In late 2016, when I worked in a psychiatric hospital , I received an email informing all staff of an increase in the cost of an antipsychotic medication called quetiapine. I didn’t think too much of this. It had no relevance to my work as an Assistant Psychologist.

Fast forward a few days and I’m sat in a ward round where the consultant psychiatrist wanted to prescribe a relatively young man the same drug. “No!” suddenly snapped the ward doctor, before giving her a strange look. She responded “oh yes, of course. Maybe something else.”

Now, this psychiatrist was my supervisor, and I later asked her about this exchange. She reminded me of the email I had read, and explained she was being put under pressure not to prescribe the drug, as it’s cost had increased from £1.59 per tablet to an eye-watering £113.10 per tablet. No, that’s not a typo. That actually happened. She explained to me she knew Quetiapine was the best option for this patient; it’s one of the better antipsychotics in terms of effectiveness, and has far less side-effects compared to it’s counterparts. As the patient was so young, she did not wish to put him at risk of unnecesary health complications. But she couldn’t do this, because it was too expensive.

This saddened me on a professional level – I had to watch a patient drooling on himself and gaining excessive weight, when I knew deep-down he didnt need to. But more than this, it broke my heart on a personal level. What I hadn’t mentioned to my boss was that I was on a daily dose of the same drug myself.

During my lowest time, somewhere around 2014-15 when I returned to unviersity, I was unable to sleep at all. I was a mess. I was crying and self-haming most nights and couldnt calm my thoughts to sleep. I was exhausted on multiple levels. I went to my (incredible) GP weekly, and begged her to help me sleep. She was compassionate, and as by this point she had begun to suspect I might have a personality disorder, suggested I try a small dose of quetiapine. It has sedative effects at low doses, and is often used to supprot PD patients with emotional regulation.

This drug changed my life.

That sounds dramatic, but it’s true. I was able to sleep properly for the first time in years. Unlike sleeping pills I wasn’t left feeling groggy the next morning, and felt pretty normal aside from feeling far more rested. This had a knock on impact to my mood and ability to tolerate minor stressors without explosions of emotion. I felt like I was finally getting better.

By this point I’d been under MH services for a good few years, and tried 2 different anti-depressants, anti-anxiety medication and 2 differnt forms of tranquilisers. Nothing had even come close to the impact Quetiapine gave me. And I’ve never experienced a single side-effect.

I now often think what would happen if I presented to that GP today. Would she be unable to prescribe it to me today, fearful of it’s cost? Would I have to carry on feeling like a zombie on benzodiazepines, or risk more aggressive antipsychotics or mood-stabilisers? I’m thankful for my repeat prescription, but fear the day when I’m encouraged to cease my Quetiapine.

And this is happening with a number of psychiatric medications. Olanzapine, another antipsychotic medication, has experienced similar exponential cost increases. The concerning thing is that these are medications you can’t easily substitue with another – they work uniquely for that individual, who has often tried other options previously without success.

I sincerely hope these costs will lower in future, and that the drugs needed to allow people to recover become more readily avilable, presribed when needed, without fear of the cost.

L

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