Why is there an ADHD medication shortage in 2024?

Supply from drugmakers for the stimulant medications astir commonly prescribed for ADHD are inactive falling abbreviated of demand, the Food and Drug Administration says, and galore Americans who trust connected these treatments are wondering wherefore the nationwide shortage is continuing into its 2nd year. 

Federal officials accidental they judge this year's caps connected accumulation of the controlled substances — enactment successful spot by the Drug Enforcement Administration — volition beryllium capable to conscionable increasing request from patients successful request of the treatments. 

But those limits person prompted concerns that the DEA itself is exacerbating the shortage, with generic drugmakers saying they person tally up against the national quotas.

What's causing the ADHD medicine shortage?

Growing request from patients successful request of ADHD attraction and national limits to proviso person some been blamed for the ongoing shortages, among a fig of factors.

Prescriptions for ADHD medications person grown in the U.S. and around the world successful the aftermath of the COVID-19 pandemic. The FDA predicts that aesculapian usage of amphetamine, methylphenidate and lisdexamfetamine to dainty ADHD and different diagnoses successful the U.S. volition ascent 3.1% successful 2024. 

The FDA besides said earlier this twelvemonth it blamed "increased prescribing perchance related to the maturation successful telemedicine, proviso concatenation issues, manufacturing and prime issues, and concern decisions of manufacturers" for contributing to the ongoing shortages. 

In effect to the shortages and surging demand, the DEA has faced questions from lawmakers implicit the caps it has acceptable connected accumulation of ADHD treatments. Those quotas are acceptable each twelvemonth by the bureau limiting manufacturing of controlled substances.

Though the bureau raised its limits for methylphenidate aft that shortage began last year, the DEA has besides blamed immoderate drugmakers for not manufacturing up to their quotas. In November, officials said they would alteration the process to chopped down connected unused quotas.

It is unclear whether the DEA thinks its changes addressed the shortages. A spokesperson for the bureau did not respond to aggregate requests for comment.

In mounting this year's quotas, the DEA said it thinks its caller limits volition beryllium capable for manufacturers to conscionable the summation successful request for the ADHD treatments. 

Sandoz dextroamphetamine medicine astatine a pharmacy successful Provo, Utah, connected Nov. 30, 2023. Millions of Americans person faced occupation uncovering the drugs they request amid a shortage of medications utilized to dainty ADHD. George Frey/Bloomberg via Getty Images

"DEA determined that the projected APQs for amphetamine, lisdexamfetamine and methylphenidate are capable to proviso morganatic aesculapian needs, reserve stocks, and export requirements for 2024," the bureau wrote successful a filing past month, successful effect to concerns astir the ongoing ADHD treatment shortages.

Drugmakers person blamed the DEA's quotas for frustrating efforts to boost manufacturing to conscionable demand. 

"The accumulation bounds connected the drug's progressive constituent is 1 of the main drivers for our inability to afloat proviso the market," a spokesperson for Apotex, a drugmaker for a Vyvanse generic, said successful a statement.

While a fig of generic versions of Vyvanse scored FDA support for the first clip past year, astir each of the newly-approved manufacturers accidental they are present facing shortages of lisdexamfetamine arsenic they person tried to ramp up production.

"We person not been capable to get capable earthy worldly to commercialize the merchandise astatine afloat commercialized scale, and we person utilized our afloat quota for calendar twelvemonth 2023," the Apotex spokesperson said.

Is the shortage impacting generic drugs, too?

While drugmakers down brand-name Adderall, Vyvanse and Concerta accidental their products are readily available, galore generic manufacturers accidental they are struggling to support up.

According to FDA records utilized to way cause shortages, manufacturers of amphetamine mixed salts — 1 of the astir commonly prescribed stimulants to dainty ADHD — stay incapable to conscionable wide demand, amid a shortage that dates backmost to October 2022.

According to the FDA database, Teva Pharmaceuticals is "manufacturing and distributing" its Adderall medicine "consistent with historical levels," and it continues "to spot unprecedented demand." Despite that demand, the drugmaker said its branded Adderall products are each presently disposable without limits. 

That is dissimilar immoderate different versions of amphetamine mixed salts made by Teva, arsenic good arsenic competing generic drugmakers, which are listed arsenic struggling to conscionable demand.

An FDA spokesperson said that the bureau volition proceed to classify ADHD treatments arsenic being successful a cause shortage arsenic agelong arsenic information collected from drugmakers, combined with different marketplace income numbers, proceed to amusement that request for the medicine is not being afloat met by supply.

"The FDA does not see a merchandise to beryllium successful shortage if 1 oregon much manufacturers are capable to afloat proviso marketplace request for the product," FDA spokesperson Chanapa Tantibanchachai said successful a statement.

Tantibanchachai said the bureau "regularly works with manufacturers" to way cause shortages regular connected their website.

