Thank you for helping and supporting our population and Waikato DHB during these unprecedented times. Providing POAC Services remains a priority to prevent ED presentations and hospital admissions, so please continue to utilise this service.
I understand that in some areas there is short/no supply of fluoxetine and sertraline This appears to be related to supply chains as opposed to the country running out of these medications. Some pharmacies appear to have run out of these medications; others continue to have some supplies. I understand that other SSRIs (citalopram and escitalopram) are still available.
If ongoing antidepressant treatment is required and your patient is unable to obtain supplies of their fluoxetine or sertraline, I would recommend changing to another SSRI (citalopram, escitalopram, paroxetine), or a different class of antidepressant such as venlafaxine or mirtazapine especially if they did not adequately respond to an adequate trial of fluoxetine or sertraline.
When switching medications (especially from fluoxetine), please be aware of the impact on Cytochrome P450 metabolism of other medications (e.g. warfarin) that in turn may require further monitoring and dose adjustments.
Please also closely monitor for any variations in mood, anxiety, agitation and suicidal ideation during the change over period.
I would recommend switching according to the NZF Antidepressant Switching Table: https://nzf.org.nz/nzf/resource/Antidepressant_Switching_Table.pdf.
When switching from one serotonergic agent to another, there is a very low risk of inducing serotonergic syndrome. This link provides a good summation of clinical signs and symptoms: https://www.medsafe.govt.nz/profs/PUArticles/SerotoninSyndromeToxicityReminder.htm
This patient brochure is available at: https://www.medsafe.govt.nz/consumers/educational-material/Serotonin%20Syndrome%20December%202015.pdf
Please do not hesitate to contact me should you have any questions.
Click here for printable document
Dr Andrew Darby
Primary Care Consultant Psychiatrist
Whilst all businesses are focusing on managing as best they can through these evolving and rapidly changing stages of the coronavirus pandemic, we wanted to provide you with reassurance that we remain as committed and motivated as always to provide support to you, your employees, and all respective families/whanau.
Our response to date has been to identify how we can support your people in alignment with our Government’s health advice, containment advice, and its guidelines for us all to follow and intended to reduce the chance of widespread community outbreak. This has included planning and preparation to support the wellbeing of our own people, so they are in the best possible position to cope with the unfolding situation and can continue to care for your people.
As at today, all ongoing appts (ie for those who have already commenced an EAP programme with us for attendance “in-person”) will remain to be attended “in-person”. However, and as a precursor to if and when we may all be required to self-isolate, any first appts in relation to a ‘new’ EAP programme will be scheduled to commence via Telephone and all ongoing sessions in relation to those ‘new’ programmes will continue to be scheduled for attendance via Telephone.
If and when containment advice requires, we will contact all those with existing “in-person” appointments to transition their EAP to continue as intended but via Telephone sessions.
Physical distancing does not mean social isolation. As we are coming into the weekend it’s important to remind your staff and colleagues to stay connected to others, e.g. via phone, social media, etc. Talking to people and checking in on others keeps us all connected and that is more important than ever.
Our Business Continuity Plan under these circumstances includes provisions for appropriately managing the expected increase in phone calls and requests for appointments during times of crisis. We are constantly monitoring these to ensure we have the right number of people in place to support your people. In addition to our e-flyers, our Clinical and Marketing personnel continue to produce a growing bank of supporting documentation with tips and information sheets for you and to share with your people. Please see attached, which are also accessible via our EAPNOW mobile App.
As always, we are here to help support you and your people.
Tips for Parents and Caregivers on media coverage of major events
Coping with stress during infectious disease outbreaks
Dear public health experts
Thank you to all of those who were able to participate in the online rating for Food-Epi and are planning on attending the workshops this week and next week. An agenda was been sent to participants last week. If you haven’t RSVPd to the workshops please contact me directly or if you know of any colleagues that would be interested in attending please forward this email to them and ask them to contact me.
We appreciate that because of work commitments and restrictions due to coronavirus many people have been unable to participate in the process to date.
The workshops involve developing recommended actions for government, and ranking these actions for importance and achievability.
After the workshops, we will conduct an additional brief survey for those who can’t attend a workshop to rank the actions agreed at the workshop. Participants can rank their top 10 actions for importance and achievability. This ranking will be considerably shorter than the online rating of implementation. We will send the survey link on Friday 27th March and the survey will close on Tuesday April 7th at 5pm.
Dr Sally Mackay, Registered Nutritionist
I have attached a letter from Dr Nick Chamberlain regarding the 2020 Influenza Season, and a rate increase to the Immunisation Administration Fee. I would be grateful if you could please pass this on to your General Practices.
The Abortion Legislation Bill had its Second Reading yesterday and was voted through. It now moves to the Committee of whole House before a Third Reading will take place. The timing of the Third Reading and possible enactment will depend on the amount of time Parliament needs to debate the Bill.
The select Committee’s report and the revised draft Bill is available at http://legislation.govt.nz/bill/government/2019/0164/latest/LMS237550.html
It’s important the health sector, including the Ministry, doesn’t pre-empt the Bill’s progress, but we also need to make sure we are prepared to enact the legislation if it passes. A sector working group has been assisting with implementation planning.
The Ministry will have information available for consumers and health professionals if the Bill passes. We will notify you where to find this information via this email channel if the Bill passes. We cannot provide this information in advance as any changes to the Bill will mean that the information will need to be updated, and if the Bill does not pass, the information will not be correct.
The Abortion Law Reform Team