Psycho-Babble Medication Thread 1110002

Shown: posts 1 to 9 of 9. This is the beginning of the thread.

 

NARDIL SHORTAGE....The end of Nardil is near?

Posted by cranez on May 7, 2020, at 10:52:35

Guys, I am in Australia. We have had MASSIVE problems getting Nardil.

It has been very hard to acquire Nardil here in Australia (and New Zealand, the UK, and other countries). I am sure you are all aware of this. I had a very lengthy conversation with a pharmacist at Link (Nardil's former Australian sponsor/distributor). She essentially said the following which concerns all MAOI users worldwide.

Can anyone provide any feedback or advice?


Manufacturing sites are inspected regularly (by the FDA and other authorities). In order to synthesize Nardil and Parnate, certain specialized equipment is required. This equipment is very costly.

All manufacturing sites are required, after a certain length of time, to have their old equipment replaced by new equipment (similar to the way a Boeing 747 plane can only fly a certain mileage and then must be replaced, by the airline company, by a new Boeing 747 plane)

After a certain length of time, all manufacturing sites must be upgraded. This means buying all new equipment, and any novel specialized equipment.

MAOIs (as opposed to SSRI's) requires manufacturing sites to expend more money in purchasing the specialized equipment required for producing MAOIs.

This is the result:

All Manufacturing sites that currently produce MAOIs will be asked to upgrade at a certain point in time.

Given that, globally, so few patients take MAOIs, there is little incentive for manufacturing sites to pay for the highly expensive equipment required to produce MAOIs. It is by no means a lucrative decision for them.

Thus, Nardil and Parnate will, within a few years, be no longer produced unless more patients take these medications**. Nardil will go first, and then Parnate.**

How can MAOIs be used more?

MAOIs will have to have more indications for their use; that is, conditions which makes MAOI treatment advisable (for example, a recent study on Prostate cancer suggests Nardil can provide a therapeutic effect)

More doctors will have to be educated on them and prescribe them more for the conditions for which they are already indicated (it should be known that even university lecturers who teach medical students psychopharmacology, often do not teach about MAOIs now).

Doctors have to know more about the material contained in sites such as https://psychotropical.com/
, and be aware of the journal articles that demonstrate the efficacy and safety of MAOIs.

After 20 years of studying these medications, there is no doubt at all in my mind that MAOIs are the most efficacious antidepressants available and are extremely safe when administered correctly. In fact, apart from in actively suicidal patients, there is no real justification as to why they should only be relegated as the "last treatment option". SSRIs are not as "side-effect free" as some suggest, and I have read plenty of cases where people had more side-effects on an SSRI than an MAOI.

 

Re: NARDIL SHORTAGE....The end of Nardil is near?

Posted by rose45 on May 7, 2020, at 12:21:34

In reply to NARDIL SHORTAGE....The end of Nardil is near?, posted by cranez on May 7, 2020, at 10:52:35

This is extremely worrying.

However, im in the situation of having had nardil poop out on me in 2013 and now parnate pooping out and im being left with severe problems .... and being in the uk, cant go back to nardil, or afford to pay for marplan.... so what to do? I would so appreciate some advice, even ken gillman has said I need to go to a specialist . Any help gratefully received..... i cant live a life being this incapacitated.

 

Re: NARDIL SHORTAGE....The end of Nardil is near?

Posted by PeterMartin on May 7, 2020, at 20:54:04

In reply to NARDIL SHORTAGE....The end of Nardil is near?, posted by cranez on May 7, 2020, at 10:52:35

There has been a lot of discussion about this in this Reddit group:

https://old.reddit.com/r/MAOIs/

One potential saving grace for Nardil seems to be that it's being tried (so far successfully) as a treatment for prostate cancer. If it's repurposed for that it'll surely remain available.

 

Re: NARDIL SHORTAGE....The end of Nardil is near?

Posted by alexandra_k on May 9, 2020, at 6:55:55

In reply to Re: NARDIL SHORTAGE....The end of Nardil is near?, posted by PeterMartin on May 7, 2020, at 20:54:04

That is interesting.

