The UK is hit by a medicines supply crisis, with more than half a million patients facing shortages of vital medicines. Independent I was told that.
The NHS has warned of shortages of nine key medicines for illnesses including schizophrenia and bipolar disorder, forcing patients to search for pharmacies that have them in stock, limit their dosages and take potentially less effective medicines.
Education experts are warning that shortages of ADHD medications this year are already having an impact, with students missing school to manage their symptoms.
Mark Diane, from the Nuffield Trust, said the worsening shortages were being driven by weaknesses in supply chains that had emerged in the wake of the pandemic.
Nine government “serious shortage measures” have been put in place for the antipsychotic drug quetiapine (sold as Seroquel), which is used by around 250,000 people in the UK, with the Department of Health and Social Care (DHSC) warning pharmacists and doctors that there will be shortages of the drug until at least September.
ADHD patients are also facing shortages, with NHS doctors in the South West being told to stop prescribing methylphenidate – sold as Ritalin and Concerta – which is taken by more than 275,000 NHS patients.
Ian Hamilton, honorary research fellow in mental health and addictions at the University of York, warned of the consequences for patients who are forced to suddenly stop treatment.
“Ritalin is addictive, and if you suddenly stop taking it, you will experience significant withdrawal symptoms, including fatigue, irritability and depression,” he said. “It is also very serious to deny people the antipsychotic quetiapine. For most people, if they don’t have access to quetiapine, they are at their own risk.”
Stephen Kitchen, chief executive of Bipolar UK, stressed that people with bipolar disorder need to take their medication to stay well or their symptoms risk worsening.
He said: “Before they reach the tragic situation of being so unwell that they have to be hospitalised, patients can cause a lot of damage to themselves and those around them. The risk of suicide with bipolar disorder is very high. People are relying on this drug to survive.”
Kitchen said antipsychotics can be hard to stop taking once they start working, and it can take months to switch to another medication — and patients often can’t see a psychiatrist or their primary care doctor to make the switch.
“People are being put in a situation where they have to deal with it on their own,” he said. “This is just a recipe for disaster.”
The DHSC said shortages of other ADHD medications had eased, but problems with methylphenidate remained.
In the South West, doctors were told they could not start prescribing 12-hour medication to new patients and would instead be offered short-acting forms.The NHS has seen a sharp rise in prescriptions for ADHD drugs for adults, rising from 119,000 in 2022-23 to 152,000 last year. The number of people under 17 increased from 121,000 to 123,000.
A national patient safety alert was issued last September over a shortage of ADHD medication. The supply issues were expected to be resolved by December 2023, but they continue to persist, blamed on manufacturing issues and increased global demand.
There are growing concerns about the impact on children who use drugs such as Ritalin to treat ADHD, especially with the new school year approaching.
Niamh Sweeney, deputy general secretary of the national education union, said:: “This problem is already resulting in many young people missing school due to anxiety without medication, or being expelled or suspended because they find it difficult to regulate their behaviour without medication. This is a situation that urgently needs to be remedied.”
Dr Rory Cohn, a paediatric allied psychiatrist at Devon, added: “Just this week we’ve had several patients who are rapidly deteriorating. They need to take their medication more frequently but the effect is wearing off. It’s more intermittent control rather than consistent control.”
“If there were problems like this with drugs used to treat serious physical illnesses, there would be a national outcry.”
Paediatricians said what began as a temporary shortage was dragging on with no sign of a solution, warning that the problem had “worsened significantly in recent months.”
For patients already receiving 12-hour infusions, doctors were told to consider stopping treatment, using an alternative formulation, or switching to a different medication, such as lisdexamfetamine, which may not work for some patients.
Rachel Maskell, a former NHS care worker and physiotherapist and Labour MP who sits on the House of Commons health committee, said: “Shortages of medicines would clearly have very serious implications for people who rely on them, so this is a really urgent issue that the Government must address.”
A Ministry of Health spokesman said recent supply issues for most ADHD medications have now been resolved, but they are aware of ongoing global supply issues affecting methylphenidate extended-release tablets.
The department said it was working with the manufacturers of both drugs to resolve the issue, adding that the quetiapine shortage rule was put in place to allow pharmacists to supply different strengths of the drug and to prevent patients from having to search for stock.
