THANK you, Dr Philip Gaskill (Letters, December 8) for expressing sympathy for those us harmed by psychiatric drugs, taken as prescribed. Public sympathy from doctors is welcome but it is not sufficient. Patients thus harmed should be able to have an open and honest discussion about the harm sustained with the prescribing doctor in the consulting room. To refuse this causes further distress, anxiety, depression, despair and even suicidal thoughts. It goes against all the advice to the public to seek help from family doctors.

Iatrogenic harm (adverse responses to medical or surgical treatment) is just as much a medical condition as anxiety and depression. Neurological damage from antidepressants and/or benzodiazepines is neither a psychological problem nor a psychiatric condition. If open and honest conversations about iatrogenic harm are not possible for legal reasons then a public debate is necessary. It is not enough to divert patients off to therapy such as cognitive behavioural therapy, a waste of resources.

We need to discuss the toxic effects of the drugs, the impact on the brain and body and the possibilities for appropriate testing to ascertain the level of damage. If iatrogenic harm is beyond medical understanding, an open and honest discussion must be had and patients advised at the point of initial prescribing. Patients detained under the Mental Health Act can be given medication against their will and can also suffer irreversible harm.

As for the differential costs of treatments for depression, we must look at the wider societal and economic costs linked to the harmful effects of different treatments. Is it cost effective to disable patients with long-term prescribing of largely ineffective but cheap drugs? Outcomes have been shown to be worse for patients prescribed psychiatric drugs long term. GPs are responsible for treating patients, not just those seeking help for mental health issues but also those damaged by the prescribing of medication.

The discussions always centre around improving help and treatment for depression and other mental health issues. I do not hear a discussion about how to improve the help and support for patients who have suffered iatrogenic harm, which can be every bit as serious. Perhaps we could have a public discussion about the harm caused to patients through collective denial, which only adds to the neurological damage caused by the drugs. Perhaps NHS Scotland can lead the way and develop an open and transparent approach to these matters.

Fiona French,

37 Hilton Heights,

Aberdeen.

THE Diabetes UK-funded, general practice-based study of reversal of the diagnosis of Type 2 diabetes has produced a landmark result of which drug companies would be proud (“Low-calorie diet can beat Type 2 diabetes without drugs, study finds”, The Herald, December 6). As the patient witness Isobel Murray describes it, it is a hard course to follow but well worthwhile when reaching journey’s end. I was pleased to provide some advice to the project when funding was applied for.

The figure of £32.8 million is incorrect, with costs of the research to date coming in under £3m. Contrast that with the billions spent by pharmaceutical companies in developing just one drug for diabetes. It is a big market but thanks to the teams involved in the study, it could be a shrinking one.

Philip Gaskell, GP,

Woodlands Lodge

Buchanan Castle Estate, Drymen.