ADHD Medication Shortage

Hi, everybody. I'm Dr. Danish with Philadelphia Integrative Psychiatry. I wanted to talk to you guys today a little bit about the stimulant shortage that's afflicting lots of our patients, and from what I hear, afflicting a lot of patients across the country.

So the DEA sets a limit each year on how many of each stimulant is produced. They do this in an attempt to decrease the amount of abuse that might occur. This all stems from the opioid epidemic, when a lot of doctors were over-prescribing opiates. And the DEA feels that a lot of the reason for the opiate epidemic was the vast supply of opiates out there. So they're attempting to do the same thing with stimulants and try to predict how much is going to be needed each year. But unfortunately, in 2022 and '23, they grossly underestimated how much was needed. So what started as an Adderall shortage turned into an Adderall extended release shortage. And then this led to shortages across other brands as well, including Concerta, Focalin, and Immediate Release. Focalin and Extended Release and on down the line.

Fortunately, there are other companies out there who've come out with other brands of these same chemicals. So we so far have not had any issue getting our patients their medications to replace what they were used to. And in most cases, it's the exact same chemical ingredient. And in some cases, because of the way it's formulated, it can work even better than what they were used to taking.

So, for instance, instead of Adderall XR, we're often using something called Edzenis, and I would say 90% of our patients that switch from Adderall XR to Adzenys prefer the Adzenys. Similarly, for Focalin and Extended release, we use something called Aztarys and similar ratios, where the vast majority of patients actually prefer the newer version of that. Similarly, for Concerta or methylphenidate LA, we are now using something called Cotempla, which has done very well for a lot of our patients.

Unfortunately, there is no substitution at this time for the immediate release Adderall. In some cases, what we do is give the short acting version of Methylphenidate, also known as Ritalin, and a lot of patients find that helpful.

We also use a lot of non-stimulant medications to treat ADHD. Stimulants are great at what they do, but they come with many side effects for some patients. Other options include other medication classes and also supplements. Other medications can include Wellbutrin, Guanfacine, Clonidine, Armodafinil, Atomoxetine and Amantadine, among others. And then in terms of the supplement options, there are many. Some of the stronger ones include Saffron, magnesium, Omega-3 fatty acids, and the old standby caffeine, of course.

If you want to find out more about these options and what else we treat, please contact us.