaceutical manufacturer may also have information that your doctor would find helpful in helping to discern if a particular drug is implicated in mental changes. However if one finds discussion in forums that relate to your suspicion being correct, then remember the patient's voice should be heard. Most drugs have not been monitored for psychiatric ADRs prior to being licensed. 

Many adverse side effects are only recognised officially after many years of the drug has been licensed

Just because the particular condition is not listed does not mean it has not been caused by the drug.

An example known to Millie Kieve the founder of APRIL is a drug in a group called sulphonamides. The drug Sulfasalazine or Sulphasalasine, if not tolerated, can lead to a sudden onset of psychosis. The MHRA have reports of this very serious recognised psychiatric adverse drug reaction (ADR) yet have not insisted the manufacturer places this condition on the data sheet (SPC) or the PIL.

 

Reporting Adverse Drug Reactions (ADRs)

It is well known that serious side effects of medicines are under reported and the UK regulatory body the Medicines and Healthcare Regulatory Agency (MHRA) estimate less than 10% of serious ADRs are reported.

If you are, for no apparent reason, feeling mentally distressed, it may be caused by starting or stopping medication, due to a changed dose, withdrawal effects, interactions with other drugs, or following surgery. You can request a list of drugs used pre surgery and during surgery and those for pain or infection to be taken later.

Some drugs must not be stopped suddenly

Be aware of interactions with other medicines

If you have suffered psychiatric, neurological or physical adverse drug reactions (ADRs) please report them. There may be adverse effects not mentioned on the patient leaflets (PILs) or data sheets. (SPCs)

You should be given a patient information leaflet (PIL) for all drugs prescribed, either as you are discharged from hospital, or if the pharmacy supplies you from a bulk supply of pills. (EU Directive 1997)

Please report Adverse Drug Reactions (ADRs) to:

UK - Yellow Card Reporting for Patient and Health Professional reports of Adverse Drug Reactions Report to the MHRA using this link

Alternatively, you can call us on 0800 731 6789 (9am to 5pm Monday to Friday). 

Adverse incidents involving medical devices cannot be reported by telephone. Please report online or by email to aic@mhra.gov.uk

USA and worldwide - to the Food and Drug Administration for Patients and Healthcare Professionals

Universal free, independent drug safety website - Rxisk

 

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news that may not be on this site may be on the APRIL blog

 

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