Alana attends your pharmacy every Monday to pick up her weekly blister pack (a pre-packaged and pre-sorted medication dispenser that simplifies the process of taking multiple medications). Her pack includes a regular dose of two antidepressants: amitriptyline 100mg and venlafaxine 150 mg. As Alana’s doctor has requested, she collects her packs weekly because of her mental health fluctuations. Alana has a history of self-injury (cutting) and attempted self-harm by drug overdose. You have noticed Alana has become more withdrawn recently – she has not been engaging in conversation with you, as she usually does when she visits.
It's Thursday night and Alana enters your pharmacy, where you are the sole pharmacist on duty. Alana says she lost her blister pack when she was away for work the last two nights and needs another one to last her until next Monday. She is obviously anxious, although remains clear and believable as she explains how she lost her blister pack. You are worried about misuse (including possible intentional overdose), given her history of self-harm, and her recent mood change. On the other hand, you know that abrupt withdrawal of both her antidepressants could result in serious adverse effects.
Alana’s GP is unavailable for consult. She says she has another work trip tomorrow and won’t be back until Monday. She states bluntly that she won’t be able to function at work if she can’t take her usual antidepressants, and she can’t afford to lose her job.
What should you do?