I was officially diagnosed about a year ago and had been managing my ADHD using natural methods and techniques but those aren't working anymore. I tried discussing the ADHD medicines with my psychiatrist but he informed me that ADHD meds aren't available here.
I plan to do something about it but will require your help. I might set up a petition on the internet so I might require you guys to sign the petition. I have tried contacting the government but what can a single person do? Any other suggestions?
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MLuqman-Qureshi
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Hi MLuqman-Qureshi . Sorry to hear you are having such a hard time finding adequate treatment in your country! I admittedly know almost nothing about Pakistan's situation for ADHDers, but for what it's worth, I did find a similar question on Quora, with an answer that might be interesting/helpful for you (source: quora.com/Is-ritalin-availa... ):
"Q: Is ritalin available in Pakistan?"
"A: Yes it is avaliable in Pakistan by Novartis Karachi and official price is less than $1 for 15 tablet leaf. However acquiring it is a totally different story. All of the others who answered your question probably never tried to buy it themselves like an ordinary walk in customer.
Here is my own experience, First of all no one is going to prescribe Ritalin to you, consider yourself lucky if they do and once you have a valid prescription in hand its very hard to get Ritalin in Pakistan,
For example here in Lahore where I live if you take your prescription and go to any reputed medical store to buy Ritalin the first thing you will notice is that the stupid angry counter boy will give you a very dirty look and then he will tell you in very rude way that its not available and he will not answer a single question properly related to its future availability.
And then there are some Pakistani online medical stores most of them list down Ritalin or any other controlled drug only to bring search engine traffic toward their site they don’t actually stock these drugs, Some of them who actually stock it e.g SEHAT will ask for ridiculous requirements related to prescription and they will always reject your prescription for one reason or another and won’t shy away to say “Oh we forgot to tell you that we need a stamp here or signature there or go ask your doc to write this particular note for us or oh the stock is empty check back with us in 15 days or oh your prescription is now one month old pls get a new one or get it refreshed”.
I was able to buy Ritalin from Sehat after 3 months of delay, back and forth prescription submissions, numerous follow up calls and heated emailing with their extremely shameless staff, on top of this the whole time they behaved as if I am a criminal and a drug addict who is trying to buy some narcotics from them, and upon my second order when I was in perception that after fulfilling all their requirements now they will consider me a legitimate customer instead they simply refused to process it and listed down so many new requirements by quoting “we just revised our prescription checklist because so many people are fooling us”.
I discussed these issues with my shrink who was already pissed by editing my prescription a few times because of Sehat, While telling this all I was almost crying in front of her. After this for a short period of time that kind lady helped me out in buying my meds without me going through this insulting and painful exercise but later she moved to USA. Please note out of a few psychiatrists I visited only she agreed to prescribe and arrange Ritalin for me
Its probably easier to get an illegal version of ak-47 in Pakistan but not this drug legally or without having friends in pharmacy field because medical stores usually want to sell it in black (only to their pimps on streets for higher profits). Around the year 2000 it was banned in Pakistan, ban was later lifted but it is still a hot seller in black market. But the rates in black market are too high to afford its regular usage, they sell it for USD $10 – $15 (10 Tablets only) also there is no guarantee if the tablets are original,expired or fake because some rouge elements in Peshawar are making this drug at home using a local brand name called Rital and this is also not difficult for them to print labels with Ritalin.
It is unfortunate that a harmless medicine which is being prescribed to even children in developed world is so difficult to obtain in Pakistan only because among students it is being rumored as a super magic pill and for me this is hilarious because the negligible good effects of this drug doesn’t last more than 3 hours but withdrawal is prominent and horrific which ruins your remaining day and it also takes away your sleep, Its regular usage is even more painful where you have to increase its dosage periodically, It only works a little for those unfortunates like me who are suffering from some genetic disorders which forces them to use such substances, a normal person can simply use his/her will power to overcome those issues for which Ritalin is made. For normal people Ritalin is as bad and useless as using sleeping pills for no good reasons at all.
By the way if you have some friend who has his own medical store then stop wasting time in researching and just go and buy as many cartons as you want …. It is Pakistan after all where corruption is God and nepotism is Goddess….
Good Luck"
If you wanted to try reaching out to a different psychiatrist in your country for a second opinion, I found this one with a quick search:
Thanks a bunch, I had already read this but it is missing a crucial point. The only med available here is Ritalin (which is extremely difficult to get even on legit prescription) and if it does not work, or has side effects, you don't have ANY alternative. I fear if I start taking it after the consultation with the psychiatrist and even if it works with side effects, I won't have anything else to go to in order to reduce the side effects.
No problem! Wish I could think of some better options to help you out, but it sounds like Ritalin might be your best and only (legal) option. It sounds like you have not had a chance to try Ritalin yet, correct? There's a good chance that it might work for you, and you won't need alternatives, so that's probably your best place to start. If Ritalin doesn't work for you (or it does, but you still want to try to make the world a better place for ADHDers in your country), you could try pushing for political change as you have suggested. You mentioned that you've tried reaching out to your government. What response (if any) did you get? I don't suppose there are other government agencies and contacts you could try as well? Here's the contact page for your DRA:
Maybe the Director of Controlled Drugs, Director of Pharma Licensing, and even the CEO might be worth reaching out to? In the United States, the FDA will allow the importation of drugs that haven't been FDA-approved under some specific circumstances (see: fda.gov/about-fda/fda-basic... ). Maybe your DRA has some sort of similar policy that could allow you to import other ADHD drugs that aren't approved in Pakistan? Given the way Ritalin is treated in your country, I'm guessing that other stimulants wouldn't be covered even if some kind of policy like this exists, but it might be worth asking anyway on the off-chance that there is a legal option available for you.
