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News Article
USA: Why states are tackling physicians’ concerns about mental health treatment
Patient Safety Learning posted a news article in News
Medical doctors face higher rates of burnout and depression than the general population and are twice as likely to die by suicide. The risks were magnified at the height of the coronavirus pandemic, but the problem existed long before that. More than 40% of physicians, medical school students and residents cite fear of disclosure requirements on licensure forms as a main reason they don’t seek mental health care, according to the American Medical Association (AMA), which has been pushing for legislative and regulatory changes. More states and health systems are amending licensure and credentialing forms to remove mental-health-related questions, such as asking about whether a doctor sought mental health care or treatment, or received a mental health diagnosis. Others have codified such changes into state law. The rationale for asking about mental health was to ensure patient safety. The AMA says safety can be addressed with general language that asks whether a physician is suffering from any impairment that could interfere with patient care. “Having any past diagnosis of a mental health need or a substance use problem is often not relevant,” said AMA President Jesse Ehrenfeld. “The key inquiry ought to be whether the impairment represents a current concern for safety and the physician’s ability to provide competent professional care.” Read full story (paywalled) Source: The Washington Post, 18 February 2025 -
News Article
Thomas Kingston's family calls for antidepressant prescription change
Patient Safety Learning posted a news article in News
The parents of Thomas Kingston have warned about the side effects of antidepressants after he took his own life. Mr Kingston died from a head injury in February last year at his parents' home in the Cotswolds. A gun was found near his body. The 45-year-old had stopped taking his medication, which had been prescribed by a GP at the Royal Mews Surgery in the days leading up to his death. His parents, Martin and Jill Kingston, are now calling for a change in how patients are prescribed selective serotonin reuptake inhibitors (SSRI) - a widely used type of antidepressant. Martin Kingston told BBC Radio 4's Today programme he believes both the patient and the people close to them should be told more explicitly about the potential side effects of the medication, including what can happen if they stop taking it. The couple want patients to sign a document confirming they've been told about the difficulties of going on and coming off the medication. This could include the patient being told that "it's an extreme case, but it could lead to suicide", Mrs Kingston says. "We'd really like to see that a person, a spouse, a partner, a parent, a close friend, somebody, was going to walk with them through it. Maybe they should be at that signing time." Recording a narrative conclusion at an inquest into his death in December, Katy Skerrett, senior coroner for Gloucestershire, said Thomas Kingston had taken his own life. "The evidence of his wife, family and business partner all supports his lack of suicidal intent," she said at the inquest. "He was suffering adverse effects of medication he had recently been prescribed." In a prevention of future deaths report, made in January, Ms Skerrett said action must be taken over the risk to patients prescribed SSRIs. She questioned whether there was adequate communication of the risks associated with such medication. Read full story Source: BBC News, 4 January 2025 Related reading on the hub: The question that will save lives: Interview with Katinka Blackford Newman, founder of Antidepressant Risks Long-lasting sexual dysfunction after taking antidepressants: Lack of recognition harmful to patients Post-SSRI Sexual Dysfunction: After 30 years, why is the health system still failing to recognise this life-limiting adverse effect? -
Content ArticleMr Thomas Henry Robin Kingston was a 45 year old man who was visiting his parents in Kemble Gloucestershire for the weekend. He had recently been experiencing anxiety, but had not expressed any suicidal ideation. On Sunday 25 February 2024 after lunch he began to unload his car, and prepared to return to London. Between approximately 1700-1800 hours he removed a shotgun from his vehicle which he had recently borrowed from his father for a shoot. He then accessed an annex attached to his parent’s property. Within a locked bathroom he self inflicted a gun shot to the head, and sustained injuries incompatible with life. He was subsequently found by his father. He was pronounced deceased at 1854 hours by attending police, who confirmed there were no suspicious circumstances surrounding his death. Intent remains unclear as the deceased was suffering from adverse effects of medications he had recently been prescribed. The medical cause of death was 1A Traumatic wound to head. Matters of Concern Whether there is adequate communication of the risks of suicide associated with the selective serotonin reuptake inhibitor (SSRI) medications, and Whether the current guidance to persist with SSRI medication or switch to an alternative SSRI medication is appropriate when no benefit has been achieved and/ or especially when any adverse side effects are being experienced.
