Sarah Davis EditorUpdated on February 16, 2023, at 10:36amOur opinions and evaluations are not affected by the commissions we receive from our partner links. The editorial content of our site is based upon extensive research and the guidance provided by Forbes Health Advisory Board.
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Ziv Cohen, M.D. is a psychiatrist who has been board-certified. He is also a clinical assistant professor at Weill Cornell Medicine. Ziv is an expert in anxiety and mood disorders. He is a member of the Forbes Health Advisory Board.
Dr. Cohen discussed the Adderall shortfall, first announced by the U.S. Food and Drug Administration in October 2022. He also explained what this means for the people affected.
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What was the original cause of the FDA’s initial announcement about the shortage in October 2022? Why is there still a shortage?
Adderall’s shortage is believed to be caused by a variety of factors. The FDA stated in October 2022 that manufacturing delays caused the need. They cited Teva as a generic pharmaceutical manufacturer with “ongoing intermittent production delays.” Others have pointed to the increase in stimulant prescriptions as the leading cause. In 2020, Adderall prescriptions rose 15.1% for adults, double the 7.4% increase from the previous year.
The additional increase in demand may be due to the pandemic: parents could detect symptoms more easily when supervising their children remotely while they were learning at home. This led them, both adults and children, to receive more prescriptions.
The Drug Enforcement Agency (DEA) also sets quotas on the amount of active ingredients each pharmaceutical company can purchase annually. The DEA allocates these amounts based on the previous year’s requirements. The DEA’s quotas did not match the demand when stimulant prescriptions rose during the COVID epidemic. DEA has approved some requests from pharmaceutical companies for increased volume.
The combination of increased demand for these drugs and the interruptions in manufacturing has led to significant availability disruptions.
What is the FDA doing about this problem?
The FDA and DEA monitor the demand for stimulant medications and communicate with pharmaceutical companies to inform the public about their availability. Pharmaceutical companies are trying to increase production but need approval from regulatory agencies. While the government and the pharmaceutical industry are working to remedy the situation, it needs to be faster for some patients.
What dosage is harder to obtain right now?
The shortage is mainly affecting Adderall’s immediate-release formulas (Adderall IR). Initially, the FDA stated that there was no shortage of extended-release Adderall. The lack of Adderall IR led doctors and their patients to seek alternative stimulants. This has placed pressure on the supply and demand of all inspirations commonly used, including Adderall XR, Ritalin Concerta, and Vyvanse. These medications are on backorder in pharmacies, and patients have difficulty obtaining them.
Why is the Adderall shortage a pressing issue?
Many patients use this medication. Many stimulants can be used to treat the symptoms of ADHD. However, some patients respond better to a particular drug. Adderall and Adderall XR are popular ADHD medications because they’re highly effective and well-tolerated. Patients with ADHD who don’t take medication will have less success at school and work. This can negatively affect their lives and the lives of others around them.
A distractible parent or partner can also affect intimate relationships, as they pressure the other person more. When legal, safe, and regulated stimulant medications are in short supply, some patients may seek out illegal amphetamine, especially those with addiction problems.
Does this shortage affect children more, particularly those still in school or educational environments?
It is undoubtedly a concern, especially for kids in the prime of their learning years. Teachers may also have difficulty regulating hyperactivity when the children are not taking the necessary medication. Children may have trouble doing their homework. Changes in routine can also be disruptive to children. This can make it difficult for families and children to adjust when on or off ADHD medication.
What advice would you give to people who cannot get this medication at their local pharmacy for themselves or their children?
When Adderall was unavailable, most psychiatrists and prescribers switched their patients to Adderall substitutes, like Ritalin. Concerta, Vyvanse, and Focalin. These medications may not be as effective for some patients as Adderall, but they are still better than nothing. While they wait for their regular medication to resume, patients will still benefit from having their ADHD symptoms treated.
Do you suggest that people with Adderall prescriptions ration their pills to avoid overdose? Is it safe to take it every other day or infrequently?
Even if the medication isn’t taken daily, it still works on those days. This is why stimulant medications differ from other psychiatric drugs, which must be taken daily to be effective. When patients miss doses of stimulant medications, this can disrupt their daily routines and functioning. Many patients ration their medication by taking it only Monday through Friday and not during the weekends or on vacation. On weekends, when children are off school, and adults generally aren’t working, skipping the stimulant medication can be less disruptive.
Are there other options that Adderall prescribers could consider?
The importance of non-medication treatmentÂ
ADHD is just as great as the importance of medication therapy. Psychotherapy is geared toward addressing ADHD symptoms and teaching coping strategies and skills. Exercise has also been shown to help reduce ADHD symptoms in children. Treatment of other mental health problems, such as depression and anxiety, will improve concentration and focus if the patient has ADHD.
