There have been multiple drug shortages in recent years.
There are numerous drugs in mental health professionals’ toolboxes to help get patients what best suits them. But sometimes when they reach for the one thing that’s proven to get the job done, their hands come up empty.
Right now, one of the most commonly prescribed drugs for anxiety — buspirone, which is still known by its discontinued brand name BuSpar — is in short supply.
The makers of the drugs cite increasing demand as the reason for the shortage that, as of this writing, has no foreseeable ending in sight. It’s also due to a major supplier not following safety protocols.
Experts say buspirone is a go-to anxiety treatment because of its low risk of side effects compared to benzodiazepines like Xanax and Klonopin. ‘Benzos’ are commonly misused for the euphoric high they give, which makes them prone to addiction and painful withdrawal.
Selective-serotonin reuptake inhibitors (SSRIs), another class of drugs used to treat anxiety, don’t give users a high, but they can have sexual side effects, including erectile dysfunction.
Kevon Owen, MS, a clinical psychotherapist in Oklahoma City, says buspirone is his favorite psychopharmacology recommendation because it’s not a benzodiazepine, meaning it’s nonhabit-forming and doesn’t appeal to people who are seeking out its high.
“But if you need something to break the edge off anxiety, when taken correctly, it’ll do the job,” he said. “It’s not addictive, and it’s not a nightmare to get off of.”
Dr. Alex Dimitriu, who’s double board-certified in psychiatry and sleep medicine and founder of Menlo Park Psychiatry & Sleep Medicine, says because of its limited disrupting side effects, which include dizziness and possibly sedation, “buspirone is a great medication.”
But with the drug shortage, people who are currently on the medication for anxiety may feel even more uneasy due to the increased likelihood it may not be there the next time they go get their prescription filled.
Part of it is due to a major manufacturer having to close one of its plants. Another part is there are more people in the United States with anxiety than other places.
The World Health Organization estimates that less than 4 percent of the global population — or about 264 million people — have an anxiety disorder.
In the area classified as the Region of Americas, it’s nearly double the global rate.
In the United States alone, the rates of anxiety disorders are nearly five times what people across the globe experience.
According to the federal government’s National Institutes of Health, nearly 20 percent of all adults had an anxiety disorder in the past year, according to data from the early 2000s.
Since then, at least in the United States, there’s been a lot going on to worry about on a grand scale, like natural disasters or mass shootings. That’s on top of everyday concerns, like affording to pay your rent or mortgage.
Dr. David Belk, who tracks the U.S. healthcare system at TrueCostofHealthcare.com and practices internal medicine in Alameda, California, says it’s not uncommon that only one or two suppliers will make the active ingredient for a generic medication that’s marketed by multiple generic pharmaceutical companies, such as is the case with buspirone.
“Since each active ingredient is usually manufactured in large batches that are meant to supply all of the companies for several weeks at a time, if anything happens to a batch — factory error, contamination, etc. — it will cause a shortage for a period of time until the factory can send out the next batch,” Belk told Healthline.
For example, Hurricane Maria not only crushed Puerto Rico, it also knocked out a major saline supplier there, setting off a shortage of the fluid commonly used in emergency medicine.
That’s the same with buspirone, minus the hurricane.
A Mylan Pharmaceuticals plant in West Virginia that produced about a third of the country’s supply of the drug was shut down because the facility was dirty and the company failed to follow quality control procedures, according to The New York Times.
Information from Mylan posted on the U.S. Food and Drug Administration (FDA) website currently estimates that the 100 and 500 pill bottles of 7.5 mg of buspirone will be available sometime this month.
However, the majority of the medication’s availability is listed as “TBD.” On the FDA’s website, the reason for the shortage is listed as “other,” or increased demand.
The news of the shortage has some experts worried. Not just because of the shortage, but how their patients may react to hearing news of it.
Dimitriu says he worries the “illusion of scarcity” could create a sense of panic and unnecessary anxiety for his patients.
“Certainly it is not good to start and stop psychiatric medications abruptly, and this is a definite issue with the current shortage,” he said.
Dimitriu recommends those currently on buspirone should start rationing their remaining supply “to do a ‘slow taper’ off” until supplies can be restocked, as well as speaking with your doctor and looking into alternatives to smooth the transition.
But experts say there’s an upside to the increased demand for anxiety medications: It means that people are becoming increasingly aware of mental health and seeking treatment.
As Dimitriu says he often tells his patients, the human mind is like a performance car and, in these fast times, it will inevitably need some fine-tuning.
“The destigmatization of psychiatry has certainly helped more people get the help they need,” he said.