Belgian Medical Community in Crisis Over Antidepressant Withdrawal

Brussels (Brussels Mornning) – Belgian pharmacists and psychiatrists are raising the alarm over a Danish pharmaceutical company suddenly withdrawing two commonly used antidepressants from the market.

Redomex and Nortrilen, are the brand names of two antidepressants that pharmaceutical company Lundbeck is withdrawing from the Belgian market. It causes great concern among Belgian psychiatrists. Because for around 140,000 people there is no other option than medication.

What Consequences Will Antidepressant Withdrawal Have on Patients?

“These are powerful first-generation antidepressants, which we prescribe to people for whom the alternatives do not work,” says Kirsten Catthoor, chairman of the Flemish Psychiatry Association (VVP). “It works for people with a major depressive disorder. For those people, it makes the difference between being in bed at home and still being able to go outside now and then.”

The situation is so serious that the VVP, together with other professional associations of both psychiatrists and pharmacists, wrote an open letter to the company. 

Is There an Alternative Solution for Antidepressant Shortage?

“From teenagers to centenarians, no one is immune and there is no difference. Carefully switching someone from one antidepressant to another is a job that will take six months. Carefully reduce one, then carefully increase the other and check for side effects. But that’s just it: this was often the last resort. The fact that it is an antidepressant makes the consequences even more serious. 

“There is so much talk about Ozempic’s shortage. That’s all very bad and I don’t want to minimize it, but for people with psychiatric problems, it is really of vital importance. Just the news that their waistline is disappearing makes them anxious and throws them off balance. As psychiatrists, we bring courage and hope, but this is very annoying.”

What Prompted Lundbeck to Withdraw Antidepressants from Belgium?

The reasoning given by the pharmaceutical company: it costs them more to sell the drugs here than to simply stop deliveries. Lundbeck even rejected a proposal from Riziv to “multiply” the refunded price. In other countries, sales will continue as usual.

Can Patients Rely on Government Support Amid Antidepressant Shortage?

To solve the problem, patients are advised by the government to go to the pharmacy well in advance with their prescription. They can then have the medication shipped from abroad. But that detour is not reimbursed and costs patients 8 to 13 euros per month, depending on the dose.

“At a time of scarcity, it is my responsibility to ensure that the people who need the medicine are helped,” says resigning Minister of Health Frank Vandenbroucke (Vooruit). “But I also call the company to account. They do not comply with certain legal obligations regarding supply, with all the consequences that entail. We will sanction them with a fine for this.”

Vandenbroucke refers to a transition period of six months that is not guaranteed. “These people have strong depressive symptoms or severe pain. You can’t just abandon them,” says Vandenbroucke. The government will also look for an alternative provider of the generic variant.