Withdrawing Priadel—very expensive for the NHS and extremely worrying for patients

I take Priadel, a form of lithium carbonate, to help me recover from decades of severe mental illness: psychosis, depression, suicidality, and self-harm. Priadel helps me find some sort of order within the mayhem of my psyche, so I can live well. 

My hard-earned stability is soon to be unsettled, with the looming discontinuation of Priadel. A supply disruption alert was recently announced, saying that Essential Pharma Ltd will withdraw their production of Priadel 200mg and 400mg modified-release tablets in the UK. Supplies will stop in April 2021. 

This has potentially disastrous consequences for people like me who take Priadel (there were 760,601 prescriptions of Priadel in the past year). Priadel, or lithium, is a crucial drug, prescribed for bipolar disorder, severe depression, self-harm and suicidality. Of the 3 million people in the UK who have bipolar, one in five take lithium.

Priadel stabilises my mood and helps me maintain my composure, in spite of ongoing psychotic experiences. I am dependent on Priadel, which is not necessarily a good thing, but it keeps me well. 

Any form of lithium is a “high risk” medicine, because it can be toxic and then fatal. It is hard to get the dosage correct, because there is a narrow therapeutic index, so blood tests are required every few months. Blood levels need to stay within a very tight range for the dosage to work safely. 

I understand there are other brands of lithium, but changing the brand of lithium is a complicated, long-winded procedure. I will need to rely on close monitoring from my GP and mental health team, with more regular blood tests, to prevent toxicity and ensure I take the correct dose. 

Changing brands will be expensive and a drain on resources for the NHS. Essential Pharma Ltd produces another brand of lithium called Camcolit. But this does not come in the 200mg dose, further complicating any transition. Essential Pharma Ltd have just increased the price of Camcolit to £48.18 per pack of 400mg tablets (compared with £4.02 for a 400mg pack of Priadel). Withdrawing Priadel will cost the NHS £15 million, just for the added expense of the drugs. 

I ask my consultant psychiatrist if my treatment will change and how I can be stable, without Priadel. There is a plan to switch brands, and I have to hope that this will be effective. But, I am scared about changing drugs, in case it triggers me to fall into the dangerous symptoms which defined my long illness. 

Lorna Collins, Patient Representative (Royal College of Psychiatrists) Twitter: @sensinglorna 

Competing interests: None declared.