As a reason why companies are stopping it's manufacture.

An alternative would be to lump it as part of a bundle as a 'worthy cause' somehow...

I was reading how it was difficult to manufacture one of the anasthetics. It is out of patient so being manufactured cheaply in India. It is hard to manufacture because of emulsification process or something and also has a tendancy to become contaminated with bateria because it is lipid.

There was something about how they could get people to keep purchasing it even though it was more expensive.. To promote the quality control.

Make money from some things (viagra or whatever) then re-invest those funds, not for financial profits, but for good.

Maybe someone will be able to help out MAOI's or something, like that. Because they are good things to have around and about. Without needing to grow the market for them (in ways that may be personally harmful to patients) I mean to say.

 

Re: NARDIL SHORTAGE....The end of Nardil is near?

Posted by undopaminergic on May 9, 2020, at 7:19:09

In reply to Re: NARDIL SHORTAGE....The end of Nardil is near?, posted by alexandra_k on May 9, 2020, at 6:55:55

I just have a hard time believing there is anything peculiar to MAOIs as a class that makes them harder or more expensive to manufacture. If it were just Nardil, I'd buy it, but if it applies to Parnate and Marplan too, that would be too much of a coincidence.

-undopaminergic

 

Re: NARDIL SHORTAGE....The end of Nardil is near?

Posted by cranez on May 9, 2020, at 9:47:51

In reply to Re: NARDIL SHORTAGE....The end of Nardil is near?, posted by undopaminergic on May 9, 2020, at 7:19:09

> I just have a hard time believing there is anything peculiar to MAOIs as a class that makes them harder or more expensive to manufacture. If it were just Nardil, I'd buy it, but if it applies to Parnate and Marplan too, that would be too much of a coincidence.
>
> -undopaminergic
>

Because Nardil is a hydrazine derivative?
I thought the same, but I was told it applies to all MAOIs.
It's very worrying.

 

Re: NARDIL SHORTAGE....The end of Nardil is near?

Posted by undopaminergic on May 9, 2020, at 10:05:37

In reply to Re: NARDIL SHORTAGE....The end of Nardil is near?, posted by cranez on May 9, 2020, at 9:47:51

> > I just have a hard time believing there is anything peculiar to MAOIs as a class that makes them harder or more expensive to manufacture. If it were just Nardil, I'd buy it, but if it applies to Parnate and Marplan too, that would be too much of a coincidence.
> >
> > -undopaminergic
> >
>
> Because Nardil is a hydrazine derivative?

I think Marplan is too. So if that is the issue, the problem would apply to both of them but not Parnate.

> I thought the same, but I was told it applies to all MAOIs.

Even selegiline, rasagiline, and moclobemide?

> It's very worrying.
>

Alas, I live in a country where none of the 3 classic MAOIs are available.

-undopaminergic

 

Re: NARDIL SHORTAGE....The end of Nardil is near?

Posted by PeterMartin on May 12, 2020, at 10:09:49

In reply to Re: NARDIL SHORTAGE....The end of Nardil is near?, posted by cranez on May 9, 2020, at 9:47:51

Marplan (in the US) is manufacturered by one company that specializes in outdated meds that they can jack up the prices on. Unless they're bought out it should remain available. It's not the same as relying on the big Indian generic manufacturers to make it.

 

Re: NARDIL SHORTAGE....The end of Nardil is near?

Posted by Stargazer2 on May 19, 2020, at 22:27:16

In reply to Re: NARDIL SHORTAGE....The end of Nardil is near?, posted by PeterMartin on May 12, 2020, at 10:09:49

Well in 1994 I was on Marplan and doing well, working successfully and Roche discontinued manufacturing Marplan.
My mental stability was destroyed, I couldnt work anymore and my world changed in a way I never want to see happen again. My depression has only responded to MAOs and this news would end my life if it happens. I was never stabilized on any of the newer drugs which were expected to replace the MAOs. For me it mrant literally years of drug trials and the return of my depression that brought me almost to my death. No exaggeration. This cannot happen else I will die.


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