To want to sue my local surgery?

[beeblabs]

TRIGGER WARNING: If you’re taking Zoloft/Sertraline and it’s working for you, best skip this thread.

A few weeks ago I started having dizzy spells and mild panic attacks. I also noticed my thoughts were getting racier (if that makes sense). I’ve suffered from an overactive thyroid and low blood sugar in the past, so I rang the Dr and asked for a blood test! They told me they couldn’t see me face-to-face due to Covid but asked if I wanted something for my anxiety and prescribed me 50mg of Sertraline.

From the first day of taking these tablets, I couldn’t eat or sleep! I’d lie in bed at night breaking out in cold sweats and twitching involuntarily. I rang the GP and asked them to change my meds, but they told me the benefits will outweigh the side-effects eventually and prescribed me Diazepam! By week 2, I felt like I was tripping on LSD and became utterly delusional (convinced I needed to take my life to save my son from the “evil presence” in the house!). I spent a few days in a psychiatric hospital before being discharged (when I stopped taking Zoloft, the delusions stopped).

Now my mother is talking about suing the local surgery. My husband said that I had a very rare reaction to a popular SSRI and despite my experience, they do help a lot of people.

I can’t help but feel that these mind altering drugs are prescribed too easily and there should be further tests before writing a prescription (especially over the phone, by a nurse practitioner!). I’m currently on a new antidepressant called Mirtazipine and I’m still taking Diazepam for my nerves.

Has anyone else had a similar experience with SSRIs? Or is it all positive?

Not sure why you would sue your GP and for what?
Common side effects. I'm currently on my third medication test for my spinal issues, the side effects are really bad - not thinking about suing the specialist any time soon. Different people react to medications in a different way.
Please talk to your GP as soon as you realise you're experiencing bad side effects of a medication. Read the leaflet so you know what to expect. Get better.

With any medication if you are having dangerous side affects you should stop taking the medication.

@YellowPurple a nurse can prescribe as long as they have completed a prescribing course. Besides this was a nurse practitioner, they generally have masters degrees and other further study and don't need as doctor to oversee their practice.

Very similar happened to me. I ended up attempting suicide and lost my children (I now have one in my life and it was one hell of a battle). It completely destroyed my life.

SDTGisAnEvilWolefGenius
Because it is apparently a known side effect and that these kind of drugs have a known issue on people with learning difficulties and bi polar which my son had already been diagnosed with. Unfortunately the psych did not tell me this.

You’ve unfortunately had contraindications with Sertraline. How frightening and upset. Hope you are making a recovery and are not adversely affected

We all have individual physiology and reactions that are unique to us, so whilst a majority of individuals will experience none or minimal symptoms you unfortunately experienced significant side effects

Symptoms you experienced They will be listed as potential side effects
If you haven't do so already do Let GP know so they can report via Medicines and Healthcare products Regulatory Agency (MHRA) yellow card system

It need to be flagged on your notes that you had a severe reaction to setraline

In terms of suing the gp, I cannot see what the basis of the claim is however I appreciate you’ve had a ghastly experience.

What difference would a face to face consultation have made, for those who think the HCP should have done one? GPs (or prescribing nurse practitioners) don't take bloods - they would write a referral for blood tests which would be taken to a blood test service, generally. And SSRIs are prescribed based on a patient's self-report of mental health or psychiatric symptoms, which are the same over the phone as they are in person.

Given the potential for GP surgeries to become a major node of infection, of course it is right for them to do all consultations which can be dealt with by phone or virtually via this method.

It can happen. My dad was given naproxen which people think of as fairly innocuous. He had itchy palms and I told him to go to a&e
Then he had an anaphylactic reaction. He's fine with ibuprofen

Don't sue them, but write a detailed letter of complaint so that the doctors can learn from it.

Two of my best friends are psychiatrists and they despair of GPs prescribing ADs and anti-psychotics like smarties without much mental health training.

Their general advice is don't let GPs prescribe you such drugs, insist on an appointment with a psychiatrist - they know the drugs well and will monitor you closely.

The legal case to answer is for GP’s that prescribe medication without fully discussing the side effects, complications and prescribing these types of drugs without even seeing the OP in person.
That said I don’t understand why you would jump to suing them. Finances have nothing to do with it. Surely a formal complaint to ensure this does not happen to someone else is what you should be aiming for.

