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Views And Reviews Provocations

Doctors shouldn’t reveal so much

BMJ 2018; 361 doi: (Published 11 June 2018) Cite this as: BMJ 2018;361:k2495

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Re: Doctors shouldn’t reveal so much

As a member of the online prescribed dependent and harmed community and an active campaigner for recognition of the devastating effects of prescribed drugs of dependence, I would have to disagree with Daniel Sokol. Patients have battled long and hard to have their concerns about these drugs taken seriously in the consulting room and for many it has been to no avail. This has resulted in immense pain and suffering, physical, emotional and psychological. Consequently, a large online community of patients has been formed and patients have become far more expert in the subject of benzodiazepine and antidepressant withdrawal than most prescribing doctors simply because they have been forced to do their own research on this subject. We have indeed created a parallel universe because the medical profession has failed us so terribly and mutual understanding is extremely difficult to achieve.

The BMA has taken our concerns seriously (1) and now Public Health England is conducting a review (2). The Scottish Government is also planning a parallel review after pressure from campaigners and a petition which achieved an unprecedented number of submissions.(3) We have met resistance from RCPsych and largely silence from the RCGP. Patients have tried extremely hard to engage via Twitter with these bodies and their representatives but it has been largely fruitless. This has been completely counter-productive, fuelling greater despair and only making campaigners more determined to intensify their demands. Indeed, what we now seek is a public inquiry into the issues of drug dependence, particularly benzodiazepines and antidepressants. Meantime a formal complaint to RCPsych remains unresolved several months after it was first lodged.(4) This has caused further pain and distress to patients.

In Scotland only one GP and one psychiatrist has spoken publicly in support of the Scottish petition and thereby the wider patient community, Dr Des Spence, GP (4) and Dr Peter Gordon, psychiatrist who regularly blogs on our behalf. Both have been very honest about the issues at play here. Dr Gordon was recently interviewed by a member of the patient community, James Moore. (5) We also have the support of Dr Terry Lynch, GP in Ireland and of course Dr David Healy, psychiatrist and international expert on SSRIs in Wales. Each of these doctors has sent supporting statements to the Scottish Public Petitions Committee. (3) Dr Healy and campaigners appeared together on a Talk Radio Europe show only recently. (6)

We have the utmost respect for these doctors for their openness, honesty and integrity whilst we only have contempt for those who have tried to silence our voices and who remain silent themselves. Dr Peter Gordon has talked about his own experiences and difficulties with an SSRI antidepressant. We think he is extremely brave to have done so. I am sure there are many more who could do the same. The ongoing battle between patients and the medical establishment around antidepressants has come about entirely because doctors have been less than honest with patients about the possible benefits and risks of these drugs. Perhaps this is to maintain the illusion that they can provide an effective remedy or may simply be a desire to help. Or they have simply been misled by the marketing tactics of the pharmaceutical industry.

The ongoing battle for recognition of patient suffering, the silence of most doctors and the lack of communication from the medical establishment have been the biggest obstacles to a successful resolution. It is time for greater openness, not less. The respect for doctors is on the wane because patients have so much more access to information than in the past and know how very fallible doctors indeed are. We have no desire to see them as somehow separate and superior to the rest of us, we do however expect them to be competent at the job they do. Working conditions are crucial as are training and education. If GPs do not have enough time to discuss the adverse effects of the drugs they prescribe, then there can be no informed consent and it seems lack of time, inadequate guidelines and insufficient education and training in prescribed drug dependence and withdrawal are crucial factors here. I hope many doctors will continue to speak out, patients will appreciate it.







Competing interests: No competing interests

15 June 2018
Fiona H French
Member of online prescribed dependent and withdrawal community
Aberdeen, Scotland