Shortages of life-saving and vital psychotropic drugs endanger hundreds of thousands of patients

More than half a million patients are facing shortages of vital medicines as the UK faces a medicines supply crisis. The Independent was told.

The NHS has issued warnings about shortages of nine key drugs for conditions including schizophrenia and bipolar disorder, leaving patients scrambling to find pharmacies that stock the drugs, rationing doses and potentially taking less effective medication.

Education experts warn that the shortage of medication for ADHD (attention deficit hyperactivity disorder) has already had an impact this year, with students unable to attend school due to their symptoms.

According to Mark Dyan of the Nuffield Trust, the increasing shortage of medicines is due to the fragile supply chains that have emerged as a result of the pandemic.

The antipsychotic quetiapine – sold as Seroquel – which is taken by around 250,000 people in the UK, is subject to nine government “severe shortage protocols”. The Department of Health and Social Care (DHSC) has warned pharmacists and doctors of shortages of quetiapine until at least September.

ADHD patients are also facing shortages. NHS doctors in the South West are no longer allowed to prescribe methylphenidate. The drug is sold under the names Ritalin or Concerta and is taken by more than 275,000 NHS patients.

Ian Hamilton, Honorary Fellow for Mental Health and Addictions at the University of York, warned of the consequences for patients who would suddenly have to stop their treatment.

“Ritalin can be addictive, meaning that if someone abruptly stops taking the drug, they will experience significant withdrawal symptoms such as fatigue, irritability and depression,” he said. “Taking a person off quetiapine, an antipsychotic, is also very serious. Most people put themselves at risk if they don't have access to quetiapine.”

Steven Kitchen, chief executive of Bipolar UK, stressed that patients with bipolar disorder need their medication to stay healthy, otherwise their symptoms can worsen.

He said: “They can do a lot of harm to themselves and those around them before they get to the horrific scenario where they have to be hospitalised because they are so unwell. The risk of suicide in bipolar disorder is very high. People rely on these drugs to stay alive.”

Mr Kitchen said it can be difficult to stop taking an antipsychotic once it is working and it can take months to switch to another medication. Patients are often unable to see a psychiatrist or even a GP who can help them do this.

“People are being left to their own devices,” he said. “It's a recipe for disaster.”

According to the DHSC, while shortages of other ADHD medications have decreased, methylphenidate remains a problem.

In the South West, doctors were told that new patients could not be prescribed a 12-hour dose but would be offered shorter-acting variants instead. The NHS has seen a sharp rise in prescriptions for adult ADHD medication, from 119,000 patients in 2022-23 to 152,000 last year. The number of patients aged 17 and under rose from 121,000 to 123,000.

In September last year, a national patient safety alert was issued due to shortages in the supply of ADHD medication. Supply issues were expected to be resolved by December 2023, but problems persist and are attributed to manufacturing issues and increased global demand.

There are concerns about the impact on children taking medications such as Ritalin to treat their ADHD, particularly with the new school year fast approaching.

Niamh Sweeney, deputy general secretary of the National Education Union, said: “This problem has already resulted in many young people staying away from school because of their anxiety without medication, or being expelled or suspended from school because they cannot control their behavior without medication. This is a situation that needs to be addressed quickly.”

Dr Rory Conn, a child psychiatrist in Devon, added: “This week alone I have had several patients who have become progressively worse. They have to take more frequent doses which are less effective for them. The experience is one of intermittent rather than continuous control.”

“If we had this problem with medications for a serious physical illness, there would be a national outcry.”

The pediatrician said the initially temporary shortage continues with no solution in sight and warned that the problems have “worsened considerably in recent months.”

For patients already taking the 12-hour medication, doctors have been advised to consider treatment breaks, alternative dosage forms, or switching to another treatment, lisdexamfetamine, as it does not work for some patients.

Labour MP Rachael Maskell, a former NHS nurse and physiotherapist who sat on the House of Commons Health Select Committee, said: “Shortages clearly have very serious consequences for people who rely on medicines, so this is a very urgent matter that the Government needs to get under control.”

A DHSC spokesman said recent supply issues with most ADHD medications had now been resolved, but the department was aware of ongoing global supply issues related to extended-release methylphenidate tablets.

They said they were working with the manufacturers of both types of medicine to resolve the issues, adding that the protocols to avoid shortages of quetiapine were put in place to allow pharmacists to provide different strengths so patients do not have to search for supplies.