• Health

Antidepressants & Availablity in Japan

Introduction

 

As part of modern psychiatry, various antidepressants are used as a basis for pharmacological therapy.  Along with other forms of treatment, antidepressants are tools that doctors can use to help patients.

 

Japan doesn’t have the same variety of more modern antidepressants typically found in western countries. 

 

They just started to approve the use of SSRIs and SNRIs in the 1990s and the current list of approved medications is very small.  Japan’s standard for approving a medication involves proving it to be superior to other older and more traditional medications, unlike in the west, a medication only has to prove it is effective and safe on its own.  

 

This is why the approval process has been slow for many modern medications.

Popular antidepressants not available in Japan

 

In particular, there are two antidepressants that we often encounter when dealing with teachers that are simply not approved in Japan:

 

Prozac  (Fluoxetine)

Wellbutrin (Bupropion)


We know that Prozac did not enter Japan because the manufacturer decided to pull it after disappointing trials in Japan.  Wellbutrin was not accepted because it is chemically similar to amphetamines, which are basically illegal in Japan.  In the case of a teacher who is treated with either medication, we recommend using a “Yunyu-Kakunin Sho” (YKS) to import a supply for their entire period in Japan.  Neither are illegal to import for personal use.


Currently approved antidepressants in Japan

 

Based on our research, this list is the most up-to-date list of antidepressants currently available in Japan. 

SSRI Category

 

Brand Name

Chemical Name

Paxil

Paroxetine

Luvox

Fluvoxamine

J-Zoloft

Sertraline

Lexapro

Escitalopram

SNRI Category

 

Brand Name

Chemical Name

Cymbalta

Duloxetine

Toledomin

Milnacipran

Effexor

Venlafaxine

Other Category

 

Brand Name

Chemical Name

Remeron

Mirtazapine 

Trintellix

Vortioxetine 

Reslin

Trazodone

Dogmatyl

Sulpiride

Tricyclic Category

 

Brand Name

Chemical Name

Tofranil

Imipramine

Tryptanol

Amitriptyline

Surmontil 

Trimipramine

Noritren

Nortriptyline

Anafranil

Clomipramine

Amoxan

Amoxapine

Amplit

Lofepramine

Prothiaden

Dosulepin

Tetracyclic Category

 

Brand Name

Chemical Name

Maprotiline

Maprotiline

Tetramide

Mianserin

Tecipul

Setiptiline

How to get treatment with antidepressants in Japan

 

The most common way to get treatment is to visit a mental health clinic and receive a prescription from a psychiatrist.  There are mental health clinics in most cities and towns in Japan.  Some allow walk-ins and some require appointments, however, it is not necessary to obtain a referral in order to be seen.  

 

Clinics are divided into two types:

 

Psychiatry – dealing with “traditional” mental illnesses (schizophrenia, bipolar disorder etc)

Psychosomatic Internal Medicine – dealing with depression, anxiety, eating disorders etc

 

Typically many clinics offer both types of services, and either type can prescribe antidepressants.  It’s not necessary to choose one type over the other as the clinic will assign you as a patient to the correct type.  


After seeing the doctor and receiving a prescription slip, the patient takes the slip to the pharmacy and the medication is dispensed there.  Typically a first prescription will be for 14-28 days and after a follow up appointment, typically one month intervals thereafter.

Other medications used alongside antidepressants in Japan

 

Similar to western countries, other ancillary medications may be prescribed as needed by doctors.  Mood stabilizers, antipsychotic medications, major and minor tranquilizers, antiepileptic drugs, and sleep aids are available and prescribed as needed.  Most of the common types used in the west are available in Japan.  

 

The only types that are not available are combination drugs including antidepressants and antipsychotics together.  Japanese doctors typically would prefer to prescribe multiple medications independently in order to better control the dosages of each. 


What should a prospective teacher who is treated with antidepressants do before coming to Japan?

 

First, consider the motivations you have for coming to Japan.  Are you certain that relocating to Japan will help your condition?  Consider that in the initial period, you will no doubt suffer from culture shock and culture stress, and these are troubling enough for people who aren’t undergoing treatment.  We’ve seen plenty of people who thought that the cure to their issues was leaving their country, only to come to Japan and find out that their condition was no better here.  Deeply examine your motivations for wanting to come to Japan and objectively evaluate if it will make your life better or worse.

 

Next, find out if your current therapy is available in Japan.  Obviously, since you’re almost done reading this article, you’ve got an idea if it’s possible to continue or not.  You might need to look into things a bit more and we’re happy to help if you let us know.  

 

Be aware of the limitations of the mental health care system in Japan.  Mental health care that is covered by national healthcare insurance is based on pharmacological treatment, not on talk therapy or counseling.  The doctor you see for prescription refills isn’t really a counselor, and is only paid by insurance in 6-minute blocks to see you, so there may be pressure to deal with the medications and end the visit.  Talk therapy and counseling are things that are done off insurance at an extra charge.  

 

Finally, make a plan.  Plan how you are going to import an initial supply of your medication, and how you are going to get refills once in Japan.  Set a date for when you will have an appointment with a new doctor.  Be ready to follow through on your plan.  Familiarize yourself with some medical vocabulary in Japanese.  If you need help, contact us or your branch staff and we will do our best to help.  

 

Being treated with antidepressants doesn’t disqualify you from becoming an Interac ALT, assuming that you take all the necessary steps to continue your treatment after arrival and that your teaching performance in classes is satisfactory.  For Interac’s part, we will do everything we can to make you a successful teacher, providing quality training and support for you at every step.  

 

For more information about teaching in Japan as an Interac ALT, click here.

About the Author

Brian McDonough is a consultant at Interac, Japan’s largest provider of ALTs (Assistant Language Teachers). Originally from the US, Brian has lived in Japan for over 25 years, giving him a unique perspective on the cultural differences and challenges people face when moving to Japan. He has first-hand experience of working in Japan as an American.