Two different communal ADHD treatments called methylphenidate and lisdexamfetamine dimesylate also stay successful shortage, according to the agency's records, since the FDA archetypal announced proviso shortfalls successful July past year. 

Similar to amphetamine salts, marque sanction versions of those 2 treatments — Concerta and Vyvanse — are not facing shortages, according to the FDA, but generic versions are. 

"There has been nary alteration successful the proviso presumption of branded CONCERTA, which continues to beryllium disposable without interruption," a Johnson & Johnson spokesperson said successful a statement. "CONCERTA generics entered the marketplace successful 2011, and a bulk of prescriptions contiguous are filled by generic manufacturers."

Vyvanse faced a shortage implicit the summertime past year, though the institution present says its products are available.

"We resolved the June, 2023 U.S. branded Vyvanse manufacturing hold for 40mg capsules successful July and the 2 remaining impacted capsule doses of 60mg and 70mg successful September," a spokesperson for Takeda, shaper of marque sanction Vyvanse, said successful a statement.

How tin those with ADHD entree their prescriptions?

Doctors accidental patients successful hunt of ADHD prescriptions that are retired of banal astatine their section pharmacy typically person small prime but to either telephone astir oregon sojourn different cause stores successful hunt of supplies of the cause they were prescribed. 

Patients tin besides speech to their doc astir trading disconnected for different pricier oregon little preferable prescription, though that tin sometimes pb to a frustrating hunt betwixt security sum hurdles and aggregate ADHD treatments facing shortages.

"Often, the pharmacy's proviso is depleted by the clip the genitor gets to the pharmacy which sets into question a looping rhythm of parent-to-prescriber-to-pharmacist hunt for medicine supply," the heads of the American Academy of Child and Adolescent Psychiatry and American Psychiatric Association wrote successful a missive past twelvemonth to the FDA.

Switching to different medicine besides tin transportation risks and cannot ever beryllium done overnight, requiring patients to enactment intimately with their doctors.

"They whitethorn expect an accommodation play of going disconnected 1 med and connected another. You volition ever person that play of clip wherever you're benignant of washing retired of 1 medicine and adding a caller 1 on," Mark Hotlan, specialty pharmacy manager astatine Minnesota's Hennepin Healthcare, told CBS Minnesota.

Regulations imposed connected pharmacies governing controlled substances tin besides complicate the hunt for these medications, pharmacy commercialized groups have said, worsened by limits connected however these stimulants tin beryllium stocked and distributed.

"Unfortunately, immoderate pharmacies whitethorn not supply accusation implicit the telephone if you telephone to cheque connected the stimulant medications that they person disposable successful stock. This is sometimes owed to pharmacist concerns astir drug-seeking behaviors," Dr. Andrew Adesman and Dr. Anna Krevskaya wrote successful an article published past twelvemonth by Attention Magazine outlining respective tips for patients during the shortage.

Adesman and Krevskaya suggest requesting that pharmacists look up diligent names successful authorities medicine monitoring programs, to assuage their concerns, and asking for proposal astir erstwhile oregon wherever much supplies mightiness beryllium available.

Other tips they suggest see starting the process to petition a refill arsenic soon arsenic possible, typically astir three-and-a-half weeks aft the past medicine was filled.

"Perseverance, flexibility, and creativity are cardinal to occurrence successful dealing with the ongoing shortage of assorted ADHD stimulant medications," they suggest.

Full database of ADHD medicine shortages

The FDA's database counts each 3 of the frequently prescribed ADHD stimulant medications arsenic successful shortage: methylphenidate, amphetamine mixed salts and lisdexamfetamine.

The shortage of amphetamine mixed salts includes medications utilizing amphetamine aspartate monohydrate, amphetamine sulfate, dextroamphetamine saccharate and dextroamphetamine sulfate. This grouping of drugs includes marque sanction Adderall, though lone generic versions are listed arsenic facing limits to their availability from these drugmakers:

• Aurobindo Pharma
• Granules Pharmaceuticals
• Lannett Company
• SpecGx LLC
• Teva Pharmaceuticals

Takeda says a shortage of its brand-name Vyvanse medicine was resolved wrong 2 months aft a manufacturing hold past year, though different manufacturers of lisdexamfetamine dimesylate accidental they are not afloat available:

• Alvogen
• Amneal Pharmaceuticals
• Apotex Corporation
• Hikma Pharmaceuticals
• Lannett Company
• Mylan Pharmaceuticals
• Rhodes Pharmaceuticals
• Solco Healthcare
• SpecGX LLC

Johnson & Johnson besides says their branded Concerta merchandise remains disposable with limits to supply, though immoderate generics of extended merchandise methylphenidate hydrochloride are successful shortage from these manufacturers:

• Dr. Reddy's Laboratories
• Lannett Company
• SpecGX LLC
• Sun Pharmaceutical Industries
• Teva Pharmaceuticals

In:
• Food and Drug Administration
• ADHD
• Drug Enforcement Administration