Sudbury psychiatrist receives ‘advice’ over medication dispute with patient

The patient complained of being over-prescribed certain medications and developed an addiction as a result, leading the College of Physicians and Surgeons to offer ‘advice’ to Dr Hanumantha Rayudu Koka on the prescription of benzodiazepines .

A Sudbury psychiatrist has received professional advice following a complaint from a patient who claimed to have developed an addiction to certain antidepressants and said his doctor had failed to inform him of the addictive properties associated with the drugs.

The matter was first handled as a complaint by the patient (whose name is withheld by Sudbury.com) to the Inquiries, Complaints and Reports Committee of the College of Physicians and Surgeons of Ontario. (OMCO).

The issue came to light in April 2020 when the patient wrote to the CPSO expressing concern about Dr. Hanumantha Rayudu Koka of Sudbury, whose specialty is psychiatry.

The hearing was told that in late July 2019, the patient presented to Health Sciences North Emergency Department (ER) after feeling progressively more depressed, anxious and experiencing panic attacks and sleep disturbances following a change in medication. He was referred to Koka, who saw the patient on August 9 and 28, 2019, the hearing transcript said.

At the August 9 appointment, the complaint reads, the patient told Koka that he wanted to get better in time for his return to college, and so Koka prescribed the plaintiff a month’s supply. in Prozac, Lorazepam (Ativan) and Temazepam (for short-term treatment of insomnia) and also provided the patient with repeat prescriptions for an additional five months, as the patient said he had to complete a university semester outside the city.

In his original complaint, the patient alleged the following:

  • The doctor over-prescribed him with benzodiazepines, which led to addiction;
  • The physician did not inform the patient of the risks associated with benzodiazepines, and;
  • The doctor ruled out the possibility that he would become dependent.

In his response to the complaint, Koka said his consultation was for a 21-year-old college student who had already been taking Prozac for about four years, but his family doctor changed the prescription to Citalopram and then Zoloft, which are also antidepressants. The patient reported having symptoms of depression, anxiety, panic attacks, brain fog, loss of appetite, difficulty concentrating, loss of confidence, lack of energy and sleep problems.

Koka also told the hearing that he switched the patient back to Prozac because it had proven effective in the past. Additionally, in accordance with its standard practice when prescribing medication to the patient, the risks, side effects, and benefits of Prozac were reviewed with the patient.

Koka said he further informed the patient that antidepressant medications such as Prozac usually take time to work, so he might not feel any appreciable benefit until he leaves for school in a few weeks.

Given the patient’s time concerns, Koka also prescribed lorazepam (Ativan) as a temporary medication to relieve the patient’s symptoms in the short term, while the Prozac dosage was optimized and while waiting to see if Prozac would provide any benefit. sufficient.

Koka said the patient expressed some concern that he might develop an addiction to the drug. However, the plaintiff also indicated that he generally disliked taking pills, according to the transcript.

Given that the plaintiff was alert to addiction issues, had no history of substance abuse, and was prescribed a low dose of lorazepam and temazepam, Koka’s assessment was that the risk of drug abuse and/or developing an addiction was quite low, the transcript said. .

Following the initial hearing, the Inquiries, Complaints and Reports Committee issued “advice” to Koka “to be cautious in prescribing benzodiazepines, including considering alternatives, avoiding several types of benzodiazepines at once and avoid multiple prescription refills for patients seen in follow-up.”

In October 2020, the patient requested a review of the committee’s decision, suggesting that the CPSO review was inadequate.

A review took place in November 2021. The appeal board disagreed with the patient. In a decision issued on February 24, 2022, the review board said the first decision to counsel the physician was adequate and addressed all of the concerns raised by the patient the first time around.

Len Gillis is a reporter with the Local Journalism Initiative at Sudbury.com. The Local Journalism Initiative is made possible by funding from the federal government.

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