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News ArticleA woman who said she has become severely suicidal during a year of being prescribed the same antidepressants as royal family member Thomas Kingston has issued a warning over their side effects. Lingling Wang, 48, told The Independent she felt she was not made adequately aware of the potential effects of taking antidepressants before she was prescribed them for insomnia and mild anxiety last January. Read full story Source: Independent, 11 January 2025
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News ArticleMore than 100 alerts were made in a decade to the UK’s medicines regulator over deaths linked to the antidepressants which Thomas Kingston was taking before he killed himself. A coroner ruled that Mr Kingston, the husband of Prince and Princess Michael of Kent’s daughter Lady Gabriella Kingston, fatally shot himself after an adverse effect to the medications he had been prescribed, which included the common antidepressant citalopram. The UK’s medicines regulator, the Medicines and Healthcare Products Regulatory Agency (MHRA) said it is undertaking a review of safety warnings for 30 antidepressants including citalopram and prozac. Data analysis by The Independent has now found the MHRA has received more than 71 alerts over fatalities linked to the antidepressant citalopram since 2014. The data, called yellow card alerts, also shows 114 alerts over fatal adverse reactions linked to sertraline, another antidepressant taken by Mr Kingston, over the same period. However, the data does not determine whether the drug was the direct cause of death. Read full story Source: The Independent, 8 December 2024
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Content Article
Post-SSRI Sexual Dysfunction (PSSD) is a long-term adverse effect of Selective Serotonin Reuptake Inhibitors (SSRIs), a type of antidepressant medication. In this opinion piece, Harriet Vogt, Patient Safety Partner at NHS Sussex Integrated Care Board, outlines the need for recognition and research into PSSD to allow patients to make truly informed choices when considering SSRIs. She looks at the impact PSSD has on the sexual and emotional lives of thousands of people and highlights a new research study analysing the obstacles to quantifying its incidence and prevalence. Harriet argues that while the health system is beginning to recognise the value of placing patients at the heart of efforts to improve safety, this focus on listening is rarely given to individual patients who express concern about the impact of their medication or treatment. How many reading this piece have ever heard of Post-SSRI Sexual Dysfunction (PSSD)? I expect a lot of people will be aware of the sexual dysfunction that is an acknowledged adverse effect of taking Selective Serotonin Reuptake Inhibitors (SSRIs), which includes loss of desire, diminished orgasm and erectile dysfunction. But PSSD is different. It is an iatrogenic condition that persists, sometimes for many years, after the original medication has been halted. In medical terms, PSSD is “characterised most commonly by genital numbness, pleasureless or weak orgasm, loss of libido and erectile dysfunction.”[1] In human terms, it is a life-limiting dysfunction caused by a prescribed medication. Many people are now sharing their accounts of PSSD—here are two examples that illustrate the impact the condition has on people's lives: "I only took escitalopram for 4.5 months at a low dose from August to December of 2020 and did a taper to stop the medication. I have been off the medication for over 2 years now and I have not made a significant step forward in recovery of my PSSD symptoms. On the medication, I could hardly function. I experienced sexual dysfunction, complete anhedonia, I couldn’t feel my emotions at all and couldn’t cry. I also experienced extreme DP/DR, Visual snow, Tinnitus, full body numbness, severe fatigue, lack of strength. I can’t have a relationship in this state, and knowing that others can experience pleasure in their life while I feel stuck behind a glass jar is torture." Rosie, 23 "I have now endured PSSD for almost 16 years, with no significant improvement in any of my symptoms, except for perhaps a slight reduction in genital numbness. My libido and orgasm intensity are still only about 10% of what they were before PSSD. Additionally, I've had to deal with a lot of disbelief and gaslighting from doctors who have refused to acknowledge this condition, contributing significantly to the trauma of living with it. There have been instances where doctors even laughed at me when I sought help for my persistent sexual symptoms, which was an unpleasant and humiliating experience." Roy, 38 You can read many more accounts on the website of the PSSD Network, a patient-led charity. The battle for recognition of this awful condition—fought by a small number of principled academics and clinicians as well as growing numbers of suffering patients—is a painful action replay of the valproate, pelvic mesh and primodos scandals uncovered by the Independent Medicines and Medical Devices Safety Review (IMMDS review), sometimes referred to as the Cumberlege Review. The IMMDS Review stated: "We have found that the healthcare system… is disjointed, siloed, unresponsive and defensive. It does not adequately recognise that patients are its raison d’etre. It has failed to listen to their concerns and when, belatedly, it has decided to act it has too often moved glacially. The system is not good enough at spotting trends in practice and outcomes that give rise to safety concerns. Listening to patients is pivotal to that."