Cost of treatment

17/09/12 11:51 [Monday]

I have had thoughts consequent on revising my website and as an aside to it altering ‘no charge’ in my description of the cost to me of treatment over the years to ‘mostly free of charge’. What I mean by the alteration is that in the past when I needed tablets to counter the side-effects of the injections which were the primary means of medicating me I (or in truth my father) had to pay prescription charges. The way I regarded it when I was more angry than I am now (when I was not on the present lightweight régime of Risperdal) was as getting money out of me (or out of my family) through threats. That is, if I did not accept the primary medication I was locked up, and if I accepted the primary medication I could not do without the anti-side-effect medication (and suffered a lot even with it).

I must criticise the NHS psychiatrist who played such a large part in spoiling my life over decades: Anthony Dew Armond. My thinking now, with the success in my case of this treatment with Risperdal I am now getting, is that extraordinary lengths should be gone to to gain the patient’s acceptance of the treatment plan. Armond had a completely different view from this and enforced drug treatment on me by keeping me liable to be detained over a period of years (that is on a Section but having long periods of leave at home), ignoring my protestations about side-effects totally. The conclusion I drew from the experience I had with medication was that I must be super-sensitive and unable to tolerate any dosage however low of dopamine-blocking drugs. This has been proved wrong by the success of my present treatment, and it is thanks to the doctor I had at the time of my detention in 2010 and 2011 and for a few years before - Dr Matthew Kurian - who followed the policy of attending to what I said about the initially higher dosage of Risperdal I was on and reducing it, in other words as I say the policy of doing everything reasonably possible to gain the patient’s acceptance.

Dopamine-blocking drugs have powerful effects on the patient’s mind, indeed in his overall life, as do psychotic illnesses these drugs tackle. A doctor who sees the patient every few weeks or every few months will not be able to see for himself the sometimes devastating effect of the medication, and the only thing to do is trust what the patient says certainly once he has recovered from what may be plain delusions. The far-reaching effects of dopamine-blocking - especially since these drugs affect some people in ways which show more obviously than in some other people - are not fully understood and certainly not fully reported, and the only individuals who know the ins and outs of the effects on them are the patients taking the medication (and they may not realise all the effects which are in truth caused by the medication rather than by the illness or anything else).

So my summary is: once the patent is no longer out-of-touch with reality care must be taken not to ride rough-shod over his possibly weak-egoed objections to aspects of his treatment. Every effort should be made to gain his willing acceptance of the treatment prescribed.