Antidepressant shortages cause anxiety for patients with mental illnesses

With two popular depression medicationsin short supply,mental health experts say prescribinggeneric replacements ordifferentdrugs can lead torelapseand a new set of side effects.

Certain formulations ofWellbutrin(bupropion)and venlafaxine sold under the brand nameEffexor, among others are not available throughout the country.

It's a "big problem," according to Dr. Pierre Blier, who treats patients atThe Royal Ottawa Mental Health Centre and isdirector of mood disorder research at The Royal's Institute of Mental Health Research.

Because of theshortage he was forced to prescribe a fast-release version of Wellbutrin, which hascaused serious side effects in some of his patients

"Often we see a relapseor a return of their symptoms," he said.

'Rebound anxieties'

Over the last few months, Blier has also had to switch patientstakingEffexor to a generic brand.

"Sometimes if[the patients] are switched to generic brands, it's as if they weren't taking anyactive ingredient," he said.

Other patients have described what Blier called discontinuation symptoms, including "rebound anxieties or a sensation like electrical shocks," hesaid.

Vanier pharmacist Phil Emberleysaid he's worried because many of hiscustomers takeEffexoror Wellbutrin.

The pharmacy he works at, Pharmasave Respect Rxon Selkirk Avenue,has a close working relationship with Recovery Ottawa, an addictiontreatment centre.

"I see it as being quite problematic because for patientsthat are stabilized on an anti-depressant,it's very challenging to have to switch them to another medication that isn't as effective or may come with additional side effects they haven't experienced before," Emberley said.

People taking medications for mental illness are especially vulnerable, he argued.

"You don't want to create any more anxiety in the patient," he said.

"There is a certain degree of, for lack of a better word, experimentation, to find the certain drug to treat their anxiety or depression, soyou don't want to constantly change this."

Shortages ongoing

Drug shortages are nothing new in Canada. Overthe last few years there havebeen short suppliesof blood pressure medications and some anesthetic drugs used during surgery.

Last summer, acritical shortage of EpiPens which many people with life-threatening allergies depend on to stop an anaphylactic reaction raised serious concerns.

InCanada it'smandatory for drug manufacturers to reportanticipated andactual shortagestoa national website Health Canada oversees.

The shortage of various formulations of Wellbutrin which is primarily used to treat depression but also seasonal affective disorder has been ongoing since September 2018.

The current shortfall is with Wellbutrin SR, which releases slowly.

According to Arthur Shannon, a spokesperson for Wellbutrin manufacturer Bausch Health, it's due to a shortage of an active ingredient in the drug that's supplied by another company.

Bauschcan't say when Wellbutrin SR will be available again, Shannon said.

SandozCanada, one of the manufacturers of venlafaxine, saidit doubled its sales of the drug last month and it's now completely out of some formulations of venlafaxine and in limited supply of others.