[2] An important paper was published last week in Epidemiology and Psychiatric Sciences, titled ‘Post-SSRI sexual dysfunction: barriers to quantifying incidence and prevalence’. It was authored by two academic clinicians, founder members of the long established, independent research organisation Rxisk, whose stated purpose is ‘to make medicines safer for all of us’. The original paper is well worth reading as it details: The struggle to achieve formal regulatory and medical recognition for PSSD, even though the UK Medicines and Healthcare products Regulatory Agency (MHRA) indicated that the first report of enduring sexual dysfunction after an SSRI was halted involved fluoxetine in 1991. The obstacles to establishing the prevalence and incidence of the condition, including lack of awareness amongst both clinicians and patients, patient embarrassment and vagueness about their own sexual responsiveness over time and ethical issues with setting up research that would involve exposing patients to the risk of PSSD. Establishing the prevalence of PSSD is much more important than being a ‘nice to know’. It is essential for delivering properly informed consent to patients, enabling them to weigh the possible benefits and establish the risk of harms which could have material significance to how they want to live their lives. I also believe there is a problematic cultural overlay. As medicine has become increasingly ‘scientised’ and ‘evidence-based ‘, it is too easy to forget that clinical trial data, to demonstrate that a drug essentially works, is looking at the ‘average patient’. Of course, there is no such person. The individual patient in front of us is not an anecdote. Equally, most of the clinical trials, funded by companies for whom returns to investors are their understandable priority, are designed and results ‘ghost written’ to show products in their most favourable light, emphasising benefits and diminishing adverse effects, known as ‘side’ effects. These issues are powerfully articulated in the book Pharmageddon by David Healy. It feels in every way right that patients are at the centre of the NHS National Patient Safety Strategy and the Patient Safety Incident Response Framework (PSIRF). Claire Cox gave a brilliant demonstration of putting patients at the heart of an investigation with assiduousness and sensitivity in a presentation about Patient Safety Incident Investigations (PSII) under PSIRF at a recent Patient Safety Management Network (PSMN) meeting. How and why patients, such as those with PSSD, are not always afforded this same individual attention and respect when it comes to prescribed medication, is a matter that needs to concern us all. It’s a truism that the web has transformed human life in a multitude of ways, not least in the democratisation of knowledge. Medical expertise and training remain in the hard-grafted ownership of professionals, but patients congregate in social media communities to share their experiences of medical treatments. Suggesting that patients shouldn’t listen to ‘Dr Google’ misses the point. What patients are listening to is other patients articulating their experiences of medicine in all its dimensions. For example, patients have no need to understand the complexities of neurobiology, because what matters to them is their experience of treatment—how it makes them feel. It is tragic to see PSSD patients, whose sexuality, sensuality and emotional reactivity have effectively been deleted, literally begging for official recognition, support and research. It is a similar story to those whose experiences of antidepressant withdrawal were sidelined for 30 years. As a health system, we must learn to listen more deeply, and act with decent speed. Related reading Long-lasting sexual dysfunction after taking antidepressants: Lack of recognition harmful to patients The question that will save lives: Interview with Katinka Blackford Newman, founder of Antidepressant Risks References 1 Healy D, Mangin D. Post-SSRI sexual dysfunction: barriers to quantifying incidence and prevalence. Epidemiology and Psychiatric Sciences. 18 July 2024 2 First Do No Harm: The report of the Independent Medicines and Medical Devices Safety Review, 8 July 2020- Posted
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News ArticleLucy will never again dance with her three-year-old daughter or hold her 12-month-old baby boy. She died by suicide in September this year after suffering from postnatal depression and psychosis. Her family say she was failed by mental health services. It was the second time Lucy suffered with the condition, but she had no extra support in her second pregnancy. They are calling on the government to end what they say is a postcode lottery of perinatal mental health care. Lucy's death is part of a bigger picture. The postcode lottery of perinatal services is stark. Yet one in 10 women suffer from postnatal depression according to the NHS. Research from the Maternal Mental Health Alliance (MMHA) reveals North Yorkshire, where Lucy lived, did not meet the care quality standards for perinatal care set by the Royal College of Psychiatrists 2023. Karen Middleton, head of policy at MMHA, says mums are being failed by the lack of consistent maternal mental health care. “Maternal mental health isn’t fully understood and has been historically under-invested," she said. "We need to raise awareness so commissioners and managers at the local level provide sustainable funding that is based on the levels of need in their area.” Read full story Source: BBC News, 14 November 2024
