No meds for mental illness

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antidepressants_1673710c
Scores of Eastern Cape patients suffering from psychiatric conditions have been turned away from some East London hospitals and clinics that have run out of crucial anti-depressant medication.

The worst affected site, Mdantsane’s Cecilia Makiwane, has reportedly been without the necessary selective serotonin reuptake inhibitors (SSRI) drugs for about a week.

As a result, doctors say they have had to send both in- and out-patients home without medication.

Although an “older” form of anti-depressant is available at the hospital, doctors say they cannot use it as it has toxic side-effects and overdosing on it could be fatal.

The Eastern Cape chairwoman of the South African Society of Psychiatrists (Sasop), Professor Zukiswa Zingela, yesterday told the Daily Dispatch that she received reports on Friday that there was a shortage of anti-depressants at both Frere and Cecilia Makiwane hospitals.

“We fear this problem will affect other parts of the province soon.

“It has not been reported in Port Elizabeth, but we do have fears, and as a result have asked for a stock count to be done so we can know where we stand,” Zingela said.

The shortage has sparked concerns about an increase in suicides in the city over the Christmas season, particularly since the patients affected are those who suffer from depression and anxiety, among other conditions.

Provincial health spokesman Sizwe Kupelo said the problem lay with the supplier of the medication, but could not say when the supplies were likely to be available.

The CMH mental health unit caters for more than 1000 patients from across the Amathole district, while Frere Hospital deals only with out-patients.

“There is an anti-depressant that is in short supply from the supplier countrywide. An alternative is available and patients are given the drug,” Kupelo said.

“No one is turned away at CMH and denied care. All psychiatric patients are seen at CMH, at Frere it may be down referrals to the clinic.”

A doctor however, told the Dispatch: “We have been without medication at CMH for at least a week now and it is a serious problem.

“We have had to send patients home. We can’t treat children and the elderly who suffer from depression and anxiety unless we use the old medication which has a lot of side-effects.

“Some doctors have even questioned why they still go to work because they can’t work now.

“We have had no choice but to send patients home. There is a valid reason why they were put on the modern medication as some have chronic conditions and the old medication is very sedating.

“It affects the heart and drops the blood pressure, we can’t use it,” said the doctor.

The provincial health authorities have over several years been under fire for failing to prioritise psychiatric care. Had it been a shortage of HIV/Aids anti-retroviral drugs, the matter would more likely have received urgently attention, one doctor said.

Outgoing Sasop president Dr Mvuyiso Talatala said there were no reports of anti-depressant shortages in other provinces.

“There are drug stock-out reports across the country but nothing specific to anti-depressants. There should never be a shortage of anti-depressants, especially because they should be available with the general doctors and at clinics.

“There are so many companies that manufacture the drugs, when there is a shortage it is usually a problem with the tender awarded, not with supply,” Talatala said.

He said the patients who were now missing out on medications were mostly likely to relapse and be less motivated to go back for medication after being told there was no medication available.

“If there was an alternative available we would not be having this conversation. I can understand why they are sending the patients back home because the old medication is very dangerous. It is toxic in overdose and is a big risk,” Talatala said.

Sasop’s national public sector convener for psychiatry, Dr Lesley Robertson, said she was not aware of any anti-depressant supply problems experienced nationally.

“There have been no complaints, and even if there was a national supply problem, provinces can source out their medication from another manufacturer. They can buy from another source, so I don’t think supply should be an issue,” Robertson said.

However, Kupelo said the provincial department could not buy from another company as the tendering process was done at a national level.

A study published in the South African Medical Journal earlier this year noted that suicides increased at this time of the year.

“There were peaks noted in December and October – the same two months when male suicides peaked in South Africa in 2009,” it said. — mamelag@dispatch.co.za

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