Fatal Aplastic Anæmia and D-Penicillamine

Myelotoxicity of D-penicillamine.

“…The mean dose of D-penicillamine at the time of marrow depression was 615 mg per day (range 250-1000). Reports on 3 of the patients have already been published (Richards et al, 1976;McAllister and Vale, 1976;Bourke et al, 1976), and 3 of the cases had been reported to the CSM.…”

A case report and focused literature review of d‐penicillamine and severe neutropenia: A serious toxicity from a seldom‐used drug

“…Indeed, much of the safety literature surrounding the use of d ‐penicillamine relates to its treatment of patients with RA in the 1970s‐80s. The association between d ‐penicillamine and severe neutropenia, including case reports of patients diagnosed with aplastic anemia, has been extensively described in this population with fatalities reported . In Wilson's disease, where the overall toxicity is purported to be less, the literature includes fewer descriptions of very low neutrophil counts .…”

Scaling up psychological treatments for common mental disorders: a call to action

“…For example, the COBRA trial in the UK demonstrated that nonspecialist junior mental health workers with no previous professional training in mental health services successfully delivered a treatment package that focused on the core element of behavioural activation. Results showed equivalent effectiveness in reducing depressive symptom severity as specialists delivering longer courses of cognitive behavioural therapy 5 . Similarly, in India, lay counsellors trained over 3 months to deliver a culturally adapted version of behavioural activation attained improved remission rates and sustained outcomes in primary care attenders with moderately severe to severe depression 6 .…”

“…Daisy R. Singla 1,2 , Giuseppe Raviola 3,4 , Vikram Patel 3,5 Progress in developing a classification of personality disorders for ICD-11…”