HearUs Open Forum meeting – Tuesday 6th May 2014
Posted: May 27, 2014 Filed under: Audio / video / reflections / talks, Croydon | Tags: Croydon VA, Diet and healthy eating, HearUs, Institute of Psychiatry, Medication, Mind in Croydon, Untapped Theatre Company Leave a commentMatthew Mckenzie attended the HearUs Open Forum meeting on Tuesday 6th May 2014.
This month’s guest presenters were Peter from Mind in Croydon, Sarah Mines from the Untapped Theatre Company, Dr Constantina Papoulias from the Institute of Psychiatry, Psychology, and Neuroscience, KCL , Georgina Boon, Dr Joseph Rodrigues and Dietitian specialist Deborah Thompson.
Matthew has done a great video blog about this event. It includes a lot of information about medication and diet – and much more….
You can also view photos of the event here: https://www.facebook.com/media/set/?set=a.722541431121959.1073741888.476820022360769&type=3
Antidepressant citalopram heart safety warning
Posted: April 17, 2014 Filed under: News | Tags: Antidepressant citalopram heart safety warning, antidepressant drugs, anxiety, citalopram (Cipramil), depressive disorder, doctors, escitalopram (Cipralex), European Medicines Agency (EMA), GPs, Medication, Medicines and Healthcare products Regulatory Agency (MHRA), Obsessive Compulsive Disorder, panic disorder, reports, The Daily Telegraph Leave a comment“Safety warning over Britain’s most common antidepressant,” The Daily Telegraph reports. “Doctors have been told to lower the maximum dose” for all patients, the Telegraph continues.
The news is based on drug safety advice issued in October last year by the UK’s drug regulator about the antidepressant drugs citalopram (Cipramil) and escitalopram (Cipralex). The revised advice for doctors followed findings from a study that found both drugs were associated with abnormalities known to increase risks to the heart. Importantly, it found that the risk increased at higher doses. This news was ignored at the time but has surfaced today with the Telegraph reporting criticism of the drug regulator for “failing to make a public announcement”.
People who have been prescribed citalopram and escitalopram should not be alarmed into stopping taking their medication. If you are concerned about the dosage of your depression medication you should discuss it with your GP.
What is citalopram and what is it used for?
Citalopram is a selective serotonin reuptake inhibitor (SSRI), a type of antidepressant drug commonly used to treat people with major depressive disorder, anxiety and obsessive compulsive disorder. It is more commonly known by its brand name in the UK, Cipramil, and is manufactured by the pharmaceutical company Lundbeck.
A variation of citalopram (escitalopram – brand name Cipralex), also made by Lundbeck, was included in the drug safety update. It is used to treat major depressive episodes, panic disorder with or without agoraphobia, anxiety disorders and obsessive compulsive disorder.
What is the safety advice?
The safety advice for citalopram and escitalopram was issued to healthcare professionals by the UK’s Medicines and Healthcare products Regulatory Agency (MHRA). Included in the safety warning were updated recommendations about new maximum daily dose restrictions, as well as warnings and contraindications (which indicate when it is not advisable to prescribe the drug).
The advice followed a study carried out by the l. The randomised controlled trial (RCT)found that citalopram and escitalopram were associated with increased electrical abnormalities of the heart (known as QT interval prolongation) and that these abnormalities increased with increasing doses (known as dose-dependency).
In the RCT, electrocardiogram measurements showed that when a 60mg dose of citalopram was given, it took twice as long for the heart to recover as when a 20mg dose was given. For a 60mg dose it took the heart 16.7 milliseconds to recover (90%confidence interval 15.0 to 18.4) and for a 20mg dose it took the heart 7.5 milliseconds to recover (90% confidence interval 5.9 to 9.1).
Importantly, the risks of both drugs on QT interval prolongation have been known for some time and have been included in the product information of both drugs. These study findings further defined this risk and have clarified that the drug’s effects on QT interval are dose-dependent. The safety update clarifies this dose-dependent effect to ensure that doctors, who should already be aware of the risk, can prescribe safely and appropriately.