Do any ADHD support/advocacy groups (like CHADD here in the US) exist in Pakistan? If so, it might be worth connecting with them. Maybe they have information on how to get ADHD medications, and/or advocacy efforts you can support to change the system.
I can get Ritalin on prescription with some efforts but I am concerned if it works for some time and stops working after e.g. a month, I might end up getting worse than I am now. As for the contact with the government officials, I contacted the CEO of DRAP (drug regularity authority of Pakistan) and he pointed me towards the essential medicines assistant director who informed me that I will have to provide an application with the copy of CNIC along with other documents, though I am skeptical as the tax laws here are ridiculous and ordering a single medicine worth PKR 30,000 to PKR 40,000 is not only very costly for a month but also risky as the environment here does not support ADHDers.I am planning to write a petition on change.org but the chances are very slim that a government employee or official reads it and acts upon it.
I did find a trust (Kazim trust) but they only deal with therapies and not medicines.
I just another idea for you: Have you looked into whether there are any clinical trials for ADHD medications in Pakistan? Maybe you could enroll and get free access to medications that are not currently approved by your drug regulatory agency, and as a result, could also potentially help your fellow ADHDers gain new medication options. Seems like the stars would really have to align for things to work out this way, but perhaps it's still worth looking into?
Sorry you have to deal with these sorts of constraints in your country! I just read some more depressing information from the organization you mentioned on the CHADD website ( chadd.org/attention-article... ) :
Mental health in children is an overlooked subject worldwide, even in developed nations. In Pakistan, awareness is building gradually, but the situation of mental health institutions is dark and far from the mark. There are not nearly enough psychiatrists and psychologists in the country. There are approximately two to three psychiatrists per one million people in the urban centers; they are nearly non-existent in rural areas. Existing hospitals and healthcare institutions are poorly utilized due to the social stigma associated with mental illness. The general misconception is that mental illness is caused by curses and evil spirits.
Developing mental health awareness for children requires serious attention, since half of the country’s population is under the age of 18. There are limited trained personnel in the field of child psychiatry. Out of 3,729 outpatient mental health facilities in Pakistan, only one percent are just for children and adolescents. To add to this, the stigma attached to being a parent of such a child further complicates the matter.
The idea of a child suffering from a mental disorder is so unfathomable, undesirable, and shameful for the parents that they opt to avoid treatment for their children. This results in delaying a child’s admission into a special school, rendering the child vulnerable to severe comorbidities. If the child is already anxious, for example, a plethora of ADHD-related difficulties will add to the anxiety. Parents may feel free from humiliation, but it is at the cost of their child’s mental health.
That sucks that you have to struggle and cannot take meds for your ADHD. Well done for trying to manage your symptoms naturally! It’s really tough.
Raise some awareness if you can and post it on this group - I am sure everyone will be willing to help you spread the word and support you.
Have you heard of SNRI medication? It’s similar to SSRI antidepressants but instead of a Serotonin reuptake inhibitor it is a Norepinephrine reuptake inhibitor. It ensures there’s enough Norepinephrine available in our body.
I was prescribed an SNRI before I received my official diagnosis for ADHD. With ADHD we suffer with Norepinephrine and Dopamine “deficiency” or they aren’t working as they should.
So, this could help a bit while you are waiting or looking for more help.
It helped me, though it certainly isn’t a substitute for stimulant medication.
The one I was prescribed is called “Venlafaxine” or “Effexor”.
Please hang in there and I am glad you have reached out on here .
Let us know if there is anything we can do to help! I’m in the UK 🇬🇧 by the way. Nice to meet you. X
The psychiatrist had prescribed me some anti-anxiety meds but I could not tolerate them and some side effects so I quit it as it also did not affect the symptoms. Though I will check to see if SNRI meds are available hereI do plan to spread awareness regarding ADHDers in Pakistan here and on some FB groups
Though I am enrolled in the University of London distance learning program and finding it quite good.
I am from Pakistan as well, and was just diagnosed with ADHD today and still Doc told me that Ritalin is out of stock, so he prescribed Atomoxetine; I was just wondering what is the current situation and are you able to find Ritalin (or other stimulant medication) from any where, whats the situation after three years? Any help would be appreciated from anyone.
I am struggling with same issue. I have been diagnosed ADHD and been prescribed lisdexamphetamine which is not available in Pakistan. Why ADHD is not taken seriously here and no medicines for it. How will patients live without it ,is not a concern for Health department. I have tried ritalin but it gives me a burnout kind of feeling and cold body temperature with Reynolds kind cold extremeties. I want to try alternative but it's not available in Pakistan. What to do about it? Is it my fault to have this condition? It's 2024 now and still we don't have access to medicines. Isn't it shameful for our government and health authority. People like me who are diagnosed with this condition have the right to get better in our lives and career, we are not asking for illegal drug which are by the way easily available everywhere.
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