This post covers difficulties primarily on antidepressants that medicines can cause to people in schools or universities who end up unable to study or do course-work, as well as the difficulties people can have trying to get off medicines, a process that can be pretty disabling.
The materials linked to this post are being put in your hands to run an experiment and hopefully feedback to all of us. Based on feedback it may become clear just what certificates are needed and if we need different documents for different countries. If we get the formula right, the materials can be extended to include mood-stabiizers, antipsychotics, antibiotics (like doxycycline and fluoroquinolones) and other drugs.
Withdrawal Certificates for Disability
Several people badly disabled by drugs, especially antidepressants, suffering from protracted withdrawal or PSSD and related problems are in such a poor state that work is close to impossible. But they have to survive. So the question of disability or insurance payments comes on their radar – just as it might for anyone incapacitated by any other illness.
Dependence on antidepressants or any prescribed drug is however an iatrogenic illness. This makes things different. It would be good to hear from anyone who has managed to get a payment for a specifically drug induced illness – its a different iatrogenic ballgame if a surgeon has chopped off the wrong leg.
Its desperate thinking but some people have turned to RxISK hoping we can help. We can’t do much but there are two RxISK Certificates Withdrawal Certificate 1 and Withdrawal Certificate 2, which you can download. Read on to see what help if any these might provide.
For anyone hoping to apply for financial or other support in managing the disability that exposure to antidepressants can cause, a report by a specialist confirming that you are dependent on and perhaps effectively unable to stop your medicines may not be a great deal of help.
It might be of minimal help if the specialist actually met you, ideally on several occasions and had access to all your medical records.
The key person is your family doctor. If, for instance, your primary care (family doctor) record does not mention the problem or perhaps casts it in terms of a somatising disorder or more generally arising from factors other than your antidepressant, then specialist input will be of no value, unless the specialist knows you well and has done so over time.
The first step in applying for disability or any other support must lie in acquiring your medical records, to which you have a right, and reviewing these to see what they say.
If your doctor has recently converted to the possibility that your antidepressant is causing problems, it may need a letter from her/him entered into the medical record to indicate that prior views in the record appear to be wrong and s/he is now of the view that there is a problem linked to treatment and has been for some time.
This is where the RxISK Certificates comes in. They state there can be a problem. They don’t state you have a problem. One is more hard-hitting than the other. You can chose, which one to take to your Family Doctor and see how they respond. They will likely respond best, if at all, to Withdrawal Certificate 2.
Another ‘game’ might be to take both and ask which of these works best for them. This gets the message of the hard-hitting (C1) one in under the radar – most will choose C2.
You might have to wait some time, till they come around. You can’t push on the door or it will stick shut.
Even then, it will be uphill.
The assessment for disability or other claim lies in the hands of assessors employed by an insurance company or other payor rather than in the hands of a family doctor or specialist. These assessors are slow to concede there is a problem that warrants a disability payment. They are likely to make suggestions about further treatment – many of which are almost certain to make the problem worse, giving you a terribly difficult judgement call – do you go along with the suggestion or not?
The chances of success in getting a disability or insurance payment are pretty low but it is still worth applying for disability support in that this is definitely a way to raise the profile of these issues with both medicine and politicians. With time the disability is more likely to be recognized and it may stimulate more research on finding an answer.
The alternative is doing nothing which lets the system roll on. It has begun to label people disabled by antidepressants as Treatment Resistant Depression and steer them toward Medically Assisted Dying.
If any family doctor wants to make contact, about the above, they can email firstname.lastname@example.org.
If you have an account of your experiences either with your Family Doctor or with some hired gun assessor that you want to share – such as their fool proof way to get off antidepressants or their absolute certainty you were born with an SSRI deficiency, please share through comments.
What would be most helpful is any ideas about how to shape an approach so that it has a better chance of working – we may need different approaches for different countries and different situations.
People seeking disability don’t need to specify the cause and it may be politically easier to accept your doctors saying you’re depressed and have neuropathic pain (even if all caused by Efexor). Anyone seeking workers compensation needs to specify a cause – such as a failed back surgery for an injury sustained at work. This is where failed antidepressant treatment for burnout caused by bad management practices might start to get interesting.
Legal Action for Dependence
Jim Gottstein of PsychRights has recently had an article published on the possibility of anyone suffering from Antidepressant Dependence taking a legal action for this. Jim’s article focusses on the problems.
Most plaintiff law firms will only be interested in something like this where there are thousands of claimants. Baum-Hedlund in the United States took a successful action paroxetine dependence case in 2004-2005. Its not clear that anyone has done much since.
Taking Political Action
One of the contributors to RxISK who hopefully will have a post soon, found a quite extraordinary development. In New York seven years ago, there was a serious effort to get the major hazards of antidepressants noted as part of an informed consent process. Somewhere along the line, this sensible bill S2243a got written out of history. It would be good to find out what happened.
The people who are most likely to get a Bill or something like it (that won’t backfire on them) to happen are the pharmaceutical industry as part an effort to kill the SSRIs and replace them with something that will cost a lot more.
And all of our efforts will be used as evidence that everyone should avoid those nasty twentieth century, last millennium drugs. Heads they win, tails we lose. Still it is worth exploring avenues like this.
The disabilities that many drugs can cause don’t just affect people in work or unable to work. They affect students both at school and university. The problems are not confined to antidepressants or withdrawal. Over 200 drugs can cause pretty bad agitation, up to suicidal or psychotic levels, with people ending up on a cocktail of drugs as a result, none of which are likely help their cognitive function. Memory and concentration may be impaired, with people reporting Brain Fog or Chemo Brain, not just on the cocktail but after they stop.
Again as with the Withdrawal Certificates, the Educational Certificate here states in principle that many drugs can compromise educational performance. But it will be down to a Family Doctor or other doctor who knows you, has access to all your records and can interview you and perhaps family members to work out whether these problems that can happen in principle have in fact happened to you.