The new recommended daily doses for citalopram are:
- 40mg daily for adults (previously 60mg)
- 20mg daily for patients older than 65 years (previously 40mg)
- 20mg daily for those with poor liver function (previously 30mg)
For escitalopram, the maximum daily dose for patients older than 65 years is now 10mg. Other recommended doses remain unchanged. Further studies have not shown an added benefit at doses higher than 40mg.
The MHRA also recommends that citalopram and escitalopram should not be used in patients with known QT interval prolongation or in combination with other medicines known to prolong the QT interval. For example, prolonged QT interval is also a symptom of “long QT syndrome”, which is a type of heart arrhythmia. This was one of the several possible causes of thecollapse and heart attack in March of the Premier League footballer Fabrice Muamba.
The MHRA advises doctors to exercise caution when prescribing citalopram to patients who have a high risk of developing a condition known as Torsade de Pointes (a kind of heart rhythm problem). Those at risk include people who are known to have:
- congestive heart failure
- previous myocardial infarction (heart attack)
- bradyarrhythmias (slow heartbeat)
- predisposition to hypokalaemia (low potassium levels in the blood) or hypomagnesaemia (low magnesium levels in the blood) because of other illness or medicines
When was the new advice issued?
The safety update was issued by letter to healthcare professionals by the Medicines and Healthcare products Regulatory Agency (MHRA) on October 24 2011. The product information of each drug was also updated.
Why is it a problem now?
According to the Telegraph, the Medicines and Healthcare products Regulatory Agency (MHRA) came under fire “last night” (June 29 2012) when “experts criticised the MHRA for failing to make a public announcement – as it has done over other alerts such as the PIP breast implant scandal”. This is because, at the time of the safety update, only health professionals were notified, the Telegraph claims. It is not clear which experts the Telegraph is referring to. The newspaper’s story includes a quote from a consultant cardiologist saying that GPs should not stop prescribing the drugs. However, the Telegraph’s story includes a quote from a spokesman from a patient safety charity – Action against Medical Accidents – critical of the apparent failure by regulators to alert the public. The spokesman said that, “it is particularly disappointing that there has been so little transparency with patients and the public about this”.
Beyond these new quotations, it is difficult to see why the Telegraph has reported this as news today. The updates were available on the MHRA website in December 2011.
People receiving citalopram and escitalopram should not be alarmed and should not stop taking their medication. Anyone concerned about the dosage of their depression medication should discuss it with their GP.
At Last, A Report That Skewers Iain Duncan Smith’s Welfare Policies
Posted: December 9, 2013 Filed under: ESA, DLA, PIP & Universal Credit, News | Tags: ATOS, Conservatives, disabled people, DLA, Duncan Smith's welfare policies, ESA, Handicapped, Iain Duncan Smith, Medication, Member of Parliament, MPs, news, Petition, PIP & Universal Credit, reports, self harm, Universal Credit, vulnerable people, welfare reform, Work capability assessment Leave a commentToday Iain Duncan Smith is being questioned by the Commons work and pensions committee on universal credit, after finally admitting last week that the scheme’s targets had been “reset”. Last week, the petition calling for a cumulative impact assessment of the way welfare reform affects sick and disabled people, known as the WOW petition, passed 100,000 signatures, triggering its consideration for debate by the backbench business committee. To add to Duncan Smith’s woes, the well-respected Centre for Welfare Reform has released details of its report, How Norms Become Targets, which exposes the myth that Atos, the private company responsible for assessing the needs of people unable to work, does not do so on the basis of targets.
Today also sees the publication of the stunning People’s Review of the Work Capability Assessment (pdf). It has been compiled by the anonymous organisation, We Are Spartacus, whose activism in this area has been hugely empowering. The report is a collection of statistics surrounding welfare reform and reactions of MPs, charities and professional groups to the way in which it has been administered. An almanac of condemnation, if you will. Most importantly, the report compiles statements from sick and disabled people actually going through the system.