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Content ArticleThis briefing was commissioned by the Maternal Mental Health Alliance who are dedicated to ensuring all women, babies and their families across the UK have access to compassionate care and high-quality support for their mental health during pregnancy and after birth. One woman in five experiences a mental health problem during pregnancy or after they have given birth. Maternal mental health problems can have a devastating impact on the women affected and their families. NICE guidance states that perinatal mental health problems always require a speedy and effective response, including rapid access to psychological therapies when they are needed. Integrated care systems (ICSs) have a unique opportunity to ensure that all women who need support for their mental health during the perinatal period get the right level of help at the right time, close to home. Key points Maternal mental health problems are common and can be extremely serious. Timely access to effective help can make a big difference to long-term health outcomes for mothers and generations to come Integrated care systems can ensure that comprehensive and evidence-based support is provided to women and birthing people during the perinatal period Maternal mental health care must be developed equitably, adapting to the needs of groups of women with higher risk and poorer access to effective support Universal services – midwifery, general practice, and health visiting – are vital to identify needs and provide timely support Access to NHS Talking Therapies is essential for women with many diagnosable mental health difficulties during the perinatal period Specialist community perinatal mental health services are a priority for the NHS Long Term Plan and can meet the needs of women with more serious and complex conditions Adequate provision of specialist Mother and Baby Inpatient Units prevents women being separated from their babies if they need to be admitted to hospital The voluntary sector, including peer support, plays a vital role and needs to be commissioned and properly funded
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Content ArticleAn evidence review into the scale of the prescribed drug dependence and withdrawal problem in England published by Public Health England (PHE) in 2019 called for support for patients experiencing withdrawal symptoms, including a national 24 hour helpline and associated website. These calls have since been echoed in a recent BBC Panorama episode and other media accounts, but despite the evidence reviews, media interest and public awareness, nothing has changed. This open letter to the Government published in the BMJ calls for specialist NHS services to support patients harmed by taking prescription medications. Signed by healthcare professionals, it highlights that there are still almost no NHS services to support patients who have been harmed by taking medicines as prescribed by their doctor, such as antidepressants and benzodiazepines. The signatories believe that the NHS has a clinical and moral obligation to help those who have been harmed by taking their medication as prescribed, and are urgently calling upon the UK Government to fund and implement withdrawal support services.
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Content ArticleElectro-Convulsive Therapy , or ECT, is a controversial treatment for a number of severe mental illnesses. In essence, an electric current is passed through the brain and induces an epileptic seizure. Though less frequently used these days, it may still be employed in cases of severe depression and mania resistant to other therapies. After treatment, patients may suffer headaches, feelings of confusion and temporary memory loss. In this article, Dr Paul Lambden summarises the treatment, technique used, the risks and side effects, and longer term outcomes.
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Content ArticleDoctors are dying by suicide at higher rates than the general population—somewhere between 300 to 400 physicians a year in the US take their own lives. This article in The Guardian looks at why so many surgeons are dying to suicide and what can be done to stop the trend. It examines how the culture of working long hours and the expectation to be 'superhuman' leads surgeons to suppress their symptoms and avoid seeking help for mental health issues. The article also tells the story of US surgeon and President of the Association of Academic Surgery Carrie Cunningham, who has lived with depression, anxiety and a substance abuse disorder for many years.
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Content ArticleIn this article, inews columnist Kate Lister looks at the andropause, sometimes called the 'male menopause' that can affect men in their later 40s and early 50s. A gradual decline in testosterone levels can contribute to some men developing depression, loss of sex drive, erectile dysfunction and other physical and emotional symptoms. She looks at current research and views around the issue, highlighting her own bias in initially dismissing the idea and linking this to the societal notion that 'only women are hormonal'. She highlights that although the drop in testosterone men experience is not like the sudden hormonal changes that causes the menopause, men can still experience severe symptoms that require treatment with hormone therapy. "Despite my scoffing at the idea, it turns out that the andropause is very much a real thing that can impact some men very badly. The treatment is exactly the same as it is for women struggling with menopause and perimenopause. It’s hormone replacement therapy: this time in the form of testosterone."
