For a patient suffering from anxiety and having a history of depression, often overlapping conditions, "you may want to avoid a benzo as they can also be depressants, and buspirone may be a safer option and more reasonable, "he said.

Patients also do not have the choice to pay more to buy the Buspirone brand version, Buspar, because it is no longer manufactured.

Buspirone prescriptions dispensed to the United States increased from 10.2 million in 2015 to 13.5 million in 2017, with an estimated figure of nearly 15 million last year, according to IQVIA, a technology provider. health and data analysis. The reasons for this increase are unclear, although the opioid epidemic may have made some physicians more reluctant to prescribe highly addictive anxiolytic drugs that can be fatal when they are associated with opioids .

The main reason for the buspirone shortage appears to be an interruption in production at the Mylan Pharmaceuticals plant in Morgantown, West Virginia, which has supplied about one-third of the country's drug supply. The Food and Drug Administration said the facilities were dirty and the company had not followed the quality control procedures.

Mylan told the F.D.A. the date of resumption of buspirone production is "T.B.D."

"Companies do not have to inform the F.D.A. how long the scarcity will last or when they expect it to come back, "said Erin Fox, director of pharmacy at the University of Utah Health and director of its information and support services at the University of Utah Health. drugs, making planning difficult for physicians and patients to manage.

Most drug manufacturing plants are already operating at full capacity. Therefore, "when you close, even for a short time, there is no resistance in the supply chain that can make up the difference," said Dr. Fox.

The extremely low prices of some generic medicines also contribute to the crisis. Consolidation among wholesalers has led to the creation of three consortium giants buying 90% of generic pharmaceuticals in the United States, said Adam Fein, consultant and general manager of the Drug Channels Institute. These "monsters" buyers have reduced manufacturers' prices, and "some of these generic drug companies decide that profits are so low that they can not make money, and they fall out of the category" said Dr. Fein.

At least one relatively small buspirone maker, Impax, has left the market.

"Drugs such as buspirone are not considered essential or life-saving drugs by the AF," said Dr. Beth Salcedo, president of the Anxiety and Depression Association of America. "But the reality is that when you look at anxiety and depression, you lose a lot of people every year because of these diseases."