The Moment of Truth
Those who read my posts in the past know that I battled with depression and anxiety disease. It got better with the years as I developed strategies for my life but, to be honest, I wasn’t sure how much it been due to the fact that I was still using antidepressants. Up until now, I was still using Doxepin, a tricyclic antidepressant medication used to treat major depressive disorders, anxiety disorders and trouble sleeping. I’ve never been a great fan of the idea but if you’ve been in a position where things can’t get worse, you start to experiment. And honestly, in retrospect, it was the right decision to start taking the Doxepin pills back then, just not the way my doctor wanted me to take them. I tested 100mg and it basically did put me to sleep 24 hours straight and the few minutes I was awake I felt like my depression got a thousand times worse. In other words, I absolutely couldn’t get out of my bed anymore. If you feel like getting out of the bed is worse than starving (not being able to go to the kitchen), then you can be sure your doctor did decide for the wrong dose.
But I didn’t give up and as soon as I found the energy, I did my own research and decided to give 20mg a try. My doctor didn’t like my rebellion against his suggestion but eventually gave in. And see there, after 2 weeks of taking 20mg each evening, my anxiety symptoms basically disappeared and not just that, my mood stabilized and it felt like it’s worth living again. Every other improvement after that have happened due to life strategies I developed, at least that’s what I thought so far. But if I would be 100% sure about that, I would have discontinued medications on my own by now. So, there was still some kind of fear that my issues could get worse again if I discontinue the medication even if my doctor thought 20mg would already be a homeopathic dose. The thing is that I find it worse to get all those symptoms back than taking this type of medication. Anyway, my whole situation improved in such a way over the years that I gave discontinuing a serious thought. During the last two years, I thought I might do it soon, just not now. And if so, very slowly by reducing the dose further over time because discontinuing too fast after so many years can have serious side-effects.
What I didn’t know was that I might be forced to discontinue the medication earlier than I wanted. That’s what I learned yesterday when I visited the community pharmacy with my new prescription. There is a serious supply bottleneck for Doxepin. That happened in the past too but it was always possible to get a generic drug, which means another brand with the same pharmaceutical ingredients. So, it never really mattered that much, because it was all the same. But yesterday, I was standing there trying to get my medication and they told me that there is a supply bottleneck and that it’s not possible to get any of those brands. I visited a second pharmacy, a third pharmacy because maybe any of them would still have them in stock. Vainly. Then I just learned that it’s not just with antidepressants but the same with certain medications for high blood pressure, cancer treatment and so on.
So, today I did spend time to read the medical news and tried to understand the issue. And it turns out, it’s another effect of capitalism, deregulation or liberalization. The government does not have control over the pharmaceutical industry anymore. Germany was once a nation where the medicine was produced but like with everything else, that is not the case anymore. Our medicine is now produced in Asia because it’s cheaper for the pharmaceutical industry. And thus, production is not as diverse anymore as there are just a few manufacturers. If one production line has a problem, it’ll have an effect on the international market. That happened recently with Ibuprofen, where a manufacture burned down and international demand couldn’t be satisfied anymore, thus pharmacies ran out of it. Now it happens with many more medications. The fact that German health insurance funds asking for rebates makes it worse because now the medicine is sold to countries where the pharmaceutical industry can earn more. Welcome, enjoy the world of never-ending maximization of profits. Not even our health system is safe of this evil monster anymore. By the way. Our hospitals are affected as well. I’ve read that they can’t get all anesthetics anymore, especially Propofol which is one of the most used anesthetics.
Talking about myself again, I visited another pharmacy today, the fourth as the last try and heard the same stuff again and they told me that they tried to get Doxepin for 3 weeks without a chance. They also told me that it will get worse in the future as we barely still produce medication on our own. That’s about what you can take from news articles about the issue as well. I am done with this, it’s a true shame how far we have come. For me, this is the moment of truth. I might battle with severe withdrawal symptoms soon but after that, it’s maybe a chance to see how it is with my health. I usually took 2 pills of 10mg in the evening but yesterday I went down to 1 pill to stretch the time a bit and to be able to get away from it slower in hope that it will give me fewer withdrawal symptoms. I still have 5 pills, that means 5 days. Since Doxepin stays in the system for a while, it might take some weeks until I see what will happen. The best case would be that I realize I don’t need antidepressants anymore, the worst case is of course that things will get tough again.
I don’t want to compare diseases with each other. When I told a pharmacist today that I’ve read in the news that people with blood pressure or cancer are affected as well, she replied: “Many people rely on their medication, you too, it’s a shame that you’re put into the situation and I as a pharmacist feel like people don’t trust me anymore”. I am a calm person and try to understand the root of the issue by doing my research but not everyone is like that. I can just imagine what doctors and pharmacists go through right now because they’re the persons who interact with people and some might be understandably upset. As my mother and grandparents rely on medication for high blood pressure, I forewarned them that they might run into the same issues I ran into with my antidepressants.
Yesterday before I went into bed, it felt like a bad movie. I grew up in Germany and you always could get any kind of medication if your doctor thought you’d need it. So, I fell asleep and dreamed that a war broke out and that I couldn’t get my medication anymore. When I woke up, I realized the part with the war was just a dream but not the part with the medication. So, let’s see how discontinuing my medication works out for me. At a dose of 10mg, I only have 5 days ahead until I run out of supply…