what are nhs policies and my rights?

[Nik]

As tragic as thalidomide was, it had not been tested for teratogenicity in humans.

And how exactly would you do this ?? And besides you can't reproduce human gestation in animal models. Agomelatine is obviously going to go throguh clinical testing in humans because it is an anti-depressant ! Prescribing is never a simple, black and white process - antidepressants generally have an unfavourable record in adolescents, so should you not be relieved that your GP is "erring on the side of caution" by not prescribing it ?

[Ashley]

And how exactly would you do this ?? And besides you can't reproduce human gestation in animal models. Agomelatine is obviously going to go throguh clinical testing in humans because it is an anti-depressant !

You seem to misunderstand me. My point is that that you can't compare the thalidomide situation to agomelatine because agomelatine has been tested in the population group that I am a part of for a number of years, thus the risk of prescribing me agomelatine is incomparable to that of the risk of prescribing thalidomide to pregnant women in 1957, a straw man if you will. Of course there are potential unknown long term risks but people haven't died en masse after taking it for a couple of years, it's about risk balance in the end.

Prescribing is never a simple, black and white process - antidepressants generally have an unfavourable record in adolescents, so should you not be relieved that your GP is "erring on the side of caution" by not prescribing it ?

The sri's have intolerable side effects ie, sexual dysfunction, thus necessitating other medication. I personally think that trying a newer medication is preferable to the patient receiving no treatment at all or self medicating, my psychiatrist seems to agree as she is willing to prescribe me it.

[Nik]

Private psychiatrist ? I bet they would be really happy to prescribe a new expensive drug . If you're options are exhausted then other things will need to be considered, but just because a new medicine is available does not mean it should automatically be prescribed. Clinical trials cannot test for long term safety and are not robust enough to determine the place of a new drug in therapy - i'd agree that some doctors would want to consider a new drug if other things have been tried but it is much better (and safer) to let those experienced in that field to start the ball rolling before it is routinely prescribed in primary care.

[Ashley]

Both the NHS and private consultants were willing to prescribe it, at least at some point. I agree that it should be left until other medications have been tried but he wouldn't prescribe me other well established anxiolytics/antidepressants like bupropion, tianeptine or buspirone either so I was running out of options, I actually had to go behind his back to get a referral.

[Nik]

Tianeptine ? Never heard of it. You seem committed to dealing with the issues you face, which is commendable but don't forget a patient-doctor relationship is two-way - your surgery is not like a supermarket where you can pick what you want prescribed (your GP is, or should be, looking out for you). Presumably with all these drugs mentioned it might be more worthwhile him referring you to a consultant psychiatrist.

[johnep]

Munchausen syndrome?
johnep

[Nik]

Someone's been watching House