This is an update to a previous post titled: Nearly a year on, Bupropion is still not available
I was worried the previous post might cause confusion to those who came across it hoping for the return of bupropion. Below, I’ve tried to go into a little detail about the potential reasons for the announced return – but please bear in mind I might have easily misinterpreted certain details, and an announcement from a secondary source does not mean resupply is confirmed. I’ve also given an update on the current availability of bupropion in the UK.
So, a notice popped up about a week ago in the form of an exclusive article by David Lipanovic of the Pharmaceutical Journal. It announced that bupropion will once again be supplied to the UK starting around December 2023.
Smartphones are the devil.
Okay, bit harsh. Smartphones are undoubtedly very useful. The “I got lost” excuse for arriving late is not valid anymore – a quick few taps in your mobile map app of choice and you can instantly find out where you are (and where you should be).
In terms of good mental health, however, smartphones are one of the fiercest opponents I have encountered. It isn’t necessarily the magnitude of the effect they have on my mood. It is the smartphone’s ability to cling to my brain like a leech. They are almost impossible to remove once latched. The short, sharp and seemingly neverending rewards smartphones offer are intoxicating. And this is putting it mildly.
Update: GSK announced UK and EU resupply of Zyban (bupropion) for December 2023, see this blog post for more details
It has been just over eight months since GSK announced they were halting the supply of Bupropion (the brand name is “Zyban”) due to nitrosamine impurities. Since my previous blog post about the supply shortage, I have heard very little.
One of my worries when writing articles about the psychiatric system is that a reader will interpret arguments I make as a form of advice. I want to make clear I am not in the position to make any recommendations. I write from my current experience as a patient and past experience as a physics researcher to hopefully add a few insights where psychiatric research, lived experience and physics meet.
So, when someone seemingly mis-read and mis-interpreted my Lithium Story article, I was a little distressed. I re-read the opening paragraph of my article. While I was telling a story of my opinions at the time, I could see how it might have been possible to interpret it as a recommendation for twice daily dosing. This was not my intention. I am not against once daily dosing.
I realised this was an opportunity to look back and clarify past statements I have made in both my Physics World and Lancet Psychiatry articles.
When I first started to take lithium, I wanted to calculate my peak serum concentration using my 12-hour sample value. I knew it was going to be a very rough estimation, but for me, doing the calculation made me feel less anxious about toxicity.
My plan was to use the exponential decay formula to find the peak concentration (assuming the peak occurred around five hours). I wanted to find out, given I knew my serum creatinine levels, what my approximate lithium half-life was. I went looking for data in the lithium pharmacokinetic literature to figure this out.
I am very fortunate that the current cost of living crisis in the UK only mildly affects me. It means I can afford to be creative when coming up with money-saving ideas without the consequences most would suffer if the idea didn’t work.
By the end of the summer of 2022 (I’ve just had 40-degree Celsius heatwave flashbacks, eurgh) the intensity of my generalised anxiety lowered to the point of being able to go outside and hang my washing out on my own.
I wanted to prepare for the winter ahead and the astronomical energy bills. After about ten minutes of solid googling, I discovered that the primary energy culprit in the home was dryers.
If I had persisted for at least ten more minutes of googling, I would have discovered that the electricity bill was not the one to be worried about – it was the heating bill. This was reason number one why hanging my clothes outside in winter was a terrible idea.
This blog post is in reference to my article in the May 2023 edition of the Lancet Psychiatry – Lithium Story: Eight Guidelines, Eight Recommendations. It is adapted from notes I sent to one of the editors when constructing the article
In a previous blog post, I looked at two examples of imprecise language in a Grandjean and Aubry paper about lithium pharmacokinetics (which I used in my May 2023 Lancet Psychiatry article). In this post, to show that the problem is not limited to a single paragraph in a single review paper, I have included a couple more examples of unclear messaging.
This blog post is in reference to my article in the May 2023 edition of the Lancet Psychiatry – Lithium Story: Eight Guidelines, Eight Recommendations. It is adapted from notes I sent to one of the editors when constructing the article.
It might seem strange to say from someone writing a blog post criticising clarity and precision of language, but I personally find it very difficult to write clear and precise language. Goodness, if you could see my first-year PhD report!
But, because I had to work very hard to clarify the muddled thoughts in my head, I recognised mistakes in lithium pharmacokinetic literature similar to those I used to make in my writing.
In the Lancet Psychiatry article, I focus on the paper “Lithium: updated human knowledge using an evidence-based approach” by Etienne Marc Grandjean and Jean-Michael Aubry. It is an extensive collation of knowledge on lithium treatment. However, producing a paper with such breadth of knowledge, can in turn, lead to unclear and imprecise language given how much the authors are required to understand.
There are very few upsides to living with a severe mental illness. One of them is quite a bit of free time. Previous times the clocks have gone back have been a nuisance to me. Especially since I started taking antidepressants. For whatever reason, my brain is very sensitive to the time I take them. If I take my dose late, even by only half an hour, my reality is thrown from side to side like a ship in rough seas.
To be taken safely, my medications have to be taken a set time apart (therefore at fixed intervals in the day). This means that twice a year the time I take my medication shifts by an hour each day. Why don’t you take your medication at the same time all year round? I hear you ask…
With the ongoing uncertainty regarding one of my medications not looking to end anytime soon, I have tried to distract myself with other absurdities going on in the world. In this blog post, I have combined two: ChatGPT and Matt Hancock. I hope that regardless of your political background, you agree that the UK health secretary during the covid-19 pandemic, Matt Hancock, made many mistakes (some with terrible consequences). I have been in and out of the loop of his, frankly, bizarre story. So, I asked ChatGPT to write an article for me by the wisest person I could think of… Yoda.
Mistakes, Matt Hancock made, hmmm? The Conservative politician, he was, yes. Many errors, he made, hmm? Mistakes, let us discuss.