Martins Ifijeh

As part of efforts to improve treatment options for mental health in Nigeria, health experts in the country have called for replication of innovative treatment measures successfully in use in developed countries.

They said currently in Nigeria, clinicians use trial and error of evidenced-based medicines in treatment of mental illness; using medications without knowing whether it will work for specific patients or not.

This was the thrust of a stakeholders meeting by chief medical directors from neuropsychiatric hospitals in Nigeria and Professors of Psychiatry in Abuja recently. They were hosted by Primly Services Nigeria and Synapse Services.

The Chief Host and Medical Director, Synapse Services Mental Health and Rehabilitation Centres in Nigeria, Dr. Vincent Udenze, stated that he was keen to see partnerships between the government and private sector organisations in improving the practice of mental healthcare in Nigeria.

He said that it saddens him to see new treatment measures in the western world that are not available in Nigeria.
The United Kingdom-based consultant psychiatrist, said in Nigeria, medication is not easily available.

“Not only are we 10 years behind, but we also don’t get the best generics that enter into the country, sometimes. There’s need to embrace change by the residents and give patients available choices so that they can make decisions for themselves.”

Udenze said he wanted all medical directors to look at ways of influencing manufacturers of medications and equipment used in mental health to reduce prices for sale of their products in Nigeria.
A Professor of Psychiatry, University of Nigeria, Nsukka (UNN), Dr. Jude Ohaeri, said the main thrust of the programme are four and the overall one is to bring together experts, who understand and can further the objectives of mental healthcare delivery in the country.

He said it was to bring together a forum whereby they can put heads together and bring out healthcare services in the country, not just the development but bringing new ideas, new way of diagnosing patients’ problems and new ways of treatment.

The second objective he said, was about the new way of diagnosis and treatment.

“These really are applications of new biological findings. Up till now, we have more or less acted blindly. That is, you come in and we diagnose you as having this or that and we don’t really have the biological basis, like we don’t have a drug test.

“For instance, somebody have diabetes – you take his blood and measure the amount of glucose, we don’t have that but now these tests and treatments are based on concept that germs could be behind the kind of problems that this person has.

“Germs could also be responsible for the way this person reacts. So, these innovations as brought here by our friend Vincent and the group are sponsored by a company called Genocept and the other companies who are doing the same thing.

“They are focused on depression and they have a number of germs, about 18 of them and they are saying that if you take the blood of people with depression, instead of treating them blindly with whatever drugs you think, you have to genotype them. We are going to get patterns of genotype that will help us determine which drug they are more likely to respond and get better and which drug they are more likely to have side effect to.

“I want to say that this has some scientific bases really. The second innovation is a new method of treatment called Repetitive Trans- cranial Magnetic Stimulation. It is a brilliant treatment in the sense that it is not complicated. You are not equipped to sleep; you are awake and it doesn’t give you headache.

“They are a quite safe method of treatment and it’s used for a wide variety of problems (4:55). So, these are the kind of new concepts and we want to think of how we can further this process.

“But there are also other things it is talking about too. For instance, there is a question of ADHD which means Adults who have attention deficit, that is, they cannot sit at a place and listen to you and one effect of this is road traffic accident.

“All of us experience it; you get to a road and there are people behind you, they just cannot wait. You might want to wonder whether they have this problem. So we want to highlight these problems and whether we can get a group that will be an advocate for people with this type of problem in the country and how to put hands together to do this,” he said.

Asked whether the group would involve the federal government in this task, Ohaeri said with the model of modern development, the government cannot do everything as it is hampered by all sort of things.

He said, “So we are emphasising what private individuals can do now; the government is tired. By my own training at my own time, it was what government can do but now government cannot employ so many of her youths so it depends on us to think, bring out something and market it to government so government could be our patron not our sponsor.”

On his part, the Medical Director, Federal Psychiatric Hospital, Maiduguri, Dr. Ibrahim Abdulwakawa, said as a psychiatric, he is sometimes confronted with questions from patients like, “Doctor you started treating me without conducting a test.”

He said it has been very challenging because most of the diagnosis are based on synchronic approach; “the presence of certain symptoms, you match them and you reach a diagnosis so the importance of this workshop is that it matches signs with clinical practice.”

The medical director explained, “With the symptoms you generate, you take samples and it will help you in reaching or deciding on appropriate treatment to render.”

He said some of the challenges in addressing these problems are that some of the first germs sects help in determining the right drug to be used on person with depression.

“Some of the test particularly the genocide with help you in actually finding some of the medications to be used on a person with addiction problem and it will help you know medications that you will not use in certain conditions and this is a very big step in the right direction that we have not been privileged to have previously in this country.”

The lead Consultant psychiatrist of the Genomid –Primly Genecept project, Dr. Nwife Akhator–Eneka, introduced the group to this new investigation.

She said the new gene assay will study about 18 genes in a patient’s body and determine which medication is likely going to work for the patient and side effects a patient might likely develop.

According to her, the technology also tells which patients are like going to be addicted to pain killers used in oncology or pain from trauma for example accidents, saying, “This is revolutionary as it will significantly reduce time wasted trying different medications.”

Dr. Bukola Willimas introduced the rTMS Machine, that is repetitive Transcranial Magnetic Stimulation Machine which is currently licenced in the treatment of depression and has some evidence in management of schizophrenia, cocaine and alcohol addiction, gambling addition, autism, Post traumatic stress disorder etc.

The machine is available in two centres in Nigeria and most medical directors indicated commitment in getting such a modern treatment to the neuropsychiatric hospitals.