Availability of ADHD meds

[hudzyb]

both my son and my husband need ADHD meds and I can’t get either prescriptions filled right now because, I guess the entire nation is out of stock? This normally doesn’t happen until November, which is bad enough. But I am alarmed at this point. Is anyone else experiencing this and do you have any advice on how to get the meds?

[STEM_Dad]

What medications are out?• Is there a different formulation of their medication type available? (i.e. different formulation of amphetamine or dexamphetamine, or methylphenidate, whichever is their type?)

• If none available, can they try the other type of stimulant?

I know that at the time of the first shortage Adderall and other amphetamine based meds that ran out first, then the methylphenidate ones started to run out.

Just months before the first shortage, my doctor changed me from Adderall to a non-stimulant, atomoxetine (aka Strattera). I haven't had any issues getting my meds, except when I moved and changed pharmacies...and that was just a few days wait for the order to come in.

~~~~~

Has either your son or husband been tried on a non-stimulant? Qelbree is supposed to be a good new option for kids. (It's similar to Strattera, but reportedly works better for more people and with less risk of side effects. It's new, so it is only available in name brand.)

Also, there are some non-ADHD medications that have been discovered to help treat ADHD, both alongside a stimulant or even just by themselves. (Not typically as effective as a stimulant, but probably better than no medication at all.)

These include:

• guanfacine (aka Intuniv, a blood pressure medication)

• clonidine (a similar blood pressure medication)

• bupropion (aka Wellbutrin, an 'atypical' antidepressant, not an SSRI)

Talk to your son's doctor about options to try. Suggest to your husband to talk to his doctor about the same.

[hudzyb in reply to STEM_Dad]

Thank you! My husband takes Adderall 25 mg, and my son takes Concerta 54 mg plus guanfacine. We are in Orlando Florida. My husband has strong side effects with Strattera and Astarys and Focalin doesn’t seem to do anything for him either. But we have never tried Wellbutrin as an alternative and I am hopeful that one could at least take the edge off with minimal side effects. Thank you so much!

[STEM_Dad in reply to hudzyb]

Wellbutrin is a norepinephrine and dopamine reuptake inhibitor (NDRI). Those are both of the neurotransmitters associated with ADHD.

By contrast, Strattera is a selective norepinephrine reuptake inhibitor (SNRI), and stimulant medications are dopamine agonists (meaning they stimulate the release of dopamine).

So, if your husband is normally well treated by a stimulant, then he might more likely to see benefit from Wellbutrin than he was on Strattera. However, Wellbutrin carries similar risk of side effects to Strattera.

~I've been on Adderall XR (brand name, only worked a little for me, and the daily letdown made me irritable).

~I've been on Strattera (generic, at least twice as effective as Adderall did at it's best).

~I'm now on Wellbutrin (generic, slightly better than Strattera, because it treats my ADHD, almost eliminates my persistent anxiety, and seems to keep my occasional depression at bay).

Another benefit of the non-stimulants is that they keep working 24x7. No letdown. (No "medication holidays" allowable, unlike stimulants. Plus, they can take a long time to build up enough to me effective. It only took a few days for them to work for me, but I consider myself to be a rarity in that respect.)

Definitely a conversation that should be had with the doctor. I can only tell you what I've read and my own experiences. Each person will respond differently.

[Onthemove1971]

Great advice from STEM dad..

We moved our son to Wellbutin and find it has been a great switch. His child Psycharist recommend this to us and said it often helps with impulse control.

He also takes Guanfacine and the two together have really helped him.

[hudzyb in reply to Onthemove1971]

how old is your son? Mine is 10. I am reading about Wellbutrin as an ADHD alternative medication and it says that the effectiveness is not known for patients under 18. I’m wondering if your son is close to 18 years old?

[Onthemove1971 in reply to hudzyb]

Great to question things like this. We started during COVID due to the medication shortage so that was 4 years ago. So he was around 14 years old when we started.

Yes, he just turned 18 years old.

Are you working with a Child Psychiatrist? They helped us so much.

[Imakecutebabies]

"This normally doesn’t happen until November"? Do you mean that this is a regularly occurring yearly cycle?

I've been considering trying to switch my son from a non-stimulant to a stimulant, but you're making me think I should pursue other options instead.

[hudzyb in reply to Imakecutebabies]

we tried a few non-stimulant versions of ADHD medicine and they just not effective for my family. It’s a shame! My husband will use coping skills to the best of his ability, though he didn’t learn those until later in life. My son is still not good at using his coping skills even though he’s in training, you know kids, it takes a full 18 years of training to do the simplest, self hygiene things anyway, much less advanced emotional control skills The shortage that we experience in the United States for controlled substance stimulant medication’s for ADHD happens every year toward the end of the year because the FDA has a maximum amount that they are allowed to make each year, which is regulated by the government. Apparently having ADHD is our own fault and we need to pull ourselves up by our boot straps. (read with sarcasm.) so yes, this is pretty common, but it doesn’t normally start until November or December. There have been many many new diagnoses of ADHD in the last few years and so the problem is getting worse.

