Patients suffering from bipolar disorder cannot get treatment in Montenegrin pharmacies for months, so they buy the drug lithium carbonate with a prescription abroad.
The only solution to this problem is for the Government to amend the Basic List of Medicines, so that the same medicine can be found on it, but in a different pharmaceutical form - capsules, which are currently offered to the state "Montefarm" by importers.
However, it is now certain that patients, who normally face stigma due to the diagnosis, will see October 10, World Mental Health Day, without the necessary therapy.
"News" was contacted in the past few days by patients who claim that since April, there are no pills that serve as mood stabilizers anywhere in Montenegrin pharmacies, including private ones.
They claim that they are forced to get lithium carbonate in the region, where they also ask for a report from a specialist in psychiatry, but the only difference is that it has to be bought.
"It is not right that we should look for a medicine that is obtained at the expense of our health fund and only by prescription in the region. Also, it is not aspirin, but a strong medicine for serious affective disorders", said one of the patients.
They also point out that some of them, in the absence of lithium carbonate, are helped by epileptics, while others do not respond to this replacement therapy.
Importers only offer capsules
"Montefarm" replied to "Vijesta" yesterday that lithium carbonate in 300 milligram tablets is on the list of medicines by international unprotected name INN, on the basis of which they are announcing the procurement procedure. They claim that they requested the mentioned drug through procedures for the procurement of oral drugs three times this year, and the last time in August, but no importer came forward with a suitable offer. This is confirmed by the data from the website of Montenegrin electronic public procurement (CEJN), from which it can be concluded that two months ago "Montefarm" requested a tender for 50.000 tablets, worth 6.000 euros.
"Subsequently, we were informed by an importer that there is a possibility of purchasing this drug, but in a different pharmaceutical form, that is, capsules. However, the current list of medicines limits the procurement only and exclusively in the form of tablets, so there is no way to carry out the procurement at the expense of the Health Insurance Fund until the correction, i.e. supplementing the form of capsules, is eventually carried out", the institution explains.
In "Montefarm" they claim that they have an announcement from the authorities that the list of medicines will soon be updated, and the institution has no insight into the changes, so they expect that there will still be corrections, which would immediately enable them to obtain the missing quantities of the medicine lithium carbonate 300 mg, but in to another pharmaceutical form.
Bearing in mind the announcement by the authorities that the list of medicines will soon be updated, and whose changes MONTEFARM has no insight into, we hope that there will be corrections in this part, which would immediately enable us to procure the missing quantities of the medicine Lithium Carbonate 300 mg, but in a different pharmaceutical form .
"We note that citizens have the option of realizing prescriptions in over 100 private pharmacies, however, when official importers do not have medicine available for the Montenegrin market, at that moment there is a shortage in Montefarm pharmacies, as well as privately owned ones," said this institution.
Patients must not be without therapy
Psychiatrists interviewed by "Vijesti" say that patients with bipolar disorder should not remain without therapy, due to worsening of the underlying disease and possible complications. They indicate that replacement therapy, given that lithium carbonate has a small therapeutic range, does not suit all patients, and they remind that this drug is often prescribed in combination with other drugs, such as anxiolytics, antidepressants, antipsychotics...
Pharmacists, on the other hand, indicate that if the state finally acquires 300 milligram capsules, it will not be a solution for all patients because the medicine is usually given in divided doses. They claim that the doses required for treatment are adjusted based on regular monitoring of drug concentrations in plasma, all to prevent toxicity.
Bipolar disorder is accompanied by mood disorders, from deep depression to extreme euphoria. It is a potentially serious, disabling disease, and the symptoms can be very pronounced and significantly affect the social and professional functioning of the patient.
According to the estimates of the World Health Organization, about 60 million people in the world suffer from some type of bipolar disorder.
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