Mrs F complained about how the practice managed her antidepressant medication during her pregnancy. She was also unhappy about the support she received following her miscarriage. She felt that this contributed to her mental breakdown.
What happened
Mrs F suffers from depression and was prescribed an antidepressant. She became pregnant and in summer 2012 discussed this with Dr O. He advised her to wean off the antidepressant over two weeks but review this if her depression worsened. Mrs F's depression worsened and the next month she again spoke to Dr O, who advised her to restart the antidepressant. He said that, whilst the manufacturer advised that the drug should be avoided during pregnancy, there was no firm evidence of risk.
Soon afterwards, Mrs F miscarried and her mental state worsened. Her antidepressant dose was increased and lowered again. The following spring it was replaced with another antidepressant. Mrs F also said that Dr O was not helpful when she asked for counselling to help with her depression. She said that she had a mental breakdown and later required hospitalisation.
Mrs F complained to the practice later in 2013. Dr O explained that his advice was appropriate, based on his understanding of the risks the first antidepressant presented during pregnancy. He did not respond to Mrs F's other issues about the lack of support she received, although she was offered a meeting, which she declined.
What we found
Dr O managed Mrs F's medication appropriately. While guidance explains that there may be a small risk of birth defects if taking the first antidepressant during pregnancy, it does not mean it should never be used. In some cases it is still appropriate. There is no suggestion that it can lead to miscarriage.
Dr O appropriately reduced and increased Mrs F's medication. When he changed it, this was on the instruction of Mrs F's mental health trust.
The mental health support Mrs F received from the practice was reasonable and she was referred to appropriate organisations for help.
The practice's complaint handling could have been better. Its responses did not fully address Mrs F's concerns about the reduction of the antidepressant and the support she received for her mental health problems. The poor complaint handling contributed to Mrs F's distress.
Putting it right
The practice acknowledged that its complaint handling was poor and apologised for this. It undertook to improve its complaint handling.
A GP practice
Leicestershire
Not applicable
Apology
Recommendation to change policy or procedure