Antidepressant Prescription Error Claims – Sertraline and Medication Mistakes
Millions of people benefit from antidepressant medication. When appropriately prescribed and monitored, medicines such as sertraline, citalopram and fluoxetine can play an important part in treating depression, anxiety and other mental health conditions.
But antidepressants are prescription medicines and errors can occur.
A patient might be prescribed an inappropriate dose, receive somebody else’s medication, experience problems following an inappropriate change in treatment or even be given an antidepressant when they were supposed to receive an entirely different medicine.
Where an avoidable medication error causes physical or psychological injury, there may be grounds for a clinical negligence claim.
Are antidepressant medication errors common?
NHS Resolution reviewed 1,420 claims relating to medication-process errors received between April 2015 and March 2020. It identified antidepressants among the five groups of medicines most commonly implicated in medication-error incidents, alongside anticoagulants, opioids, antimicrobials and anticonvulsants.
That does not mean antidepressants are inherently unsafe. It demonstrates why appropriate prescribing, dispensing, monitoring and advice matter.
What antidepressants are commonly prescribed?
Selective serotonin reuptake inhibitors – usually called SSRIs – are commonly prescribed antidepressants.
They include:
- sertraline;
- citalopram;
- fluoxetine;
- paroxetine; and
- escitalopram.
The NHS explains that sertraline may be prescribed for depression, obsessive compulsive disorder, panic disorder, post-traumatic stress disorder and social anxiety disorder.
Other classes of antidepressant include SNRIs, tricyclic antidepressants and MAOIs.
What can go wrong with a sertraline prescription?
Potential errors involving sertraline and other antidepressants can include:
- prescribing the wrong medication;
- prescribing an inappropriate dose;
- dispensing the wrong strength;
- medication being given to the wrong patient;
- failure to consider potentially important drug interactions;
- inappropriate switching between antidepressants;
- failure to respond appropriately to significant side effects; or
- inappropriate cessation of medication.
Not every side effect or unsuccessful course of treatment amounts to negligence. Antidepressants can produce recognised adverse effects even when treatment has been entirely appropriate.
A compensation claim requires something more: evidence of a breach of duty which has caused an identifiable injury.
Can sertraline cause side effects?
Yes.
The NHS identifies recognised sertraline side effects including nausea, headaches, dizziness or drowsiness, sleeping difficulties and sexual problems such as reduced libido.
There are also less common but potentially serious complications.
One is serotonin syndrome, a rare but serious condition which can cause symptoms including a rapid heartbeat, sweating, shaking, muscle twitching, confusion and agitation.
The existence of these recognised risks does not itself mean a doctor or pharmacist has been negligent. The legal issue is whether reasonable professional care was taken in the circumstances.
What about antidepressants prescribed for too long?
This requires careful analysis because long-term antidepressant treatment is not necessarily inappropriate.
Some patients legitimately require treatment for extended periods. The NHS states that people who have experienced previous episodes of depression may need antidepressants long term and should be reviewed at least twice a year to consider whether treatment remains necessary.
A potential claim might instead involve questions such as whether appropriate reviews occurred, whether significant adverse effects were investigated, whether the medication continued to be clinically justified and whether reasonable alternatives should have been considered.
The patient’s medical records and independent expert evidence are likely to be important.
Antidepressant withdrawal errors
Stopping an antidepressant can itself require appropriate management.
NHS advice is that antidepressants should not normally be stopped suddenly without discussing this with the treating doctor. Withdrawal symptoms can include dizziness, nausea, sleep problems, anxiety, palpitations, confusion and unusual sensory symptoms sometimes described as “brain zaps”.
Some patients can experience severe or prolonged withdrawal symptoms.
Accordingly, an allegation involving antidepressant withdrawal requires consideration of the drug involved, dosage, duration of treatment, the method by which it was reduced or stopped and the patient’s subsequent symptoms.
Errors when switching antidepressants
Changing from one antidepressant to another can require particular care.
Certain combinations or switching regimes can increase the risk of serotonin syndrome. NHS Specialist Pharmacy Service guidance, for example, advises that some switches require gradual dose reduction and a washout period, and that cross-tapering is inappropriate for certain combinations because of serotonin-syndrome risk.
Whether a particular switch was negligent will depend upon the clinical circumstances and the standards applicable at the relevant time.
What if a pharmacy gives me sertraline instead of my normal medication?
This is an important distinction.
Sometimes the prescription is completely correct but the medication inside the packet is wrong.
For example, a prescription may have been issued for blood-pressure medication, but the pharmacy inadvertently supplies sertraline. If the patient takes the tablets believing they are their normal medicine, two separate issues can potentially arise:
- the effects of taking a drug which was never prescribed; and
- the consequences of not receiving the medication which should have been taken.
That second issue can sometimes be just as important as the effects of the incorrectly dispensed drug.
Where this causes physical or recognised psychological injury, there may be grounds to investigate a pharmacy dispensing error claim.
Can I claim for psychological injury caused by a prescription error?
Potentially.
A medication-error claim does not necessarily require a permanent physical injury. A recognised psychiatric injury caused by negligence may itself potentially form part of a claim.
However, worry, upset or inconvenience alone will not necessarily amount to a compensatable psychiatric injury. Medical evidence may be required to establish the nature, severity, duration and cause of the psychological condition.
What evidence is needed for an antidepressant medication claim?
Relevant evidence can include:
- GP records;
- hospital records;
- pharmacy dispensing records;
- prescriptions;
- medication packaging;
- photographs of tablets or packaging;
- blood-test results;
- communications with the pharmacy or GP;
- details of subsequent treatment; and
- evidence of financial losses.
Where possible, the medication and packaging involved in a suspected dispensing error should be retained rather than discarded.
Independent expert evidence may then be required to establish breach of duty and causation.
How long do I have to make a claim?
The general limitation period for clinical negligence claims in England and Wales is three years from the negligent event or the claimant’s relevant date of knowledge.
There are important exceptions, particularly for children and people lacking relevant mental capacity. Anyone concerned about limitation should therefore obtain legal advice promptly.
Speak to us about an antidepressant prescription error
If you have been given the wrong antidepressant, prescribed an incorrect dose, suffered injury following an inappropriate medication change or received sertraline instead of your normal medication, the circumstances can be investigated.
Hutcheon Law specialises in medical negligence claims and can consider whether there is sufficient evidence to pursue compensation.
Read our guide to medication error claims or contact us to discuss what happened and whether your case can be investigated.
Contact Us Now To Claim
This article provides general information about the law in England and Wales. It is not a substitute for individual legal or medical advice. Patients should not stop or alter prescribed medication without appropriate medical guidance.
