The Crisis: Quetiapine Supply Disrupted

Since January 2025, France has been grappling with a shortage of quetiapine, a medication crucial for managing conditions such as schizophrenia and bipolar disorders. Supply chain issues have impacted all forms of the drug, leaving many vulnerable patients without consistent access to their prescribed treatment.

Alarming Consequences for Patients

Quetiapine, often marketed as Xeroquel, is essential for stabilizing individuals with severe psychiatric disorders. the National Medicines Safety Agency (ANSM) attributes the shortage to production problems at Pharmmathen International,affecting all available dosages.The impact is substantial; according to Antoine Pélissolo, head of service at CHU Henri-Mondor de Créteil, “More than 2.8 million Quetiapine boxes are sold in pharmacies each year, which allows to treat around 200,000 patients.“

The scarcity of quetiapine can lead to a destabilization of patients’ mental health, increasing the risk of relapse and potentially perilous behaviors. UNAFAM, the National Union of families and friends of sick people and/or the mentally disabled, has reported “unprecedented distress” among those affected and their families. Without consistent medication, individuals may experience a resurgence of symptoms, requiring urgent medical intervention and potentially leading to hospitalization.

Recommendations for Healthcare Professionals

In response to the crisis,the ANSM has issued specific guidelines for healthcare providers:

• Doctors: Consider therapeutic alternatives for new patients and,if feasible,for existing patients,accept those experiencing a depressed episode within the context of bipolar disorder.
• Pharmacists: Prioritize unit dispensation of quetiapine or offer compounded preparations for immediate release. These compounded versions can definitely help bridge the gap until the supply chain stabilizes.

European Collaboration for a Solution

To mitigate the shortage, the ANSM has activated the European voluntary solidarity mechanism. this allows other EU member states to provide support by sharing available stocks of quetiapine, ensuring continuity of care for French patients and minimizing the adverse effects on their mental health.

Details for Patients per ANSM

here’s what patients need to know if their prescribed quetiapine is unavailable:

• Option Treatments: “Your doctor may have to modify his prescription Depending on your situation. He will then prescribe another medication by adjusting the dose and with suitable monitoring methods.”
• Masterful Preparations: “In the event of unavailability of your usual treatment from Quetiapine to prolonged Liberation (LP) in pharmacies, The pharmacist will be able to provide you with Quetiapine capsules in immediate liberation (LI) in the form of a masterful preparation.” A masterful preparation is a drug made by the pharmacist, in the event of unavailability of the prescribed drug. “He will give you a use sheet, read it carefully before taking the medication.”

Important Considerations:

• “The form in immediate release will require adapting the number of sockets per day. If the pharmacist or the doctor tells you that you must take the quetiapine in immediate liberation in twice (morning and evening), Respect an interval of 8 to 12 hours between the catches.”
• “Please note, the frist dose of immediate liberation quetiapine should be taken approximately 24 hours after the last dose Quétiapine prolonged Liberation (LP).”
• “Quetiapine in immediate release capsules can increase the effects of drowsiness and dizziness…do not drive a vehicle or do not use tools or machines before knowing what effect these capsules will have on you.”
• “Report to your doctor any side effect or symptom that you consider unusual or if you have the impression that treatment does not act as usual.”

Understanding the Quetiapine Crisis

archyde: Dr. Dubois, thank you for joining us. Can you explain the current quetiapine shortage in France and why it’s such a meaningful concern?

Dr. Dubois: thank you for having me. The shortage of quetiapine, a crucial medication primarily used for conditions like schizophrenia and bipolar disorder, is indeed causing widespread anxiety. It stems from production issues affecting Pharmmathen International, disrupting the supply chain and leaving many patients without consistent access to a medication vital for their mental stability. It’s a domino affect that has far-reaching consequences.

Impact on patients and Families

Archyde: What are the immediate consequences for patients who can’t access their regular quetiapine prescription?

Dr. Dubois: The implications are severe. Abruptly stopping or reducing quetiapine can destabilize a patient’s mental state, potentially leading to relapse, increased anxiety, and even hospitalization. As UNAFAM has highlighted, this shortage is causing “unprecedented distress” for patients and their families. The disruption to their treatment can undo months, sometimes years, of careful management.

Navigating Treatment Alternatives

Archyde: The ANSM has issued guidelines for healthcare professionals. Can you elaborate on the recommended therapeutic alternatives and the effectiveness of compounded quetiapine preparations?

Dr. Dubois: Doctors are being advised to consider alternative medications, particularly for new patients or those not currently in a depressive episode related to bipolar disorder.Pharmacists are also vital in offering compounded, immediate-release preparations of quetiapine. While not identical to the prolonged-release versions many patients are used to, these compounded options can serve as a temporary bridge, maintaining some level of therapeutic effect until the supply chain stabilizes. Patients need to be carefully counselled on dosage adjustments, especially timing, and potential increased sedation when using compounded formulations.

The Role of European Collaboration

Archyde: How effective is the European voluntary solidarity mechanism in addressing this quetiapine shortage?

Dr. Dubois: The collaborative effort through the European solidarity mechanism is essential. By allowing other EU member states to share their quetiapine stocks, it can help alleviate the immediate pressure in France and ensure continuity of care for patients. Though, it’s a temporary solution. We need a more robust, long-term strategy to prevent future shortages of essential medications.

Patient Awareness and Advocacy

Archyde: What advice would you give to patients currently struggling to obtain their quetiapine prescription?

Dr. Dubois: First and foremost, contact your doctor or psychiatrist instantly. Discuss alternative treatment options and ensure close monitoring. Understand the differences between your usual prolonged-release quetiapine and any immediate-release alternatives,paying close attention to dosage timing. Report any unusual side effects or changes in your condition to your healthcare provider promptly.advocate for secure medication supplies by contacting your local representatives.

A Broader Perspective on Medication Security

Archyde: Looking beyond the current crisis, what systemic changes are needed to prevent future medication shortages?

Dr. Dubois: We need a multi-faceted approach.This includes diversifying pharmaceutical manufacturing locations, enhancing supply chain transparency and resilience, implementing stricter regulations on pharmaceutical companies, and investing in domestic pharmaceutical production capabilities. also, promoting open and honest dialog between all stakeholders involved (authorities, manufacturers, doctors, and pharmacists) is mandatory to act diligently and efficiently. Critically ensuring that policies are in place that prioritize continuity of care and patient access to essential medications is paramount.

A Question for Our Readers

Archyde: Dr.Dubois, this has been incredibly insightful. To our readers: What steps do you think governments and pharmaceutical companies should take to ensure a stable supply of essential mental health medications and prevent situations like this quetiapine shortage from happening again? Share your thoughts in the comments below!