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Content ArticleIn this podcast episode, Rosie, Sean, Carlton, and Emily share their experiences with Post-SSRI Sexual Dysfunction (PSSD), a condition where individuals face persistent sexual side effects and other side effects after taking or discontinuing certain antidepressants. Throughout the conversation, they emphasise the need for increased awareness and research on PSSD, sharing personal stories to shed light on this often-overlooked condition. Despite the challenges they face, they remain determined to advocate for recognition and support for those suffering from PSSD.
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Content ArticleSexual dysfunction is a common side effect of Serotonergic antidepressants (SA) treatment, and persists in some patients despite drug discontinuation, a condition termed post-SSRI sexual dysfunction (PSSD). The risk for PSSD is unknown but is thought to be rare and difficult to assess. This study, published in the Annals of general psychiatry, aims to estimate the risk of erectile dysfunction (ED) and PSSD in males treated with SAs.
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Content ArticleA set of enduring conditions have been reported in the literature involving persistent sexual dysfunction after discontinuation of serotonin reuptake inhibiting antidepressants, 5 alpha-reductase inhibitors and isotretinoin. The objective of this study, published by the International Journal of Safety and Risk in Medicine, was to develop diagnostic criteria for post-SSRI sexual dysfunction (PSSD), persistent genital arousal disorder (PGAD) following serotonin reuptake inhibitors, post-finasteride syndrome (PFS) and post-retinoid sexual dysfunction (PRSD).
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Content Article
This opinion piece is by Luke* who suffers from post-SSRI sexual dysfunction (PSSD) after he was prescribed a selective serotonin reuptake inhibitor (SSRI) antidepressant. Luke introduces the condition, drawing on the experiences that others have shared through PSSD communities, to highlight the devastating impact on patients. He calls for widespread recognition, improved risk communication and better support for sufferers. *Name has been changed I am Luke. I’ve been suffering with PSSD for more than 10 years. My life has been drastically altered. I am now an active member of the PSSD UK patient group and PSSD Network, through which I help raise awareness and support fellow sufferers in the hope that our situations can improve and a cure can be found. Post-SSRI sexual dysfunction Post-SSRI sexual dysfunction (PSSD) is a disorder in which individuals, who have been administered selective serotonin reuptake inhibitors (SSRIs) or other serotonin reuptake-inhibiting (SRI) drugs, experience persistent changes in sexual function and/or genital numbness for an extended period after ceasing to take the drug. Although it is most commonly caused by SSRIs (a widely prescribed group of antidepressants), cases have also been reported following the use of serotonin-norepinephrine reuptake inhibitors (SNRIs), SRI tricyclic antidepressants, SRI antihistamines, tetracycline antibiotics such as doxycycline, and analgesics such as tramadol.[1] Antidepressants have been known for some time to impact sexual function (while being taken) and this risk is included, to some extent, in the medication information. However, the risk of long-term impact to sexual function, after a person ceases to take the medication, has lacked widespread recognition for many years despite being highlighted by patients and researchers around the world.[2,3,4] Awareness remains poor despite some formal recognition In 2019, the European Medicines Agency formally recognised that sexual dysfunction can persist beyond discontinuation of SSRI and SNRI antidepressants[5]. The Pharmacovigilance Risk Assessment Committee stated: “Sexual dysfunction, which is known to occur with treatment with SSRIs and SNRIs and usually resolves after treatment has stopped, can be long-lasting in some patients, even after treatment withdrawal.”[6] Despite this, awareness is still very poor and formal recognition still does not exist in most countries. Although some urologists and sexual medicine specialists seem familiar with the condition, many general practitioners have not heard of PSSD. Psychiatrists often dispute the legitimacy of the illness or claim that it is exceedingly rare, but don’t have any data to prove the prevalence. For a long time, PSSD has been dismissed by many doctors as being a psycho-somatic illness – for example, the result of untreated depression. It is still typical for patients to be disbelieved like this, despite the clear distinction between the diagnostic criteria for clinical depression and the diagnostic criteria that has been developed by researchers for PSSD.