These are most encouraging developments and point to a sea-change in the way our democracy works in this internet age. There is no doubt that without extensive use of the internet and social media, the compilation of such a detailed report would have been impossible and its publication unnoticed. For too long, this group of most vulnerable people, many of them with serious health and mobility problems, have been too easy a target for cost-cutting governments of all hues to demonise, recalibrate and victimise. This is no longer the case. Vulnerable people have grabbed the issue by the scruff of the neck and are taking the fight to the government. It is inspirational and points the way to a level of democratisation hitherto unseen.
I encourage you to read the report. It is packed with striking statistics and heartrending stories, in the words of people being put through this inhuman and degrading assessment. It contains the stories of those who can no longer speak, having taken their own lives or succumbed to their illness, while being hounded by the very department which is meant to protect them, people like Peter whose leg fused as a result of injury and, having suffered a stroke which meant he couldn’t grip with one hand, received a text telling him to attend the Jobcentre. He sent his partner a text which read “I give up”. He was found hanging at his home.
It contains incredibly powerful quotes which show that dissatisfaction with Atos is spread across MPs of all parties. Dr Sarah Wollaston, the Conservative MP, said of the assessment procedure: “Not surprisingly, it adds to their [claimants] sense of worthlessness – already stoked by a longstanding political narrative from both sides of the political divide that they are ‘shirkers, not workers’ or a drain on Britain’s ‘hardworking people’. They are neither.”
It contains tragic and often simultaneously humorous stories of ridiculous assessment reports, like the one on a 59-year-old woman who had had a hysterectomy following cervical cancer, which observed: “There is no evidence that the client is currently pregnant.” Or the one which concluded that someone who took an overdose of medication the previous night had “no current thoughts of self harm”.
This programme of welfare reform was always doomed to fail for a very simple reason. The purpose of welfare is to provide a safety net for the most vulnerable; its reform must have their interests at heart, rather than cost-cutting targets. Proper reform costs money. Duncan Smith himself recognised this simple fact before he came into power. In 2009, explaining his proposed reforms, he recognised that they would lead to a rise in the welfare bill in the short-term.
Iain Duncan Smith’s fall from grace, because of a botched IT system which has already caused £140m to be written off, is properly a cause of both frustration and comedy – like Al Capone being arrested for tax evasion. But I must ask, we all must ask: how many of the vulnerable people mentioned in the Spartacus report would still be alive today if that money has been properly spent?
Via welfarenewsservice.com
Major national survey prompts CQC to call for improvements in community mental health care
Posted: September 20, 2013 Filed under: News | Tags: assertive outreach, Care programme approach, Care Quality Commission, Community mental health service, CPA, CQC, England, Home treatment, Major national survey, Medication, Mental Health, Mike Richards, NHS care plan, NHS patient survey, phychosis Leave a commentToo many people who use community mental health services are not being involved in decisions about their own care.
A major national survey of more than 13,000 people who use community mental health services in England published today (17 September) by the Care Quality Commission (CQC) shows the care people receive in the community needs to improve. Of particular concern is people’s lack of involvement in their care plans and having their views taken into account when deciding which medication to take.
The 2013 survey of people who use community mental health services asks about the experiences of more than 13,000 people during the past 12 months. The survey involved 58 trusts in England who provide mental health services.
People were asked about the care and support they received from mental health services outside hospital, such as those offered by outpatient clinics, local teams providing crisis home treatment, assertive outreach, early intervention for psychosis, and generic community mental health services.
Care for people who have complex mental health needs and require multi-agency support is co-ordinated within a framework called the Care Programme Approach (CPA). Policy guidance states that people who are on the CPA should also receive support with day-to-day matters such as employment, housing and financial advice. The survey includes people who received care under the CPA as well as those who do not.
The survey results show that that some respondents said that they do not have a care plan, and many of those that do have one, do not fully understand it, this suggests that people are not being adequately involved in the decisions that are made about their care. Responses suggest that some care plans do not explain what people should do if they have a crisis and too few people have had a care review meeting in the last twelve months to discuss their care:
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Fourteen per cent of respondents on CPA said they do not have an NHS care plan. Of the remainder, fewer than half (46%) ‘definitely’ understand their NHS care plan (down from 48% in 2012).
