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Old Today, 04:55 AM
 
Location: Georgia, USA
22,113 posts, read 27,001,461 times
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Quote:
Originally Posted by newtovenice View Post
Exactly.

It is ALWAYS the patient's/caregiver's decision.

No one else's.
The difficulty arise when people massively overestimate the risk and underestimate the benefits of a drug, so a faulty analysis of the benefit to risk ratio results in a decision not to use it.

For the girl in the OP, would they have decided not to use the medication if they had known that the event that happened was uncommon and that there is evidence that it may be the infection that caused it and not the drug?

 
Old Today, 05:03 AM
 
5,262 posts, read 1,747,410 times
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Quote:
Originally Posted by suzy_q2010 View Post
The difficulty arise when people massively overestimate the risk and underestimate the benefits of a drug, so a faulty analysis of the benefit to risk ratio results in a decision not to use it.
No, there is no difficulty. What you said was that it is up to the patient to read the PI materials to make their OWN decision. The doctor is under no obligation to explain the side effects to them, and if they have questions? Ask the pharmacist.

You also said that the patient's CHOICE is the final decision regarding whether to take ANY drug.

I can quote you again, if you need a reminder.
 
Old Today, 07:59 AM
 
Location: Georgia, USA
22,113 posts, read 27,001,461 times
Reputation: 27587
Quote:
Originally Posted by newtovenice View Post
No, there is no difficulty. What you said was that it is up to the patient to read the PI materials to make their OWN decision. The doctor is under no obligation to explain the side effects to them, and if they have questions? Ask the pharmacist.

You also said that the patient's CHOICE is the final decision regarding whether to take ANY drug.

I can quote you again, if you need a reminder.
I also said ask your doctor questions.

To quote myself:

Quote:
Yes, the only way to be ignorant about any medication you take is to not ask the doctor any questions and to not read the printed material that comes with the medication dispensed by the pharmacist. Your pharmacist is also there to answer questions.
The condition is rare. Tamivir is prescribed more widely in Japan, with 24.5 million prescriptions from 2001 through 2005. There were 126 such adverse neuropsychological events reported there between 1999 and August 2005. That comes to about 5 per million doses. If doctors discussed every rare side effect of every medication with every patient they would not have time to do anything except talk about rare side effects.

Tamiflu may pose risk of mental side effects | CIDRAP
 
Old Today, 08:04 AM
 
Location: Southern New Hampshire
6,903 posts, read 12,116,769 times
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OP, you seem to be angry with posters who have simply been saying that yes, it's a known side effect, and it's listed in the written materials that come with the drug.

I feel horrible about the terror that that child must have been feeling (and her parents). But what happened DOES raise 2 questions, which I don't think you've addressed?

(1) Did the parents read the accompanying literature but just miss the possible (but remote) mental side effects?

(2) Did the parents NOT read the accompanying literature because they assumed that the doctor would have told them all the side effects?

A third question, which I think you are focusing on, is:

(3) Should the doctor have discussed all the possible side effects with the parents (instead of relying on them to read the literature that comes with the drug)? All I can say to that is that I don't think any of my doctors ever have, although they may have told me the more common side effects if I asked them directly. But the list of side effects for most drugs is very very long and the chance of each occurring is typically remote (the literature usually gives the odds), so I don't think it's common practice for doctors to go through all of them with all patients.

To me, the most important question here is: Was the child better by the next day? I hope so!!
 
Old Today, 08:05 AM
 
8,049 posts, read 3,197,009 times
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Interesting.

I googled it, and LiveScience calls it Tamiflu Psychosis.

A temporary psychosis associated with Tamiflu where the patient experiences a couple hours of violent ideations, or suicidal ideations. Called "very rare".

The doc quoted states he only prescribes Tamiflu for patients who are immuno compromised - patients with asthma, or are elderly, or small children, who are at greater risk for complications from the flu than otherwise healthy people.

https://www.livescience.com/61443-ta...psychosis.html
 
Old Today, 08:15 AM
 
Location: Georgia, USA
22,113 posts, read 27,001,461 times
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Quote:
Originally Posted by karen_in_nh_2012 View Post
OP, you seem to be angry with posters who have simply been saying that yes, it's a known side effect, and it's listed in the written materials that come with the drug.

I feel horrible about the terror that that child must have been feeling (and her parents). But what happened DOES raise 2 questions, which I don't think you've addressed?

(1) Did the parents read the accompanying literature but just miss the possible (but remote) mental side effects?

(2) Did the parents NOT read the accompanying literature because they assumed that the doctor would have told them all the side effects?

A third question, which I think you are focusing on, is:

(3) Should the doctor have discussed all the possible side effects with the parents (instead of relying on them to read the literature that comes with the drug)? All I can say to that is that I don't think any of my doctors ever have, although they may have told me the more common side effects if I asked them directly. But the list of side effects for most drugs is very very long and the chance of each occurring is typically remote (the literature usually gives the odds), so I don't think it's common practice for doctors to go through all of them with all patients.

To me, the most important question here is: Was the child better by the next day? I hope so!!
(4) Did the parents read the material, see the information about the side effect, and decide the benefits exceeded the risk?

Many doctors prefer not to have a lengthy discussion about side effects because of the nocebo effect.

https://www.smithsonianmag.com/scien...ffect-5451823/
 
Old Today, 08:16 AM
 
8,049 posts, read 3,197,009 times
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I'm curious, NewToVenice, what was the tenor of their facebook post?

Was it a caution to other parents out there, during flu season that this is a rare side effect but could happen, and be aware of these symptoms in their own children?

Or was it a tirade against the doctor, and a veiled threat to sue?

Because it's hard to believe the first case would cause any negativity. The second case, as in this thread of doctor blaming, DOES cause negativity.
 
Old Today, 08:36 AM
 
5,262 posts, read 1,747,410 times
Reputation: 8322
Quote:
Originally Posted by ClaraC View Post
I'm curious, NewToVenice, what was the tenor of their facebook post?

Was it a caution to other parents out there, during flu season that this is a rare side effect but could happen, and be aware of these symptoms in their own children?

Or was it a tirade against the doctor, and a veiled threat to sue?

Because it's hard to believe the first case would cause any negativity. The second case, as in this thread of doctor blaming, DOES cause negativity.
It was a post to indicate the dangers. The parents said that their child receives medication as necessary, is fully vaccinated, and wanted to let other parents KNOW what happened, that it is a risk and to be informed. It was a post to provide information.

There was no blame or anger in the post.

You can see by the responses here, that the posts are basically blaming the parents for not knowing. There is no responsibility given to the doctor or pharmacist or drug manufacturer as far as education on the side effects.
 
Old Today, 08:40 AM
 
5,262 posts, read 1,747,410 times
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Quote:
Originally Posted by suzy_q2010 View Post
It is ultimately the patient's decision to take the drug or not, with a clear understanding of the risks and whether the benefit of that drug outweighs the risk for the individual.
This above is what you said.

That every individual has the sole responsibility of self educating and then can make their own choice based on that self education.

Freedom of choice for deciding what medications to take. For all possible medications.
 
Old Today, 08:44 AM
 
5,262 posts, read 1,747,410 times
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Quote:
Originally Posted by suzy_q2010 View Post
I also said ask your doctor questions.
Patient: "Should I be worried about any side effects from this drug [which I have never heard of and have no information on right now during my 5 min visit with you]?"

Doctor: "No, the drug is safe. Not really anything to be worried about. But you really need to start taking it immediately for it to have any effect."

End conversation. Or does your doctor go to the PI and read every side effect to you for every drug you take, and explain all the risks/benefits and statistics during your 5 min visit?
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