WEDNESDAY, May 11 (HealthDay News) -- Due to an ongoing
shortage, some American adults with attention-deficit hyperactivity
disorder (ADHD), or the parents of children with ADHD, are having
to call multiple pharmacies before finding one that carries the
prescription they need to manage the condition.
Accounts of exactly which drugs are affected vary, but much of
the focus has been on Adderall XR, made by Shire PLC, and its two
generic versions, also made by Shire but distributed by drug
companies Teva and Impax.
However, generic versions of the widely used ADHD drugs Ritalin
and Concerta have also been affected, Valerie Jensen, associate
director of the drug shortages program at the U.S. Food and Drug
Administration, told the
Wall Street Journal on Tuesday.
Although the shortage doesn't seem severe and, according to
industry representatives, should be over by the end of the month,
not having the pills can cause significant disruptions to patients'
According to Matt Cabrey, a spokesman for Shire PLC, which makes
Adderall XR, the "supply interruption" is due both to higher demand
and to the fact that the Drug Enforcement Administration (DEA)
didn't deliver enough of the active ingredient in Adderall XR,
amphetamine, to the company. Amphetamine is a controlled substance
and strictly regulated by the DEA.
For its part, drug maker UCB SA, which makes generic versions of
methylphenidate, said its shortages stem from a spike in consumer
demand early in 2011. The company hopes to be able to meet consumer
demand for its products by May 20, spokeswoman Brenda Varney told
Novartis AG, which also sells generic versions of
methylphenidate via its Sandoz unit, told the newspaper that it is
also having trouble keeping up with market demand.
As the shortage continues, "Families who are resourceful and
able to call around to multiple pharmacies will often find what
they need -- but often is not always," said Dr. Andrew Adesman,
chief of developmental and behavioral pediatrics at the Steven and
Alexandra Cohen Children's Medical Center of New York, in New Hyde
Park. "In some households, it may not pose a major hardship if they
have a short-term disruption in terms of medical treatments, but in
some households it can prove a hardship."
One problem: these medicines typically stop working almost as
soon as the patient stops using them. Interruption at this
particular time -- when the school year is winding down -- could be
especially hard for youngsters who rely on their medications to
perform academically, Adesman pointed out.
"It could also lead to significant untoward effects behaviorally in the classroom," he said.
According to Adesman, patients (or their parents) should first
check with different pharmacies to see if another one has the
prescription they need.
"If that doesn't work, have a dialogue with your doctor," said Dr. Lenard A. Adler, director of the Adult ADHD Program at NYU Langone Medical Center in New York City.
There may be reasonable alternatives but they can be a mixed
Switching drugs isn't always an option. In some cases it can be
difficult to translate dosing to another medication, since generics
can have subtle differences from brand name drugs.
In the case of Adderall XR, this shouldn't be a problem because
the same company manufactures both the brand name and the two
generics, noted Shire PLC spokesman Cabrey.
Then there's the financial implications. Switching from a
brand-name drug to a generic could save money but going from a
generic to a brand name could have the opposite effect on the
There could also be financial repercussions if an insurance
company doesn't cover the temporary substitute.
For example, one woman ended up having to pay $140 a month for a
new medication, more than twice her previous $60 co-pay, according
Wall Street Journal.
Some patients may be able to switch from long-lasting pills to
short-acting ones but that would mean taking several pills a day
instead of just one, Adler said.
Cutting back on doses will have an impact on ADHD symptoms.
"They will decrease their improvement if they cut back on their
doses," said Adler.
The main thing, said Adler is to "be sure you don't stop your
medicine. The impairments of having untreated ADHD are
There's more on ADHD treatments at the
U.S. National Institute of Mental Health.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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