When asked if their NHS care plan covered what they should do in a crisis 58% of respondentson CPA responded ‘yes definitely’ though this is down from 60% in 2012. Less than half of thosenot on CPA (49%) responded ‘yes definitely’. Some respondents say they have not had a care review in the last 12 months to discuss their care:
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Almost half (47%) of respondents not on CPA said they had not had a care review in the last 12 months.
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The proportion of people on CPA who said they have not had a care review meeting in the last 12 months has increased from 24% in 2012 to 26% this year.
Although the majority of respondents know who their care coordinator is and were generally positive about them, results had declined from 2012:
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Seventy two per cent said they could ‘always’ contact their care coordinator (or lead professional) if they had a problem, down from 74% in 2012.
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Sixty per cent said their care coordinator (or lead professional) organised the care and services they need ‘very well’ down from 61% in 2012.
The survey also shows that some people are not being adequately involved in decisions about their medication, with almost a third (32%) saying their views were only taken into account ‘to some extent’ when deciding which medication to take and less than half (43%) of those who had been prescribed any new medication were ‘definitely’ told about possible side effects.
However in line with last year’s survey, most people responded positively to questions about the health or social care worker they saw most recently, with the majority (70%) (although down from 72% in 2012) saying they ‘definitely’ had enough time to discuss their condition and treatment, 78% saying they were ‘definitely’ listened to carefully and 72% of people saying their views ‘definitely’ were taken into account.
In a new question, respondents were asked to rate their overall experiences on a scale of 0-10 Most people (67%) responded positively rating their overall experience as a ‘7’ or above.
David Behan, CQC chief executive, said:
“This survey provides valuable intelligence about the experiences of people who are being supported by community mental health services. The survey describes some very positive experiences and flags where services can and must improve.
“People should always be at the heart of decisions about their own care. Care planning helps to make sure that people feel in control of their lives and illness and it can be vital in aiding their recovery. It is unacceptable that fewer people have adequate care planning than last year. It is also unacceptable for care plans not to include adequate crisis care management or for people to be poorly informed about the drugs they take.
“One of CQC’s key objectives this year is to focus on the care being provided to people by mental health services. The results of this survey will help our inspection teams under the Chief Inspector of Hospitals Prof Sir Mike Richards home in on the poorest providers and be able to challenge this poor performance though inspection.
“Trusts should look at their own results carefully and consider whether, firstly, they are assessing people’s needs properly in the context of the CPA policy, and secondly, whether they are giving them the appropriate level of support.
Ends
For media enquiries, call the CQC press office on 020 7448 9401 during office hours or out of hours on 07917 232 143.
For general enquiries, call 03000 61 61 61.
The results are primarily intended for use by NHS trusts to help them improve their performance. The CQC has included data from this survey in its Quality and Risk Profiles to assess compliance with the essential standards set by the government, and has published data for all NHS trusts on the CQC website. NHS England will use the results to understand patients’ experiences of NHS services and to drive improvements.
A set of tables showing the year on year results for each question is available on the CQC website, together with a national summary highlighting the key findings and the results for each NHS trust: Community mental health services survey 2013
About the national NHS patient survey programme
The Community Mental Health survey is currently under review and is expected to change ahead of the next survey.
The NHS patient survey programme was established by the Department of Health in 2002, and taken over by the Commission for Health Improvement later that year. It then passed to the Healthcare Commission, followed by CQC. The programme covers a range of topics including mental health services, adult inpatient and outpatient services, maternity care, and ambulance services.
The surveys are funded by NHS trusts, using a standard core questionnaire and methodology prescribed by the co-ordination centre, run by the Picker Institute Europe. Most trusts will use a contractor approved by CQC to undertake the survey on their behalf.
About the Care Quality Commission
The Care Quality Commission (CQC) is the independent regulator of health and social care in England.
