what are nhs policies and my rights?

[Ihavequestionsplease]

What are the nhs guidelines on augmentating drugs like ssri with buspar to counteract sexual dysfunction side effects.? I spoke to doctor today about the sexual side effects from citalopram effecting my relationship in a negative way. but i did not want to stop citalopram as it is good for my anxiety. therefore want to take a antidote drug. the doctor did not know what to do or say when i said buspar or viagra. is it because they are not allowed to precribe it or that they do not know about this area? do gps commonly precribe citalopram and buspar together?

The problem with my surgery is that when you make an appointment they give you any doctor. as you cant catch the same one in as they have partner surgerys.

in addition is stablon available? have tried mirtazapine

[bleepholder]

it is not that they are not allowed to prescribe it. Often a drug can only be used for certain indications as dictated by the mAnufacturer. It is possible that the use of viagra in yourself is not licensed. So if the Dr proceeded to give it to you, it would be outside of the terms with what the manufactucrers say it can be used for. This could then have a knock on effect, so if something happened to you because of the drug, and you took pfizer (the manufacturer) to court, you wouldn't have a leg to stand on partly because

a) i'm sure pfizers legal team are pretty dam good
b) pfizer will turn round and say well we said it couldn't be used for that indication, so its your own fault for not folowing what we have stated in our license

so the dr would be taking full responsibility for prescribing the drug to you..and he may not want to do that!!

Also if memory serves me correctly, i think you can only get viagra on the NHS for certain conditions anyway..otherwsie pay for it privately..i'm sure some dr out there wil happily take a large fee off you and see you privately?!?!

[Ashley]

My NHS psychiatrist was more than happy to prescribe buspirone with citalopram, the antidepressant Vilazodone actually combines both mechanisms of action. Try asking for a referral to a psychiatrist, in my experience GP's are poorly educated about psychiatric drugs and thus are unwilling to prescribe anything other than the most popular medications even if they are licensed for that indication.

[bleepholder]

do you blame them for not prescribing a drug they know little about!!! if anything went wrong with side effects or anything, you would be the first one running back to your GP threatening all sorts of legal action against them...i know i would!!!

Luckily pharmacy has not yet broken me!!

[Ashley]

What action can you take against a doctor who has prescribed a medication approved for that condition eg, agomelatine? The reason my doctor didn't want to prescribe it was because "it was new", which kind of defeats the point of scientists inventing new and improved drugs. We'd still be using barbiturates if all doctors had that attitude.

[johnep]

Traditionally, Drs in UK are conservative in using new medicines. It was the conservatism of the FDA in the US that is credited with saving them from the thalidomide disaster.
johnep

[Nik]

You have to remember that very often the only source of info a doctor has to rely upon when a new drug is released is that from the pharmaceutical industry reps, probably best termed "selective truths". Clinical trials results can be manipulated to make the drug look good and clearly reps are never going to talk about the disadvantages of a new drug, not least its price compared to established products. Although a minority of doctors will take on a new drug, balancing risks and benefits, newly released drugs are best left to secondary care doctors and consultants.

[johnep]

Yes, when I was a rep, I would concentrate on the consultants as their endorsing was far better than anything I could do.
johnep

[bleepholder]

The reason my doctor didn't want to prescribe it was because "it was new",.

i guess the thalidomide catastrophe is the perfect example!!! any new drug could ahve the potential to do the same, and i don't think anyone would want that on their hands??

[Ashley]

As tragic as thalidomide was, it had not been tested for teratogenicity in humans, agomelatine on the other hand has had years of clinical testing in adult males, which somewhat lessens the relevance. And while I could understand such thinking, this doctor had previously suggested quetiapine and had prescribed me metoclopramide despite the BNF strongly recommending against it in those under 20, which is not exactly erring on the side of caution considering the side effect profiles of those drugs.