'Five of our patients have attempted to take their own lives'

Dr Emily Wise is volunteering in Uzbekistan, treating TB patients with a drug that can cause depression and suicidal thoughts. She writes about the conflict of using a cure that also killsFor the past nine months, I have been experiencing first-hand the challenges of treating drug-resistant tuberculosis, a highly infectious disease that's fatal without treatment and extremely difficult to cure. I'm volunteering as a doctor for Médecins Sans Frontières/Doctors Without Borders (MSF) in Karakalpakstan, Uzbekistan, an area where drug-resistant TB is endemic. Here, I have witnessed treatment side effects ranging from rashes to liver failure – but one of the most unexpected and dangerous is depression.It's not underlying mental illness that causes people on TB drugs to become depressed. It's a chemical effect resulting from the ingestion of cycloserine, one of the cocktail of drugs we must use to treat drug-resistant TB. Cycloserine has the potential to precipitate depression, psychosis and suicidal thoughts in patients. Over the past month, five of our patients have attempted to take their own lives. Each case of drug-resistant TB therefore presents our team with a dilemma: we must try to reconcile the conflict between saving the patient from dying from TB, and our ethical concerns about the side effects of the treatment.Recently, my patient Maya rang one of MSF's trained counsellors and told them she was going to kill herself. We immediately assembled a 'crisis' team, which a...
Source: Guardian Unlimited Science - Category: Science Tags: Global health Blogposts Guardian Professional Doctors Tuberculosis World news Pharmaceuticals industry Malaria and infectious diseases Drugs Volunteering Uzbekistan Drug resistance Global development professionals network Profess Source Type: news