We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.
We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.
Via http://www.wired-gov.net via Matthew
Questions for carers to think about asking Health Professionals
Posted: August 22, 2013 Filed under: Audio / video / reflections / talks, Carers, Good practice | Tags: Audio, Bipolar, body dysmorphic disorder, Care Coordinator, Care Plan Approach, Carer support, Carers, Carers Lewisham, catatonic schizophrenia, Causes, chronic illness, confidentiality, CPA, diagnosis, Good practice, home treatment teams, information, lewisham, Medical Records, Medication, medication dosage, Mood disorders, OCD, Psychosis, relapse, side effects, Stress, substance misuse, Treatment, triggers Leave a commentThis is an audio blog by Matthew who is a carer.
They are his thoughts and suggestions about questions that carers can ask health professionals about their cared for person.
It contains some really useful tips and advice.
New Cochrane review provides strategies for managing sexual dysfunction brought on by antidepressants
Posted: August 6, 2013 Filed under: News | Tags: anti-depressants, Cochrane Report, Medication, New, news, Sexual Dysfunction, side effects, viagra Leave a comment#RT via Bridget
Here are some myths about depression and bipolar…courtesy NAMI
Posted: July 19, 2013 Filed under: Resources | Tags: Bipolar, depression, Manic depression, Medication, Mood disorders, myths, nami, personality, Resources, stigma, Talking therapies Leave a comment#RT via Jackie via http://www.nami.org/
Would you like to take part in a group discussion about genetic testing and clozapine? Final Call
Posted: July 9, 2013 Filed under: Opportunities - Paid | Tags: Brixton, Clozapine, Focus Group, genetics, Institute of Psychiatry, Medication, Opportunities, opportunities paid, Psychosis, Research Project, schizophrenia, side effects Leave a commentMy name is Ben Spencer and I am a psychiatry registrar at the Institute of Psychiatry working on a research project that is looking into people’s views of genetic testing in clozapine.
Schizophrenia is a common illness that can affect how people tolerate stress, and their experience of the world. Some people who have schizophrenia do not get better on standard medication, and treatment with clozapine is offered. Clozapine can affect the immune system and so people who take it have to have regular blood tests, and sometimes get side effects.
At the moment, researchers are looking into whether it might be possible to use a genetic test to predict if people with schizophrenia would benefit from clozapine, or would get side effects. This research may mean that people would have to have blood tests less often when they are treated with clozapine.
No one has looked into people’s views on this, and I am keen to find out what people think. To do this I have written a questionnaire about it to give to people. I need to find out though if it’s asking the questions that service users think are important.
I am looking for people who have experience of mental health services, and who would like to look at a questionnaire we have written to find out about people’s views and attend a focus group discussion on it. Ideally if you have knowledge or experience of clozapine or psychosis.
If you wanted to take part I would send you an information sheet about the study, and a copy of the questionnaire for you to complete in your own time. I would also send you a feedback form so you can write about your experiences of it.
Then I would invite you to come along to a focus group to discuss with other similar people you thoughts on the questionnaire itself (is it too long, short, too simple). Also at this group we would discuss the research itself and the issues or questions you think we should be asking.
You would be given your travel costs (up to a maximum of £10) to attend the focus group, and a £10 Marks and Spencer’s gift voucher for your involvement.
Please note the focus group session will take place on Thursday 25/07/2013 in Brixton.
Please get in touch if you are interested in being involved in this project by emailing : clozapineandgenes@gmail.com with your name, phone number, and address to post the study information to.
The deadline to respond by is Wednesday 10/07/2013.
SLaM’s mother and baby unit praised
Posted: June 28, 2013 Filed under: Good practice, News | Tags: bethlem royal hospital, CBT, Cognitive analytic therapy, Cognitive Behavioural Therapy, dance therapy, depression, Eating Disorders, Good practice, life skills, Medication, mother and baby unit, news, OCD, post birth, postpartum psychosis, pregnancy, Psychosis, schizophrenia Leave a commentThe specialist Mother and Baby Unit at the Bethlem Royal Hospital has been recognised as providing an example of “best practice” in caring for women suffering with severe mental illness during pregnancy or post-birth.
