Physicians will often prescribe a medication for conditions that the drug has not been approved by the Food and Drug Administration (FDA) to treat. This is a common practice because physicians discuss treatments amongst themselves and share techniques that have helped their patients in the past. However, the physician may not make the patient aware of the fact that the medication which they are prescribing is not necessarily intended for the malady for which it is being prescribed. It often falls to the pharmacist to educate a patient about the medications they will be taking and it is the duty of the pharmacist to warn of any potential side effects or drug interactions.Antiepileptic drugs, or AEDs, are one class of drugs that have been prescribed off label to treat conditions other than epilepsy, such as chronic pain. While there is no indication that individuals using the AEDs for their intended use saw an increase in suicidal tendencies, those using it for other conditions were more likely to experience suicidal thoughts.
The conclusion most scientists are making is that the rewards for controlling epilepsy far out way the risk associated with these drugs. However, patients who are taking AEDs – for epilepsy for another condition – should be made aware that there are some studies which are indicating a need for caution. Remind them to monitor their mental well-being and to report to their physician any signs or symptoms of depression as the dosage of the medication did not seem to be relevant in the findings.
It is important to remember that the average person trusts their physician and others in the healthcare field implicitly. They will frequently assume that if a medication is for sale, and their doctor prescribed it, then it is completely safe for them to use. If their pharmacist says nothing to the contrary, then the medication has a double stamp of approval. Consumers are not, on average, aware of the way drugs are brought into the healthcare system or the fact that a medication may be under review for years before it is ultimately pulled from distribution because of serious adverse affects. The final line of defense for the patient is their pharmacist. While it is ultimately unfair that this burden rests with one profession, it is the pharmacist that will hand over the medication to the patient, and it is the responsibility of that pharmacist to make sure the patient is aware of all the latest information that is available pertaining to the medication they are about to take.
As a pharmacist, do you find it difficult to discuss possible side effects with patients without making them fearful of the medications their doctor wants them to be taking?