"Every day, I receive calls and text messages from desperate patients": the shortage of psychotropic drugs risks putting patients in danger

Will we have to wait for deaths before health authorities finally react to the dramatic situation facing thousands of French people suffering from mental health disorders, who are unable to obtain essential medication for their mental health? This is, in any case, what Dr. Florian Coromines, a private psychiatrist in Nice and vice-president of the FMF-Specialists union, fears. "Every day, I receive calls and text messages from desperate patients whose pharmacists have told them that their medication is out of stock."

The shortage of psychotropic drugs continues to worsen, affecting a growing number of treatments: "Basic psychiatric medications, essential for the mental stability of thousands of patients, are now completely out of stock, for a prolonged period, and sometimes without any alternative. And further shortages are expected in the coming months. It's catastrophic," laments the psychiatrist.

Chronic shortages with dramatic consequences

It all started several months ago with the shortage of Concerta (methylphenidate), a highly effective medication for attention deficit disorder. Then shortages multiplied, particularly affecting one of the rare mood stabilizers used in bipolar depression, quetiapine, but also extended-release injectable antipsychotics, indicated for schizophrenia. And for the past month, two antidepressants, sertraline and venlafaxine, have been in short supply.

"These are the two most commonly prescribed medications for depression. Today, they are impossible to find. I no longer have the means to properly treat my patients." Some find themselves without a therapeutic solution, due to a lack of a suitable or well-tolerated equivalent. Others, abruptly withdrawn, sink into critical conditions. The alarm is no longer theoretical: hospitalizations are already occurring due to a lack of treatment. "Just this morning, I had to hospitalize a patient with acute depression. She has been without treatment for several days."

Magistral preparations, an alternative

Faced with this wave of shortages and the threat hanging over their patients, doctors have proposed a solution: compounding. Customized versions of medications, produced directly by pharmacists from available active ingredients. " In dermatology, it's common. In psychiatry, we can do the same for all medications. And we did it for certain antidepressants. Until the Health Insurance decided, a month ago, to no longer reimburse them—on the grounds that their cost is much higher than generics—unless there is a prior reimbursement protocol with the ANSM ( National Agency for the Safety of Medicines, Editor's note). " However, these protocols take weeks, even months, to be validated. " This is what happened with quetiapine (an antipsychotic) and sertraline; negotiations on the price of the compounded drug are still ongoing for the latter. And for other drugs, such as venlafaxine, the procedure hasn't even begun yet! We're hitting an administrative wall." The result: powerless doctors, blocked pharmacists, and patients without treatment.

"The active ingredients exist. Pharmacists can manufacture them. We have the solution. But we're drowning in price negotiations. It's absurd ," the specialist exasperated. "It's urgent that these preparations be automatically reimbursed as soon as a shortage is detected, in order to guarantee rapid and equitable access to treatments for patients."

Towards a breaking point?

This pharmaceutical chaos comes at a time when French psychiatry is already under extreme pressure: a shortage of practitioners, an exponential rise in disorders, endless queues to access a consultation... "Mental health is already the poor relation of medicine. Now, its legs are being cut off." And the worst may be yet to come. Tensions are now appearing over lithium, a key treatment for bipolar disorder. "If it becomes effectively in short supply, the risk of suicide will explode," warns ^Dr. Coromines.

While the whole of Europe is affected by supply tensions, France is particularly vulnerable. Laboratories there receive little compensation for their medicines, which provides little incentive to ship their stocks there.

While 2025 has been declared the "Year of Mental Health," caregivers are denouncing absolute cynicism. "We debate the additional cost of compounding, but we must understand that we're not talking about minor injuries! The medications currently in short supply prevent suicides, hospitalizations, intensive care, prolonged work stoppages, and serious decompensations that can endanger the lives of patients or others... The human and economic cost they represent is far greater than that of compounding." The psychiatrist calls on the media, patients, and families not to remain silent. To alert, question, and shake up the authorities. " Patients need to know. They need to be able to talk about it with their doctor. They need to anticipate it. And above all, they need to understand that this is not an isolated case. It's an entire system that is failing."

Beyond a trivial administrative malfunction, France is facing a public health crisis. If nothing is done quickly, it will cost lives.