Belfast Telegraph

Concern GPs prescribing anti-anxiety drug much too readily

By Victoria O'Hara

The "abuse" of an over-prescribed anxiety drug that is costing us £17m a year has led to calls for better alternative mental health services.

The figure was revealed in a Northern Ireland Audit Office report, that discovered Pregabalin - which can produce feelings of euphoria similar to tranquillizers - is more frequently prescribed here than anywhere else in the UK.

Pregabalin, which is also used to treat epilepsy and pain, is the most prescribed medicine dispensed by GPs in Northern Ireland.

The report showed that, in 2013, £9.43 was spent per head on the drug here compared to approximately £4 in the rest of the UK.

The report confirmed it has potential to be abused, but said it was "not clear" why it was so heavily prescribed. The drug reduces the volume of pain signals sent to the brain from damaged nerves.

Last year the cost of prescribing Pregabalin here at a higher rate than the rest of the UK was £9.7m. During 2012 it was £8.5m.

Tom Black, chair of the Northern Ireland General Practitioners Committee for the BMA, said he agreed that the drug was prescribed at a "much higher level" here.

"I think they are right about Pregabalin, we are not closing our ears and saying we can't do something," he said.

"These drugs, to be blunt, are prescribed at a much higher level than elsewhere and I take that on board."

NICE - the National Institute for Health and Care Excellence - initially recommended the drug as a first line treatment in its early guidance on management of nerve pain in 2010, but within 18 months withdrew the recommendation.

Dr Black said in cases of anxiety the drug was prescribed as there were poor levels of alternative mental health services available.

"I have never started a patient on Pregablin but I have written many prescriptions on the basis of recommendations of orthopaedics and psychiatrists. If you ask me which is the most, I would say the use of Pregabalin is at a much higher rate in mental health than other countries because we don't have the mental health services," he said.

The report said the Health and Social Care Board set a target to reduce Pregabalin usage by £1m during 2014, but the audit team say this is "not challenging".

The report added that it considered that "GP practices in Northern Ireland could move much more quickly to prescribing levels elsewhere in the UK".

It went on to say that it was "essential" the Health and Social Care Board builds on the work to promote efficient prescribing of the drug.

Dr Black added: "If you ask me where the extra money should go the first (in the health service) it should be mental health and the second general practice. The Department of Health know very well from Bamford (report) they need to be spending more money on mental health services. If they don't spend money on mental health services they will spend more on prescriptions.

"We would wish that patients had the alternative of talking therapy - if we had that we would need fewer drugs."

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