MH@H Mental Health

Manufacturer’s Shortage – Where Did Our Meds Go?

pills spilling out of a bottle

I recently saw an article on the Canadian news site  It warned that there was a manufacturer’s shortage of the antidepressant bupropion, both brand name and generic.   No reason was given for the shortage, and Health Canada doesn’t require this information.  The brand name manufacturer told CBC that the shortage had been resolved and the medication would be appearing in pharmacies “imminently”.  Earlier this year, there was a Canadian shortage of Epi-Pens, the life-saving medication to treat anaphylaxis.

Canada is certainly not the only country to have drug shortages.  The blog Vision of the Night has mentioned shortages of the antidepressant clomipramine in the UK.  A 2017 article in The Lancet said that the antipsychotic haloperidol was one of the most commonly shorted medications in South Africa.  A 2017 study in the Saudi Pharmaceutical Journal found that over half of the community pharmacies surveyed had shortages of psychiatric medications including amitriptyline, aripiprazole, bupropion, buspirone, duloxetine, haloperidol, and lithium.

Unlike Health Canada, the Food and Drug Administration (FDA) in the United States requires that manufacturers report the reasons for drug shortages.  2017 statistics from the FDA show that the reasons given were manufacturing (30%), supply/demand (8%), natural disaster (3%), raw material (2%), discontinuation (2%), and the most common reason unknown (53%).  It seems rather unlikely that more than half the time someone suddenly woke up at the factory and realized they’d stopped producing pills, and called the Ghostbusters to come investigate.

Sarcasm aside, it doesn’t seem as though the pharmaceutical industry is very motivated to address this issue.  Presumably there is a business case for this, although at first glance it would seem that the best way to make money is to actually sell the product.  While I’m not strongly anti-Pharma overall, the frequency at which drug shortages are occurring has a rather unpleasant smell to it.

Manufacturer shortages of medications impact health conditions across the spectrum, but I think the potential impact of psychiatric medication shortages is quite high.  Medications are often grouped into classes based on their mechanism of action, such as selective serotonin reuptake inhibitors (SSRIs).  For some classes of medication, a person can switch between drugs in the same class without much difficulty.  It’s not that simple with psychiatric meds.  Someone might respond well to one SSRI, but have poor effect and considerable side effects with another.  For some psychiatric medications, like bupropion, mirtazapine, and lithium, there are no other medications that have exactly the same mechanism of action.

Aside from hoping that our meds won’t be shorted, there’s not a lot we can do.  If you hear about a shortage, coverage issues can make it hard to follow the example of Elaine on Seinfeld in her quest to buy up every remaining Today sponge from every pharmacy in the area.  I don’t know what the answer, but I think our national health regulators need to lean on Big Pharma a little harder than they’re doing right now.

Have you ever experienced a manufacturer’s shortage of your medication?  How did you manage?

For more posts on psychiatric medications, visit the Blog Index. There’s also a Psych Meds 101 series covering:

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22 thoughts on “Manufacturer’s Shortage – Where Did Our Meds Go?”

  1. I love this post. I am currently dealing with this issue with my Buspar and my Tegretol. I have to keep getting my psychiatrist to adjust the dosage to go by what my pharmacy says they have (for the Buspar at least) available and by the time I get to the pharmacy the dosage my doctor just adjusted is null and void because the pharmacy ran short on that too. It’s been horrific trying to get this situated because Buspar has been the only non-benzo to help my anxiety. 🤦‍♀️🤨

    1. A few years back I had to run around just before going on a trip out of country desperately trying to find quetiapine. I think I scared my regular pharmacy because I completely flipped out on them.

      1. That must have been horrible, but I can definitely relate! I have yet to start the tegretol since they pharmacy has been waiting a week, so far, to get it in and no news yet. I may actually give my pharmacy a call now!

  2. I worked in pharmacy for about twenty months. It was a regular, as in it might be that several times a day, a patient would arrive with a prescription from their doctor and we had to break the news that we did not have that medication because the manufacturers are not supplying it at the moment. We had very little information to provide, we didn’t know the reason why it was not available or when and if it would be available. It was hugely frustrating for us, more so for patients, who had the choice of hunting around other pharmacies to see if any had some of their prescribed medication left on their shelves, or returning to their Doctor to request an alternative. I have seen many patients who were very distressed by the situation. It seemed to happen a lot with epi-pens and many other very important medications.

    1. It would be nice if regulators put more pressure on drug companies to come up with a reason for the shortages. Instead they keep on carrying on and pharmacies are stuck dealing with the situation.

  3. The only problem I’ve had with my psychiatric meds was the cost. But that’s mostly resolved now and I take two that are ‘old’ ones relatively – Trazadone and Zoloft. I’m waiting to hear them (Big Pharm) say they’ve discontinued one or both, and that will be a bad day for me. Trazadone helps me sleep without being drug hung over the next day, and Zoloft is the only anti-depressant I’ve taken that works for me. And I’ve been put on most of the ones out there. They ALL had some sort of side effect for me or didn’t do the job, made me hyper or more depressed. Zoloft seems to keep things under control without making me so sleepy I’m not functioning, so hyper I can’t sit still, or feeling ‘weird’ (wrapped in cotton wool, out of touch with reality etc). What you report is scary, but can’t say I’m all that surprised. Big Pharma (IMHO) stopped caring about helping the patient (consumer) a long while back and is all about the bottom line.

  4. Thanks for the shout out!

    In the UK there have been a lot of stories in the news about possible drug (and food) shortages if Britain crashes out of the EU without a trade deal with Europe. I’m not sure how seriously to take them, but I doubt I could do much even if I did take them seriously.

  5. A drug shortage? Yikes! [Shakes head at how horrific that would be…] Zombie apocalype, Armageddon, four horsemen, pestilence, frogs, locusts, the black plague, comets hurtling toward the earth, people screaming in the streets, rivers of blood, the sea monster that sunk the Titanic, Wilford Brimley, I have no idea what I’m talking about. But no more meds would be that level of bad.

  6. Very well written! I found a lot of your posts very informative and easy to read! This post was by far my favourite as I can relate to it on a personal level. I have experienced withdrawal symptoms before due to a lack of pharmaceuticals. It was not a good time at all, and I definitely agree that a lot of pharmacies do not take this seriously! If you ever want to read my posts check it out 🙂
    Have a good night 🙂

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