[7] The latter outlines two ‘necessary’ criteria for PSSD to be diagnosed. (1) Prior treatment with a serotonin reuptake inhibitor. (2) An enduring change in somatic (tactile) or erogenous (sexual) genital sensation after treatment stops. ‘Additional’ criteria includes: Enduring reduction or loss of sexual desire. Enduring erectile dysfunction (males). Enduring inability to orgasm or decreased sensation of pleasure during orgasm. The problem is present for ≥3 months after stopping treatment. Also listed are both sexual and non-sexual symptoms of PSSD as per below: genital pain reduced nipple sensitivity decreased or loss of nocturnal erections (males) reduced ejaculatory force (males) flaccid glans during erection (males) decreased vaginal lubrication (females) emotional numbing depersonalisation other sensory problems involving skin, smell, taste or vision. The lack of awareness amongst the medical community also means that there is no available treatment or support for PSSD sufferers, who will often turn to the internet for help. Many sufferers, desperate to improve things, end up trialling a variety of drugs and supplements, some of which seem to make symptoms permanently worse. Medication labelling and communicating risk Only Canada and the EU countries (plus post-Brexit Britain) require any warning of persistent sexual side effects on the drug labels. In the rest of the world, there are still no warnings about persistent sexual side effects of SRI antidepressants. Non-English speakers have additional challenges finding information about PSSD, even online. With so many doctors still unaware of the illness, the risks are frequently not being communicated to patients, meaning they can’t possibly give informed consent when taking antidepressants as prescribed. A community abandoned (Image: PSSD Network photo campaign) PSSD sufferers in our communities are absolutely desperate. They feel lied to, mistreated and abandoned. We know from those with lived experience that PSSD often includes complete loss of libido and ability to function sexually, complete emotional dysfunction (anhedonia) and cognitive dysfunction. This frequently results in the breakup of existing romantic relationships and extreme difficulty in forming new ones. PSSD sufferers can find it hard to bond and connect emotionally with others due to emotional dysfunction, and struggle to find any kind of enjoyment in activities that were previously enjoyable. It can cause alienation from friends and family. Some are unable to continue working due to severe cognitive impairments. They often describe it as like being chemically castrated and lobotomised, bearing no resemblance to the experience of suffering clinical depression. Despite PSSD being a result of a prescribed medication, sufferers frequently report being gaslit by doctors, who have typically claimed that their complaints are really symptoms of underlying depression. However, patients prescribed SRI antidepressants for conditions as diverse as irritable bowel syndrome, nerve pain and premenstrual dysphoric disorder have also developed PSSD. These harmful attitudes, and the lack of any known treatment or available support, makes PSSD sufferers feel like there is no hope. Some have ended up taking their lives as a result of PSSD, despite never having been suicidal at any point in their lives previously. Improvements needed Thankfully, further research[8] and an increase in media coverage in the UK,[9] including a recent Panorama documentary, are helping draw attention to this issue and change attitudes. There needs to be further action taken if we are to see long-lasting improvements in the care and treatment of patients with PSSD. I would like to see: Widespread acknowledgement of the condition. Doctors provided with up-to-date information and training (informed by lived experience) on the dangers of antidepressants and how to support patients. Warnings on instructions for the medications updated and prescribing clinicians alerted to ensure patients are adequately informed. An awareness and media campaign launched targeting patients, prescribers and the public. Funding secured for research that helps us gain an understanding of the underlying pathophysiology, identification of a diagnostic biomarker and, eventually, a cure for PSSD. Doctors listening to patients so they can understand how PSSD is a life-changing condition and be able to refer to support services. PSSD is a modern-day tragedy which devastates the lives of sufferers and their families. There are people with this condition who still don’t know that there is a name for it and more of them come out of the woodwork with each new media mention. It is vital that the medical community begins listening and supporting sufferers, and researching a cure before more lives are lost. How you can help I’d encourage you to visit the PSSD Network website to help you understand PSSD and our campaigning work. Clinicians can offer their support by watching this powerful podcast made by PSSD sufferers, discussing the issue with their healthcare organisation and by joining the list of doctors and specialists acknowledging the condition. Researchers can get involved by contacting PSSD network or RxISK. Patients can speak out about PSSD using the initiatives under the ‘take action’ section of the PSSD Network website. Anyone can donate to research via the RxISK website or PSSD Network. References Healy D, Bahrick A, Bak M et al. Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin. Int J Risk Saf Med. 2022;33(1):65-76. Healy D. Post-SSRI sexual dysfunction & other enduring sexual dysfunctions. Cambridge University Press, 2019. Access online 18/09/2023. Healy D, Le Noury J and Mangin D. Enduring sexual dysfunction after treatment with antidepressants, 5α-reductase inhibitors and isotretinoin: 300 cases. Int J Risk Saf Med. 29 (2018) 125–134. PSSD UK. Our stories. Accessed online 18/09/2023. Pharmacovigilance Risk Assessment Committee (PRAC). New product information wording – Extracts from PRAC recommendations on signals. European Medicines Agency. 2019. Lane C. Post-SSRI Sexual Dysfunction Recognized as Medical Condition. Psychology Today. 2019. Accessed online 18/09/2023. Healy D, Bahrick A, Bak M et al. Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin. Int J Risk Saf Med. 2022;33(1):65-76. Ben-Sheetrit J, Hermon Y, Birkenfeld S at el. Estimating the risk of irreversible post-SSRI sexual dysfunction (PSSD) due to serotonergic antidepressants. Ann Gen Psychiatry 22, 15 (2023). 9. RxISK. Media Articles: PSSD & Related Conditions. Accessed online 18/09/2023. Do you have an experience or insights to share? Have you ever experienced adverse and/or long-lasting side effects of a medication you were prescribed that you didn't feel you adequately warned about beforehand? Perhaps you are a prescribing clinician who can share some of the challenges and complexities involved in medication safety? What did you think of the points raised and calls to action in Luke's article? Please comment below (sign up first for free) or get in touch with us at [email protected] to tell us more.- Posted
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News Article
Study finds ChatGPT may be better than a GP at following depression guidelines
Patient Safety Learning posted a news article in News
ChatGPT , the artificial intelligence tool, may be better than a doctor at following recognised treatment standards for depression, and without the gender or social class biases sometimes seen in the physician-patient relationship, a study suggests. The findings were published in Family Medicine and Community Health. The researchers said further work was needed to examine the risks and ethical issues arising from AI’s use. Globally, an estimated 5% of adults have depression, according to the World Health Organization. Many turn first to their GP for help. Recommended treatment should largely be guided by evidence-based clinical guidelines in line with the severity of the depression. ChatGPT has the potential to offer fast, objective, data-based insights that can supplement traditional diagnostic methods as well as providing confidentiality and anonymity, according to researchers from Israel and the UK. Read full story Source: The Guardian, 16 October 2023 -
Content ArticlePublic and patient expectations of treatment influence health behaviours and decision-making. This study aimed to understand how the media has portrayed the therapeutic use of ketamine in psychiatry. It found that ketamine treatment was portrayed in an extremely positive light, with significant contributions of positive testimony from key opinion leaders (e.g. clinicians). Positive research results and ketamine's rapid antidepressant effec were frequently emphasised, with little reference to longer-term safety and efficacy. The study concluded that information pertinent to patient help-seeking and treatment expectations is being communicated through the media and supported by key opinion leaders, although some quotes go well beyond the evidence base. Clinicians should be aware of this and may need to address their patients’ beliefs directly.
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Content ArticleSamuel Howes was 17 when he died by suicide in September 2020. Samuel had ongoing mental health issues including anxiety and depression. This led to his use of drugs and dependency on alcohol, which in turn further worsened his mental health. This blog by his mother Suzanne details her experience of the final day of the inquest into her son's death, which found multiple failings on the part of Child and Adolescent Mental Health Services (CAMHS), social services and the police.
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Content ArticleTechnologies to assist with diabetes treatment and care have evolved rapidly over the past two decades. With each new innovation coming to the market, there are hopes that technologies will solve the numerous, complex issues related to diabetes. However, although it has been demonstrated that overall, these technologies—when available—bring major benefits to people living with diabetes, they do not make the condition disappear. This article in Diabetes Epidemiology and Management discusses the interconnections between technologies and diabetes distress, an often under-acknowledged consequence of the continuous demands of diabetes.