An NSPCC report released last week suggests the wellbeing of more than one in 10 newborn babies in England could be improved if all new mothers with mental illness had equal access to good services.
The report states there is evidence to show that the work carried out at the Channi Kumar Mother and Baby Unit, part of the South London and Maudsley NHS Foundation Trust, leads to significant improvements in mental state in approximately three quarters of women, in the sensitivity of mothers with schizophrenia and postpartum psychosis when interacting with their babies and major improvements in the interaction of the babies of mothers with schizophrenia, psychosis and depression.
The 13-bed unit was set up for women who develop or have a relapse of serious mental illness during pregnancy or following the birth of their baby. The unit offers a wide range of treatment, therapy and care which is not offered on the same scale in any other unit in the UK.
One unique factor is the work of a developmental psychologist who works closely with the mothers and infants.
Dr Susan Pawlby works clinically as a developmental psychologist at the unit and academically at the King’s College London’s Institute of Psychiatry.
She said: “I think our unit stands out because we have a developmental psychologist to work with nursery nurses and nurses on the ward and most other units do not have that.
“It means we can give mothers and infants more support in forming and maintaining this early and most fundamental relationship. We have developed video feedback interventions so that mothers can see how their babies respond to them. Together we watch video clips of play sessions, talk about the communication between the mother and her baby in order to help mothers develop their relationship with their baby.
“We systematically evaluate this intervention and see how effective it is. Our work is to encourage mothers to respond to their babies’ cues, so that mothers become more sensitive and babies more co-operative in their interaction with one another. I am delighted our work has been recognised by the NSPCC.”
Alongside this support, the Mother and Baby Unit also treats mothers with medication where needed. The unit also offers various forms of therapy (psychological, art psychotherapy, cognitive behavioural therapy and cognitive analytical therapy), life skills, health skills, leisure activities, baby massage and dance therapy.
Following the release of the report the NSPCC is calling on health ministers to lead a drive to address major gaps in access to mental health services for pregnant and new mums.
Mental health problems including depression, anxiety, postpartum psychosis, obsessive compulsive disorders, eating disorders , schizophrenia, post-traumatic stress disorderand personality disorder can begin or escalate when a woman is pregnant or in her infant’s first year. They can have a damaging effect on family life, and in the worst cases, impact on babies’ health and welfare.
Evidence shows that the vast majority of these illnesses are preventable and treatable, and with the right support, the negative effects on families can be avoided.
Sally Hogg, author of the NSPCC report, said: “The Mother and Baby Unit at Royal Bethlem Hospital provides excellent support for mothers suffering from perinatal mental illnesses and their babies. They do fantastic work to help mums to care for and bond with their babies, which helps ensure these children have the best possible start in life.
“It is crucial that more units like this are made available across the country for all families who need them, as without access to specialist units such as this some mothers don’t get the right help and can be separated from their babies, which is traumatic for the whole family.”
For more information on the NSPCC report:
Read Susan’s story here
#RT via Bridget via http://www.slam.nhs.uk
SLaM Empowering Family and Carers Event
Posted: June 27, 2013 Filed under: Carers | Tags: benefits, Carers, Croydon, Empowering Family-Carers, family and carers, Medication, Mind, suite, support services Leave a commentDear Colleagues
SUITE is continuing with their successful Empowering Family and Carers Events for this year. All events have a different theme with presentations based on this theme.
These events are an opportunity for family members and carers to find out about how SLaM operates, what they can expect for themselves and their loved ones and how they can access these services. There are ‘surgeries’ for carers to meet professionals, get information about benefits, support services, medication, care and treatment and raise any concerns or complaints they have regarding the people they care for.
The next event will be on Tuesday 30th July at Mind in Croydon from 3.15 p.m. to 6.30 p.m. and the theme will be Medication. Please see poster attached for more information.
