Management of Illness and Psychaitric Medication:
A recent Public Health England (PHE) report found that over the last 10 years, more people are being prescribed more psychiatric medicines and often for longer. The prescribing of some of these medicines like benzodiazepines and opioids had fallen recently but others such as gabapentin, pregabalin and antidepressants had increased and for longer in duration. Therefore more people are at risk of becoming addicted to them or having problems when they stop using them.
However for the moment at least we have all stopped and are focusing on our health and the health of our fellow human beings. Our lives and our health seem to really matter during this epidemic. How will that change us and what we accept from our society and our healthcare providers in the future?
A large epidemic disease such as we are seeing now highlights cracks in our healthcare system as well as our psychiatric healthcare system. The World Health Organization (WHO) (2015) lists the following as key reasons for premature death among people with severe mental disorders. Note that they are almost identical to established risk factors associated with COVID-19 disease complications and mortality:
cardiovascular disease
respiratory and infectious diseases
diabetes
hypertension
weight gain and obesity
It is hard to ignore the fact that the listed reasons for premature death among people with severe mental illness are at least partly related to psychotropic medication use. This problem is not only affecting those with “severe” mental illness, but also the larger population that is being prescribed antidepressant (i.e., SSRIs and SNRIs) medications also known to cause hypertension (e.g., venflaxine or Effexor) and weight gain (almost all SSRIs such as Paroxetine or Paxil, Sertraline or Zoloft, and Fluoxetine or Prozac), and which may contribute, if not lead, to development of obesity, one of the risk factors associated with COVID-19 disease complications and mortality. Sedation is another common side-effect of psychotropic medication, and while it’s often overlooked as a “milder” or more subtle side-effect, it may be extremely disruptive, as it leads to less activity, which, in turn, may contribute to weight gain and eventual development of metabolic syndrome.
New guidance from BACP to therapists provides information to help clients struggling with side effects and withdrawal issues which have resulted from an increase in the prescription of psychiatric drugs. In particular, the Guidance for Psychological Therapists: Enabling conversations with clients taking or withdrawing from prescribed psychiatric drugs has been published following Public Health England’s acknowledgement of the growing problem of prescribed drug dependency and withdrawal.
The guidance is endorsed by the BACP as well as British Psychological Society, UK Council for Psychotherapy and National Counselling Society, which represent more than 80,000 UK counsellors, psychotherapists and psychologists. This means clients will be better supported to understand the difference between emotional distress, relapse and the side and withdrawal effects of psychiatric drugs.
Most psychological therapists now work with clients who have taken, or are taking, psychiatric drugs. PHE and NICE have finally acknowledged that antidepressant withdrawal can be severe and protracted – lasting for many weeks, and in some cases, months and beyond. Many such reactions have been misread as relapse by doctors, with drugs being reinstated, and little or no withdrawal support offered. This guidance indicates how therapists can identify withdrawal and support their clients. It is reassuring to know that our national therapeutic organisations, through this guidance, are taking their share of responsibility for addressing this nationwide problem.
If you have experienced or are currently experiencing problems that possibly can be attributed to the drugs you are taking, always to ask to your GP first. If you wish to explore further those effects and how they be affecting your personality and personal life please contact me for a consultation.
If you or your loved one see a doctor in the future and she/he tells you that a medication they will prescribe to you may help alleviate some of your symptoms, but will also likely contribute to weight gain (and whole host of other side-effects) will you accept that as a reasonable exchange? Are these our values? Numb the symptoms while we quietly acquiesce to deterioration of our physical health?
If you are affected by any of the points raised in this article, please do not hesitate to contact me for a free consultation to discuss your concerns and a possible way forward.
