Breaking
Latest health news from South Africa and around the world•Wellness, nutrition, and fitness updates daily•Medical breakthroughs and healthcare updates•Science-backed health explainers and guides•Health tech, reviews, and upcoming events•
SA Health News Desk
SASOP says antipsychotic and antidepressant stockouts since June put patients at risk of relapse. Suppliers have promised to fill orders by end November.
For families who collect psychiatric medicine from a public clinic, a missing bottle is not an abstract supply problem. It is the week the dose stops. South Africa's psychiatrists have asked Health Minister Aaron Motsoaledi to investigate a shortage of psychiatric medicines in public hospitals and clinics. They warn that patients with schizophrenia, bipolar disorder and major depression are at risk of relapse.
The South African Society of Psychiatrists (SASOP) says its members have been reporting stockouts since June. The complaints come from across the country. Most are from Gauteng, KwaZulu-Natal, the Western Cape and the Eastern Cape.
The short version: several common antipsychotics, antidepressants and a sedative injection are reported short in the public sector, suppliers have told the department they will fill outstanding orders by the end of November, and nobody should stop or swap a psychiatric medicine on their own.
SASOP named olanzapine, an antipsychotic widely used for schizophrenia. Psychiatrists have been substituting amisulpride, which costs more. The society says that substitute is now in limited supply too and will run out.
Psychiatrists who spoke to TimesLIVE listed more: the antipsychotics risperidone, aripiprazole, quetiapine and chlorpromazine; the antidepressants fluoxetine and amitriptyline; injectable lorazepam, used to calm agitated patients; and orphenadrine, which treats some side effects of antipsychotics. SASOP has not formally surveyed its members, so the list may be incomplete. A medicine that is short at one hospital may still be on the shelf at another.
The national health department's October shortage list carried 14 antipsychotic lines. That list is a snapshot of what the department itself was tracking. It is not a live stock count for the clinic you use this morning.
Dr Mvuyiso Talatala, a past president of SASOP, said the alternatives are limited and some patients respond only to the medicine they are already on.
"The impact of the psychotropic drug shortages is devastating to patients, health facilities and the community at large."
Relapses harm a patient's overall health and are harder to treat, he said. They also fill hospital beds. Psychiatric beds are already scarce, so patients wait in emergency departments for hours or days. SASOP says those departments are not built or staffed to nurse people with mental illness, which exposes patients to harm and compromises care for other emergency patients.
Some hospitals have also stopped psychiatrists from writing private prescriptions, the society says. Families who could afford to buy a missing medicine at a retail pharmacy then cannot, because the script that would let them do it has been blocked. That is a second lock on the same shortage.
Nurses and a hospital manager in Gauteng told Sowetan, in a report published on Friday 13 November, that the shortage has made wards harder to run. A manager at a Tshwane hospital, who asked not to be named, said the hospital had no chemical sedatives and that newly admitted and relapsed patients were more aggressive and harder to manage. She said nurses were being assaulted regularly.
A nurse at Weskoppies Psychiatric Hospital said substitute medicines did not always work as well, and that without injectable sedatives staff sometimes had to wait for security to help with an aggressive patient. That is a description of a ward trying to cope. It is not a judgement on the people admitted there.
Little Eden, an Ekurhuleni home for about 300 people with profound intellectual and physical disabilities, has spent almost R150,000 in three months buying medicines the state should have supplied, chief executive Ann Coetzee told Sowetan. Psychiatrist Dr Kali Tricoridis, who works with the home, said an interruption can undo months of progress, because it takes weeks to build a patient back up to an effective dose.
Health department spokesperson Foster Mohale told Sowetan that suppliers had cited manufacturing delays linked to difficulty sourcing active ingredients, along with global supply disruptions including the blockage of the Strait of Hormuz. He said suppliers have committed to filling outstanding orders by the end of November and to holding at least two months of buffer stock from December.
The department has also blamed some local manufacturers for failing to meet the standards of the South African Health Products Regulatory Authority (SAHPRA). The regulator answered this week. Communications manager Rodgers Baloyi said shortages are "multifactorial" and that "regulatory compliance interventions are not necessarily the sole cause". SAHPRA would not name the manufacturers it has found non-compliant.
SASOP says none of the explanations it has heard accounts for so many medicines, from different companies and for different conditions, running short at once. It has offered to meet the minister. A meeting is not a delivery. The date families can hold the department to, on Mohale's account, is the end of November for outstanding orders, and December for a two-month buffer.
Do not stop taking psychiatric medication. Do not change the dose because a neighbour was given something else. Go back to the clinic or hospital that prescribes it and ask what is available that day. A change of medicine needs a doctor who can see the notes. If you or someone in your family becomes unwell after a change, or after a missed dose, return to the facility or go to the nearest emergency department.
If the hospital will not write a private script, ask that refusal to be recorded and ask which public alternative is actually in stock. If you care for someone at home and the bottle is empty, take the empty container and the appointment card with you so the pharmacist can see the exact product, not a description from memory.
The society has not published a national count of patients who missed doses. The department has not published, facility by facility, which of the named medicines will arrive before the end of November. SAHPRA has not named the manufacturers it found non-compliant. Those gaps matter, because a promise of buffer stock in December does not fill a ward that has no sedative injection tonight.
None of this replaces advice from your own clinician. If you are unsure about a psychiatric medicine, a missed dose, or whether a substitute is safe for you or for someone you care for, contact the clinic that prescribes it, a pharmacy, or an emergency department. Do that especially if the person is a child, is pregnant, or has suddenly become agitated, withdrawn or unsafe.
Source: SA Health News