[Imakecutebabies in reply to hudzyb]

Oh jeez. Ok thanks.

[LAJ12345]

where are you?

[hudzyb in reply to LAJ12345]

Orlando FL

[Cyclone10]

My son has been on focalin for some time now and actually I feel like the supply issues have just been ironing out recently. Had a hard time getting it this past spring/summer but the last couple months have been fine.

As of today we are switching to Astarys to see if we can get further in the day with his med- our doctor also said this one might be easier to get because it isn’t as old/well known.

[Piperkat in reply to Cyclone10]

My son takes Focalin and we haven’t been able to get it at Walgreens or CVS in Northern Virginia for months, whereas in the spring it was still available or could be ordered.

[hudzyb in reply to Piperkat]

it makes no sense to me that the United States can’t figure out how to make enough meds for the people who need it. I actually contacted my congressman yesterday about it.

[Onthemove1971 in reply to hudzyb]

I totally get your frustration. This problem has been since COVID. From what I know is way more people are needing the medications than before and they company’s are restricted on what they can produce..

Good luck.

[Mamamichl]

maybe try a different pharmacy. Mail in seems to be more successful. Also, I haven’t had this issue yet, so I’m curious where you are. I’m usually near big cities, though our meds were in rural once and it was a bit more tough. I did read in the news that the authority that controls production has decided to up production quite a bit. We may not see the change for a while but it’s a boon. Also, see if there are meds that are more readily available. Many people go off brand and that helps too, though some say off brand isn’t as good for them.

[hudzyb in reply to Mamamichl]

Thank you! We are in Orlando Florida. My husband takes Adderall XR 25 mg and my son takes Concerta 54 mg.

[Mamamichl in reply to hudzyb]

I know there are more issues with the stimulant meds than the non stimulants. I’m in Michigan and was in Oregon. We haven’t had these issues. Our biggest issues were my partner forgetting to refill it before he ran out so he regularly goes 2-4 days without the meds.

[Onthemove1971 in reply to Mamamichl]

When our son took a controlled medication we were not allowed to have it sent to our house. I have to go to the pharmacy ( which closes at 5pm) and show my driver license in order to pick it up.

Then let's not talk about the complex system of placing the order. When they are out or stock we just get a generic response " we are having issues filling your rx... stay tuned and we will update you when we have news"..

I am very thrilled our child psycharist helped us find a medication that really works well for our son. It is mailed to our house now.. no more issues.

I hope so day there is some kind of lawsuit over medical providers/ pharmacies not giving patience the medication they need..

[Cyclone10 in reply to Onthemove1971]

Can I ask what med your son is now taking that’s working well?

[Onthemove1971 in reply to Cyclone10]

He takes Guanfacine and Wellbutrin. When he was younger he took Ritilin and Guanfacine. What I have found was that we did not address his Anxiety when he was younger and now I feel the Wellbutrin helps him control his impulsive behavior and Anxiety.

He is not a kid who would say, "I'm scared or I'm nervous", So we left it alone.

Now that he is in college and playing sports the pressure is on him.

Hope you are able to find what works. The pressure in elementary school is much less than in middle and high school.

Take care,

[hudzyb in reply to Onthemove1971]

Your description of when your son was younger sounds a lot like my son as well. I will talk to his doctor about Wellbutrin. He does take guanfacine already, combined with the Concerta.

[Onthemove1971 in reply to hudzyb]

If I could give a mom on this journey any advice it would be go with your gut and when it is telling you something is not right.. search for what is right.

Worse case if the Wellbutrin doesn't work you can check it off the list and go back to where you are now and you know you tried it.

I would say for us, middle school were the hardest years and if I had better medicine to help him it may have turned out different.

If you need someone to talk to I am always here for you. Just send me a message and if I can help I will.

Big hugs for your struggles.

[Cyclone10 in reply to Onthemove1971]

Thanks for the info! I will put Wellbutrin on my list of meds to ask our doctor about if we need a change at some point. I see lots of comments mentioning it here! We tried guanfacine for awhile and couldn’t get past the sleepiness.

[Mamamichl in reply to Cyclone10]

The sleepiness is because it was originally a blood pressure medication and lowers blood pressure. It helps not be impulsive or have heightened emotions, but generally doesn’t help with the thoughts.my stepson feinted on it.

[Cyclone10 in reply to Mamamichl]

Yep it’s an off-label use. Some people really seem to have success with it so I was hopeful but my son was near comatose on it lol.

[Mamamichl in reply to Cyclone10]

It is very common. Some kids though have high blood pressure and could use something that lowers it. Every situation is unique. Sometimes it’s a lot of flexibility and trial and error.

[Mamamichl in reply to Onthemove1971]

