Marjorie Bassendine
30 Nov 2016 · Coroner Karen Henderson · Surrey
The coroner's concerns
1. prolonged QT interval
“To recognise use of multiple psychotropic medication has the potential to prolong the QT interval”
2. lack of ECG before medication
“To undertake an Electrocardiogram (ECG) prior to commencing such medication”
3. inadequate monitoring of QT interval
“To undertake regular ECG's to ensure long QT syndrome has not developed and to help plan continuing treatment”
Responses
2016-0424-Response-by-MHRA.pdf ↗· Department of Health and Social Care
Stated action
“We have reviewed the product information (Summary of Product Characteristics [SmPC] and Patient Information Leaflet) of olanzapine, mirtazapine and indapamide and are satisfied that all three contain appropriate warnings regarding the risk of QT prolongation, particularly when used with other medication that also causes QT prolongation.”
2016-0424-Response-by-RCPSYCH.pdf ↗· Department of Health and Social Care
Stated action
“I shall liaise with the Chair of our Special Committee for Psychopharmacology to publicize these matters to the members and fellows of the RCPsych”
Stated action
“I shall liaise with the Chair of the Faculty of Old-Age Psychiatry to determine the best way to raise these issues with old-age psychiatrists”
Stated action
“We will review our continuing medical education initiatives to ensure that this issue is comprehensively covered in RCPsych material”
Stated action
“I shall inform the Presidents of the Royal Colleges of Physicians and General Practitioners, by copy of this letter, of our plans and will be ready to work with them in any suitable joint ventures”