Meds Source: Google Images

SA Depression and Anxiety Group (Sadag) has highlighted the severe impacts of a shortage of certain antidepressants and antipsychotics currently being experienced countrywide, saying this may lead to patient relapse.

The Health Department announced on Friday that the country was experiencing shortages of certain antidepressants and antipsychotics due to a range of supplier problems, including a shortage of the active pharmaceutical ingredient, production problems and industrial action at local production facilities.

Department spokesperson Popo Maja said the products most affected were Citalopram, Fluoxetine, Haloperidol and Olanzapine.

The shortage affects all provinces and may also affect availability in the private health sector.

Sadag operations director Cassey Chambers said the organisation was very concerned about the announcement and its potential impact.

“It could have serious consequences for people living with mental illnesses such as depression, bipolar disorder or schizophrenia.

“Often these medications are chronic so patients cannot skip or not be on their meds.”

She likened the announcement to telling a diabetic patient that their insulin was not in stock and to come back for it next month. “It would have serious repercussions for the patient, the same of patients with mental illness. Without the meds, patients are at risk for relapse.”

According to Maja, eight companies were contracted to produce these medicines and they have been unable to supply the quantities that have been ordered.

“To address this shortage, we have identified stock from other manufacturers (none contracted) that we have been purchasing to address the shortfall in supply.

“Unfortunately, other manufacturers do not produce the high volumes used in the state and their quantities will be limited.

“The department is managing the available stock such that facilities have adequate amounts for their patients. We are sourcing stock from other countries where this is available to address the current shortage,” Maja said.

“The medicine supply chain is very long and complex which begins with the production of base chemicals, synthesis of these chemicals into active pharmaceutical ingredients, production of the pharmaceutical dosage form and, finally transportation of the finished product from the country of production to other countries.

“A breakdown in any part of this chain will result in medicine shortages in a health facility,” Maja said.

Meanwhile, the South African Health Products Regulatory Authority (SAHPRA) issued an urgent warning, saying it had learnt about safety concerns regarding the presence of a nitrosamine impurity called NDMA in ranitidine-containing medicines.

“NDMA is classified as a probable human carcinogen (a substance that could cause cancer) based on the results of animal studies. NDMA is a known environmental carcinogen and it is present in some foods and in water supplies in small quantities. NDMA is not expected to cause any harm when very small quantities are ingested,” SAHPRA said.

Ranitidine is used to treat the production of stomach acid in patients with conditions including heartburn and stomach ulcers. It is available as an over-the-counter and prescription medicine.

“SAHPRA is urgently liaising with the registered suppliers of ranitidine-containing medicines to investigate the presence of NDMA in South African ranitidine products.

“SAHPRA advises patients to speak to their health-care professional before they stop or switch to other medicines that are approved for similar indications as ranitidine.”