@TatianaBis

Don't sue them, but write a detailed letter of complaint so that the doctors can learn from it.

Two of my best friends are psychiatrists and they despair of GPs prescribing ADs and anti-psychotics like smarties without much mental health training.

Their general advice is don't let GPs prescribe you such drugs, insist on an appointment with a psychiatrist - they know the drugs well and will monitor you closely.

I find it very hard to believe that NHS psychiatry services could cope at all if GPs referred every person reporting depression, anxiety, or other mental health struggles or symptoms to them. The waiting lists would be colossal, so most people with anything other than severe symptoms or complex comorbidities would get their referrals rejected and simply go without help. In the meantime everybody would wait a lot longer to get medication at all.

We definitely don't have a perfect medical symptom and there's a perfectly reasonable case to be made that GPs fall back on prescribing for what are largely social problems or situational reactions that would benefit more from counselling support/social services intervention/a differently structured society. But I really don't think this is the answer, and in the meantime GPs are the ones with these issues washing up on their doorsteps day in and day out and have to help people as best they can with the tools they have.

*perfect medical SYSTEM.

@beeblabs

TRIGGER WARNING: If you’re taking Zoloft/Sertraline and it’s working for you, best skip this thread.

A few weeks ago I started having dizzy spells and mild panic attacks. I also noticed my thoughts were getting racier (if that makes sense). I’ve suffered from an overactive thyroid and low blood sugar in the past, so I rang the Dr and asked for a blood test! They told me they couldn’t see me face-to-face due to Covid but asked if I wanted something for my anxiety and prescribed me 50mg of Sertraline.

From the first day of taking these tablets, I couldn’t eat or sleep! I’d lie in bed at night breaking out in cold sweats and twitching involuntarily. I rang the GP and asked them to change my meds, but they told me the benefits will outweigh the side-effects eventually and prescribed me Diazepam! By week 2, I felt like I was tripping on LSD and became utterly delusional (convinced I needed to take my life to save my son from the “evil presence” in the house!). I spent a few days in a psychiatric hospital before being discharged (when I stopped taking Zoloft, the delusions stopped).

Now my mother is talking about suing the local surgery. My husband said that I had a very rare reaction to a popular SSRI and despite my experience, they do help a lot of people.

I can’t help but feel that these mind altering drugs are prescribed too easily and there should be further tests before writing a prescription (especially over the phone, by a nurse practitioner!). I’m currently on a new antidepressant called Mirtazipine and I’m still taking Diazepam for my nerves.

Has anyone else had a similar experience with SSRIs? Or is it all positive?

Hi OP, are you on treatment for your OAT or low blood sugar? Are they doing further investigations for your new symptoms or just giving out drugs to mask them? When did you last have a blood test?

@ScarfaceCwaw

What difference would a face to face consultation have made, for those who think the HCP should have done one? GPs (or prescribing nurse practitioners) don't take bloods - they would write a referral for blood tests which would be taken to a blood test service, generally. And SSRIs are prescribed based on a patient's self-report of mental health or psychiatric symptoms, which are the same over the phone as they are in person.

Given the potential for GP surgeries to become a major node of infection, of course it is right for them to do all consultations which can be dealt with by phone or virtually via this method.

Possibly a lot. They could have taken her blood pressure, they could have written a referral for blood tests (which admittedly they could have also done over the phone but didnt), they could have assesed her overall, they could have talked to her about the side effects of Sertraline and reccomended that she break the tablets in half for the first few days (again I am sure they could have done this over the phone but they didnt). They could have picked up an impression of her mental state/how she presents and noticed the difference to the second time when she was already taking sertraline. I am not against virtual consultations at all - but they shouldnt be replacing in person consultations where those are needed, especially when prescribing drugs which can have quite significant effects.

@TatianaBis

Don't sue them, but write a detailed letter of complaint so that the doctors can learn from it.

Two of my best friends are psychiatrists and they despair of GPs prescribing ADs and anti-psychotics like smarties without much mental health training.

Their general advice is don't let GPs prescribe you such drugs, insist on an appointment with a psychiatrist - they know the drugs well and will monitor you closely.

GPs receive a substantial payment (I think £175 but I could be wrong) for treating any condition on the QOF (quality outcomes framework) including depression. I agree that depression could well be a symptom of many other conditions that require further investigation/treatment but while it is so profitable for GP's to treat, I'm afraid the patient will not get any further than that.