Wellbutrin helped my ex a bit, but not much. Guanfacien has been horrible for my famil (light headedness/feinting). Because the meds and people are so diverse, we chose to do a gene sight test to see which meds would have an adverse reaction to our bodies. Although they don’t tell us which would work for our ADHD, they did tell us which ones to avoide for side effects.

[Crazyboymomma]

if you can switch to Azstarys, it works well and I’ve found it much more readily available.

[hudzyb in reply to Crazyboymomma]

Thank you! My husband gets very irritable and cranky when he takes Sarah‘s, we tried that last year about this time of year. I’m not sure how my son would do on it though? I will talk to the doctor.

[Cyclone10 in reply to Crazyboymomma]

Slightly off topic but I mentioned in another comment here that my son switched to Astarys today- so I’m excited to see read this! He was on 15 mg Focalin and switched to the middle dose of Astarys. I’m really hoping that since he did pretty well on Focalin that his body will accept this one too since it’s similar, just with the additional component.

[Geep10]

We are in the midwest and at the start of school I called every pharmacy for miles to try and get my child's focalin prescription filled for school. I ended up paying non-insurance pricing for a place out of network where I actually found it, thankfully there was a coupon. It's so frustrating that we have finally found medication that helps, and it is a complete nightmare to keep in supply. Reading these comments I was unaware the limitations/regulations, I just thought it was controlling supply to justify high pricing. I will reach out to my representatives to make my feelings known.

[hudzyb in reply to Geep10]

we cannot afford the Adderall or Concerta using our normal health insurance. We always use GoodRx. It’s a free app, with the option of a Premier membership, but not all pharmacies except the premier.

[Cyclone10 in reply to Geep10]

I’m also in the Midwest. I had to shell out for name brand focalin a few months too after I got fed up calling 5-6 pharmacies who didn’t have it or worse yet, wouldn’t tell me over the phone (this was a random Walgreens location that apparently makes you come to the store to get this info…at that point just forget it). I didn’t know about the coupon, that would have been nice!

[Shamasamdrew]

This advice seems counterintuitive, but it has been working for us. We go to a small, independent pharmacy rather than a chain pharmacy. For whatever reason, the smaller pharmacy has been able to work out with their suppliers to get what is needed for their small clientele.

[SurvivorFan in reply to Shamasamdrew]

Yes, this has worked well for us too. We live in Mpls/st. Paul area but we found a smaller independent pharmacy in a close suburb that has almost always had our scripts for Focalin and Adderall. They are so much kinder as well!

[Geep10 in reply to SurvivorFan]

We normally use a small local pharmacy too. In our case I actually found it at a CVS after I had exhausted calling all the small ones in a 30 mi radius. I think it's sometimes just timing. Our normal pharmacy knew we were going to need it as we were on their normal filling schedule, but they couldn't get it.

[SurvivorFan in reply to Geep10]

There have been a few times over the past couple years where they couldn't fill it, but the nice thing is they have always told me in advance if it didn't look like they could get it in so I would have time to call all the walgreens,targets,etc to find it. All the big pharmacies refuse to tell you anything other than they don't have it.Just the customer service alone is worth it! They get to know your family

[MOTORMOUTH_ADHD_ODD]

ANyone know of a good child Psychologist in NYC?

[LisethHIS]

Good day, hudzyb,

Thanks for contacting CHADD National Resource Center on ADHD. Thank you for informing us about the medication shortage you’re experiencing. If you were affected by the recent hurricanes, that could be one reason for the shortage. If this is a recurring issue, here are a few steps you can take- chadd.org/attention-article... and chadd.org/advocacy-blog/tip...

If there is anything else you need, please let me know.

Best Regards,

Liseth

Health Information Specialist

CHADD’s National Resource Center on ADHD

chadd.org

[hudzyb in reply to LisethHIS]

This is very helpful, thank you!

[Lion_Creek]

We have had two long periods this year of not being able to get generic Focalin. It's really frustrating. The first wave lasted a month, and we didn't substitute it with anything. That was really hard on our daughter; she had trouble with friendships, focusing in school, and standardized tests. The second time, our psych NP prescribed Concerta to replace it, and that worked fine (although not quite as good of a fit). Whenever it happens, it's a whirlwind of calls with the pharmacy and NP's office to try to get a good med. The pharmacy will sometimes let me know if there's a slightly higher/lower dosage of Focalin available, too. Other times, they won't give me any information because it's a controlled substance. Our NP is very familiar with the nationwide supply issues so is willing to work with us to ensure our daughter has coverage even if it's not the exact medication we prefer.

[hudzyb]

Thanks for all of the helpful replies! I’m grateful that so many of you have written to try and support and help with this frustratingly common struggle. It’s so nice to know that there are good people out there with kindness in their hearts enough to speak up.😊

[Onthemove1971 in reply to hudzyb]

We are always here to struggle together. Knowing we are not alone feel so comforting. Post any time and will try share what we have been through.