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Content Article
PSSD International (Post-SSRI/SNRI Sexual Dysfunction)
Patient_Safety_Learning posted an article in Medication
PSSD International are an international alliance of people experiencing an iatrogenic (meaning caused by a medication or medical treatment) disorder known commonly as Post-SSRI Sexual Dysfunction or Post SSRI/SNRI Sexual Dysfunction. This potentially permanent disorder arises during or after the use of SSRI (selective serotonin re-uptake inhibitor) and SNRI (Serotonin-norepinephrine re-uptake inhibitor) antidepressants. Though characterized by a reduction or removal of sexual functioning, common symptoms also include emotional blunting, cognitive dysfunction, genital numbness and sleep disruption. The causes of PSSD are poorly understood and there are no known reliable treatments. The disorder can arise from brief exposure to SSRIs or SNRIs and can persist for months, years or indefinitely. This page exists to bring together people suffering from this condition and advocate for recognition, research and greater transparency within psychiatry concerning the risks of antidepressants. -
News ArticleThree in four NHS staff have struggled with a mental health condition in the last year, according to a new poll. A survey of workers carried out by NHS Charities Together over medics’ mental health comes as healthcare leaders were forced to reverse cuts to NHS Practitioner Health, a service for medics. A backlash from NHS staff over the proposed cuts forced health secretary Victoria Atkins to intervene. In the new poll of more than 1,000 NHS staff, 76% said they have experienced a health condition in the last year with 52% reporting anxiety, 51% reporting low mood, while 42% of respondents also said they’d experienced exhaustion. Meanwhile, the most recent NHS data shows the most common reasons for staff sickness are anxiety, stress, depression or other psychiatric conditions, with more than 586,600 working days lost over this in November 2023. NHS Practitioner Health began as a mental health service for GPs but has since expanded to other specialities following funding from NHS England. However, last week the provider announced this national funding was due to end, so its service would be reduced. NHS England said the decision was so it could review the services available for all NHS staff. However, it was forced to u-turn on the decision and agreed to provide funding for an additional year. Read full story Source: The Independent, 17 April 2024
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News ArticleWomen who experience depression during pregnancy or in the year after giving birth are at a higher risk of suicide and attempting suicide, researchers have warned. The British Medical Journal study warned that women who develop perinatal depression are twice as likely to die compared to those who don’t experience depression. Suicide was the leading cause of death for women in the UK in 2022 between six weeks and one year after birth, while deaths from psychiatric causes accounted for almost 40 per cent of maternal deaths overall, according to a Perinatal Mortality Surveillance report. Last year an analysis by Labour revealed 30,000 women who were pregnant were on waiting lists for specialist mental health support. The number of women waiting rose by 40 per cent between August 2022 and March 2023. The most recent NHS data shows in September 2023, 61,000 women accessed perinatal mental health services. For 2023-24, the health service must hit a target to have 66,000 women accessing care. In August 2023, the Royal College of Midwives published a research warning half of anxiety and depression cases among new and expectant mothers were being missed amid NHS staff shortages in maternity care. Read full story Source: The Independent, 11 January 2024
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EventuntilThe past couple of years have placed enormous pressures on the mental health and wellbeing of the population. The current cost of living crisis is having a significant impact on people’s state of mind with millions feeling stressed about rising food and energy prices as we head into winter. Delivered by Maximus, the Access to Work Mental Health Support Service, funded by the Department for Work and Pensions, can help employees and employers during this difficult time with their mental health. Completely confidential, the service is available at no charge to anyone with depression, anxiety, stress or other mental health issues, affecting their work. Remploy already helped thousands of people across England, Scotland and Wales, to remain in, or return to work, so our expertise speaks for itself. Led by Bethany Kimberley and Kaylena Mushen, this webinar will introduce the service, covering facts and statistics around mental health. It also looks at the service’s aims, eligibility criteria and referral process, plus what support and workplace adjustments are available at home, in an office, or other place of work. The session will also introduce and additional service, offering virtual one-to-one support appointments for employees. Learn how to gain access to fully-funded expert advice and support for up to nine months, which includes – A well being plan to help employees stay in, or attend work. Ideas for suitable workplace adjustments. Tailored coping strategies. Facts and statistics around mental health. Aims of the service. Details of the eligibility criteria and referral process. The support and interventions available. Register
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News Article
Experts call for fewer antidepressants to be prescribed in UK
Patient_Safety_Learning posted a news article in News
Open letter to government from experts and politicians says rising usage ‘is a clear example of over-medicalisation’. Medical experts and politicians have called for the amount of antidepressants being prescribed to people across the UK to be reduced in an open letter to the government. The letter coincides with the launch of the all-party parliamentary group Beyond Pills, which aims to reduce what it calls the UK healthcare system’s over-reliance on prescription medication. Read full story Source: Guardian, 5 December 2023