I'd be really careful with the diazepam tbh, most people shouldn't be prescribed them for more than 2 weeks. It is extremely difficult to come off them. Sounds like a bad reaction to the Sertraline but that is very rare and just one of those things that can happen. If I were you, personally, I'd move past the Sertraline problem and be trying to safely get off the diazepam...

@Noodella18

You know Mirtazipine is an SSRI too? So you're considering suing the practice for prescribing you one SSRI, whilst taking another that they have prescribed? If you think they acted so shockingly, why are you now taking another SSRI that they prescribed, unless you think it might help?

Nope, it's not an SSRI.

We definitely don't have a perfect medical symptom and there's a perfectly reasonable case to be made that GPs fall back on prescribing for what are largely social problems or situational reactions that would benefit more from counselling support/social services intervention/a differently structured society. But I really don't think this is the answer, and in the meantime GPs are the ones with these issues washing up on their doorsteps day in and day out and have to help people as best they can with the tools they have

Ok in principle but not if GPs are prescribing drugs that causing iatrogenic illness.

The OP is a case in point. She ended up in a psychiatric hospital, which would have cost the NHS much more and than a single psychiatrist appt at the start.

A friend of mine's mother was prescribed an anti-psychotic for anxiety by her GP which lowered her dopamine levels and now she has a pseudo-Parkinson's movement disorder.

I was once given a drug for vertigo which, after 3 doses, made me lose coordination and stagger around like I was drunk. That turned out to be an anti-psychotic which is also used for vertigo. Luckily the GP I booked to see had taken the same medication and it had the same effect on him. He said he didn't know why it was used freely for vertigo as it had quite serious side effects.

The OP is a case in point. She ended up in a psychiatric hospital, which would have cost the NHS much more and than a single psychiatrist appt at the start.

How do you pick out in advance the one patient in X hundred or thousand who has a severe adverse reaction to first line treatment for "garden variety" depression or anxiety, though? Without referring everyone for an initial psychiatric appointment, which we are very, very far from having the resources to do?

I'm not disagreeing with you that there are problems, I just don't think this is a viable solution and relies too much on things which can only be known afterwards. And first line treatment (and referral protocols) for most conditions are established and not set by the individual GP. Sertraline is the standard first reach SSRI for a patient reporting depression or anxiety unless there are specific contraindications or the patient already has negative history etc. To change that would not involve focusing on OP's specific GP.

@beeblabs

What did the hospital actually diagnose you with?

x

What a kind, supportive bunch you all are on here.

Not.

OP - I understand exactly where you're coming from and I think that they were lacking in their duty of care towards you. Despite knowing about your thyroid issues & blood sugar fluctuations, they didn't give you blood tests to rule anything else out first, they just threw some pills at you for 'anxiety' - the catch-all answer for every female patient's problem as far as many GP's are concerned.

As for not being able to see you due to Covid, that's nonsense. They can and do see patients face-to-face. I'm seeing my GP in a week or so, for among other things, a blood test.

TRIGGER WARNING: Dumbass thread

Fixed for you.

How do you pick out in advance the one patient in X hundred or thousand who has a severe adverse reaction to first line treatment for "garden variety" depression or anxiety, though? Without referring everyone for an initial psychiatric appointment, which we are very, very far from having the resources to do?

If there are not resources to monitor responsibly the drugs being prescribed then prescribe them less frequently.

A couple of major meta-analyses in the UK and the US found that ADs were no better than placebo for the majority of cases other than in the most severe depression.

Why are you more interested in making money than getting help?

OP , I do think your GP practice should have seen you for a blood test. These are still happening and I would be unimpressed if a GP/practice refused this.
I'm sorry to hear you had a bad experience with Sertraline. The only thing that should have happened, if it didn't, is that you should have been "safety-netted". This is when, in your situation, a prescribed medication is discussed, ie, why it's being suggested, how long you might expect before seeing a benefit, possible side effects and what to do in the event of, and lastly, a follow up telephone consultation in 2 weeks to see how you're getting on with it, plus the invitation to contact them sooner if you are not getting on with it.
This is responsible prescribing and care.
A nurse practitioner indeed does prescribe and often will prescribe with more thought and consideration than a GP.
Glad to hear you're better on Mitirzipine