SLAM153 – Empowering Family-Carers Poster A4 July 2013 (9)
Please help us to advertise this event by passing this on to Carers & Family members and also Service Users so they can pass it to their carers. Please note this event is for Carers and Family members only but we are always looking for staff to be involved in delivering the event.
For more information, to book a place or to find out how you can be involved in helping to deliver the event please contact
Angela.Mitchell@slam.nhs.uk Tel: 020 3228 3722
Kind Regards
Bridget Jones
Carer Consultant
Please note that I only work part-time.
South London & Maudsley Foundation NHS Trust
Bishopsgate Centre | The Royal Bethlem Hospital | Monks Orchard Road | Beckenham | Kent | BR3 3BX
Antidepressants ‘could be risk to unborn babies’
Posted: June 25, 2013 Filed under: News | Tags: anti-depressants, anxiety, depression, Medication, news, Panorama, pregnancy, SSRIs Leave a commentThe risk posed by some popular antidepressants in early pregnancy is not worth taking for women with mild to moderate depression, an expert has warned.
Professor Stephen Pilling says evidence suggests SSRIs can double the risk of a child being born with a heart defect.
The drugs have been used by up to one in six women of child-bearing age.
A manufacturer contacted by the BBC denies any link to major foetal malformations.
Panorama has spoken to eight mothers who had babies born with serious heart defects after taking a commonly used SSRI (selective serotonin reuptake inhibitors) antidepressant while pregnant. Currently, prescription guidelines for doctors only warn specifically against taking the SSRI, paroxetine, in early pregnancy.
But Prof Pilling, expert adviser to the National Institute for Health and Care Excellence (NICE), says that advice is about to be updated.
“The available evidence suggests that there is a risk associated with the SSRIs. We make a quite a lot of effort really to discourage women from smoking or drinking even small amounts of alcohol in pregnancy, and yet we’re perhaps not yet saying the same about antidepressant medication, which is going to be carrying similar – if not greater – risks,” he said.
When Anna Wilson, from Ayrshire, had her 20-week scan, doctors realised her son had a serious heart problem and would need immediate heart surgery when he was born.
“He’s got a lot of suffering ahead of him before anything else,” his mother said. “We know that’s a certainty and that’s pretty awful.”
Four years before she became pregnant, Mrs Wilson was prescribed the drug Citalopram by her GP because she was suffering from anxiety.
Her doctor told her it was fine to continue using the drug when trying for a baby. But after David was born she asked what might have caused his heart condition.
“We did meet with a cardiologist at one of the scan appointments, and he explained that as far as he knew there were no environmental factors and it wasn’t because of anything we as parents had done. It was just one of those things – couldn’t be prevented,” she said.
Prof Pilling says the guidance will now be re-written to take in to account evidence that the SSRI antidepressants, as a group, are linked to heart defects.
He says the risk of any baby being born with a heart defect is around two in 100; but the evidence suggests if the mother took an SSRI in early pregnancy that risk increases to around four in 100.
“You’ve got double the risk. And for women who are mild to moderately depressed, I don’t think that those risks, in most cases, are really worth taking” he said.
“It’s not just when a woman who’s pregnant is sitting in front of you. I think it needs to be thought about with a woman who could get pregnant. And, that’s the large majority of women aged between 15 and 45.”
Mrs Wilson will never know for sure what caused David’s heart defect, but said if she had known there was even a very small risk associated with the drug she would have stopped taking it.
“If David’s condition was preventable, and it wasn’t prevented, that’s really, really awful.
“If somebody had given me the choice in pregnancy and said ‘there’s a risk of this’, I would have stopped taking those tablets in a flash.”
Lundbeck, the manufacturer of Citalopram, says a recent review of scientific literature concluded that the drug “does not appear to be associated with an increased risk of major foetal malformations”.
“The decision not to prescribe anti-depressants to a woman who is depressed… may generate greater risks to the woman and her foetus than the risks of exposure to the medication.”
#RT via Andrea via http://www.bbc.co.uk