Discontinuation of two different depot antipsychotics

Hole Ousia

This week, UK medical professionals were alerted of the permanent discontinuation of the supply of MODECATE (fluphenazine decanoate) injection by the end of 2018:

In October 2014, UK medical professionals were informed of permanent discontinuation of PIPORTIL Depot (pipothiazine palmitate):

Advice is given with these notifications of alternative depot medications. In changing patients from one depot to another I have found that there can be severe deterioration in mental health and that this can endure far beyond the transition phase.

My concern is that patients may be started on long-term medication without realising (being informed) that the medication they are taking may not be available at a future time and that this may have consequences for them. We must also consider that depot antipsychotics can be given without consent if certain criteria of mental health legislation are met.

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‘Informed consent is a fundamental principle underlying all healthcare’

Hole Ousia

A recent Independent Review for NHS Scotland stated that: “Informed consent is a fundamental principle underlying all healthcare”

The Cabinet Secretary for Health and Sport, Shona Robisonstated to the Scottish Parliament (17 March 2017): “Informed consent and shared decision making are expected prior to any procedure being carried out.”

On the 20th April 2017, I wrote to Healthcare Improvement Scotland 
about Patient consent in NHS Scotland:

I have just completed my annual Appraisal which is a General Medical Council requirement as part of 5 yearly Revalidation. As part of this I was informed by my Appraiser that I must comply with all the LearnPro modules which I have now done.

The following screenshot comes from the NHS Lothian mandatory LearnPro module on Capacity and Consent:

I apologise as the text is small, so I have reproduced verbatim what it states to me as an NHS Lothian employee:

“Consent is…

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A tall, slightly stooping, gaunt figure

Hole Ousia

Dr Robert Hutchison died in 1960, seven years before I was born. However, his appearance as depicted in the portrait (above) reminds me of Roald Dahl. One of his closest friends and colleagues described him in this way:

Dr Robert Hutchison, like Roald Dahl, is recalled for his wonderful way with language. One of my favourite quotes – about the profession in which we have shared across centuries – is by Hutchison. I still find it extraordinary that he wrote this in 1897:

Robert Hutchison was born at Carlowrie Castle, Kirkliston, in 1871.

In the early 1990s I lived with Sian in Kirkliston, at Humbie farm cottages. I was then studying Landscape Architecture at the University of Aberdeen and Sian was completing her GP training in Livingston:

In 1893 Robert Hutchison graduated in Medicine and Surgery at the University of Edinburgh. Like me, he was a very young medical student, but unlike me he was far…

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Submission on PE01651: Prescribed drug dependence and withdrawal

Hole Ousia

As an NHS Psychiatrist who has worked in Scotland as a Consultant for over 15 years I want to offer my full support for this petition.

Recently at a Cross Party Group meeting held at the Scottish Parliament it was stated that “depression is under-recognised across all age groups” and that “maintenance treatment has a good risk-benefit ratio.” This was said without acknowledging that these statements cannot be made with absolute certainty.

I have found that my profession in Scotland seems to resist evidence of experience and at the same time prioritise the opinions of experts.

Potential for Expert Bias (one):
There is evidence that establishes that senior Scottish psychiatrists, who have provided expert input to Scottish Government strategies, and who have been involved in developing National prescribing guidelines, have had significant financially-based vested interests.

Potential for Expert Bias (two):
It is worth perhaps pointing out that Scottish Psychiatry…

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Inconvenient truths about antipsychotics should not be swept under the carpet: a response to Goff et al

Joanna Moncrieff

In my book The Bitterest Pills, I wrote of how many psychiatrists simply do not want to face up to the harms their treatments can produce. This is illustrated by the way the psychiatric establishment tried to avoid the implications of tardive dyskinesia, by suggesting it was a symptom of ‘schizophrenia,’ and ignoring the evidence that tardive dyskinesia involves cognitive impairment. Similarly, when it became obvious that some of the second generation antipsychotics caused massive weight gain and metabolic disturbance, mainstream psychiatric journals published articles suggesting that diabetes was linked with schizophrenia as well.

The suggestion that antipsychotics reduce brain volume is not new. Psychiatrist, Peter Breggin, made this claim over thirty years ago (1), but was dismissed as a crank. Over the last 10 years, however, the evidence has become irrefutable. Some leading members of the psychiatric establishment, like the UK’s Robin Murray, have even…

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‘The Professor, had in fact, had not been a professor’

Hole Ousia

In her novel ‘The Pure Gold Baby’ Margaret Drabble leaves us questioning who is the  “Professor”?

It is a good question.

The professors that I seek to follow are those with scientific and philosophical breadth. Professors who do their best to consider life between microscope and telescope. Professors that do their best to consider how time shapes us uniquely.

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