We have been reporting problems with generic Adderall (mixed amphetamines) for years. That’s because readers have told us that some generic products are not working the way the brand name does to ease symptoms of ADHD (attention-deficit/hyperactivity disorder). There have also been reports of an Adderall shortatage. The shortages include generic Adderall substitutes. Will patients who cannot obtatin either Adderall or its generic equivalents suffer withdrawal symptoms?
Why Are News Organizations Ignoring Amphetamine Withdrawal?
I suspect that most news organizations do not realize that people with severe ADHD could go into withdrawal if their medication is unavailable. We imagine that the FDA is embarrassed about this shortage and does not know what to do about the possibility of amphetamine withdrawal.
The US government has been totally incapable of dealing with drug shortages for more than two decades. It infuriates physicians, pharmacists and most important of all, patients! No one has come up with a solution to this problem. You can read more about it at this link.
Stimulants on the Increase!
The use of stimulant drugs like amphetamines (Adderall) and methylphenidate (Ritalin) has been increasing for years. But now there is an Adderall shortage. The FDA has announced that the ingredients in Adderall (mixed amphetamines) are “currently in shortage.” Will that lead to amphetamine withdrawal symptoms for some people?
Research published in BMJ Open (Aug. 13, 2021) reports that prescriptions for stimulants like amphetamines and methylphenidate are on the increase.
The authors noted:
“In this study, we have shown that US adult exposure to prescription CNS stimulants with risk of dependence is substantial—an estimated 4.1 million adults in 2018—and has grown by approximately 80% over 5 years. The total number of prescriptions dispensed grew even faster, with an increase of approximately 96%. Medication and treatment for depression, anxiety and other mental conditions were common…While use remained more frequent in the youngest age cohort, the largest percentage increases occurred in adults age 25 years and older.”
They point out that these are really old drugs.
“The amphetamine product Benzedrine was first marketed in 1933 for nasal congestion and in 1937 for depression and narcolepsy; in 1954, the US Food and Drug Administration (FDA) approved a methylphenidate product (Ritalin), which was marketed for depression, senile behaviour, lethargy and narcolepsy.”
In recent years, both Adderall and Ritalin are likely prescribed more for ADD or ADHD (attention-deficit disorder or Attention-Deficit/Hyperactivity Disorder) than for other indications. What happens, though, when there is an Adderall shortage or when a generic version doesn’t perform as expected?
Reader Reports Generic Drug Problem:
A reader reports what it is like to take an ineffective generic Adderall:
Q. I need to take Adderall for attention deficit disorder. My prescription has been filled with generics that are ineffective and causing me serious health issues. Of course, everyone thinks I am crazy!
It is affecting my mood, my memory, my intestines, my body and especially my head. Because Adderall is a controlled substance, I am stuck with this disgusting generic for three months, and I am livid. I am angry, sick, aching, and generally feeling terrible. Why can’t we just get the brand-name drug? It’s what we are prescribed.
A. You are not the only one who is struggling with generic amphetamines. The FDA has been reporting shortages of this medication for months.
Adderall and its generic formulations (mixed amphetamine salts) are prescribed for people with attention difficulties. When the drug is not available, people who rely on it may suffer. Some complain of withdrawal symptoms such as fatigue, anxiety, insomnia, depression and irritability.
When brand name Adderall is available, it may cost as much as $300 a month. While there are some generics, we have heard from others that they don’t always work like the brand. Another reader shared this:
“Comparing brand name Adderall to generics is like comparing mountain stream water to swamp water in Florida. There is a wild difference in effectiveness.”
Please let the FDA know about your experience via MedWatch. Perhaps the agency will investigate if enough people complain.
Here is an article we first published on October 31, 2022.
Q. I have ADD and have been taking Adderall to treat it since 1995. On my last refill, the pharmacist switched me from Teva, which has always worked for me, to a different generic manufacturer. It’s like I’m not taking anything. My professional life suffers and so does my relationship at home. Even my dogs don’t want to be around me.
Complaining to the pharmacy was useless. I gave up and asked the pharmacist if I could voluntarily pay for the brand-name pills. It turns out they are $500 for 60 tablets. That’s not in my budget!
It’s not like I’m trying to get high. I just need enough medication in my bloodstream so I don’t forget the intro to my PowerPoint presentation. What is going on?
Adderall Shortage Could Lead to Withdrawal:
A. Teva reported “intermittent manufacturing delays” and several doses were on backorder. Other manufacturers have not been able to pick up the slack completely. All this has led to a generic Adderall shortage.
Doctors prescribe amphetamine for people with attention deficit disorder (ADD) to improve functioning and focus. Stopping this drug suddenly may lead to symptoms such as anxiety, fatigue, sleep disturbances, irritability and depression.
Medical News Today describes it this way:
“When someone stops taking Adderall, they can reduce or completely avoid the symptoms of withdrawal by coming off the drug slowly, over the course of several months.
“If a person comes off Adderall quickly, they may notice the following symptoms of an Adderall crash:
• a craving for Adderall
• agitation and irritability
• anxiety or panic
• fatigue
• feelings of depression
• increased appetite
• insomnia
• vivid and unpleasant dreams”
Adderall Shortage and Generic Amphetamine Quality:
These readers are not the only people to report that some forms of generic Adderall don’t work very well.
Sean reports on a generic Adderall situation:
“It’s horrible. This generic Adderall is not even half as effective as a quality generic. It makes me jittery and I cannot perform my job up to my ability. This puts my well being at risk on top of making my daily life suck. Having to take double the dose to be almost as effective means I can never have the amount I need.”
Annie complains about generic substitution:
“The whole situation is incredibly frustrating. Some generics work better than others, but there’s no way to figure out which manufacturer is best, and in any case the pharmacies appear always to be shopping around for the cheapest, and often worst, formulation, so you’ll get one that works and one that doesn’t.”
Why Not Consider Authorized Generics?
There is a company that supplies an authorized generic version of Adderall XR. That means it uses the exact same formula and process as the brand name. The company is Prasco and it is located in the US.
Here is a link to its authorized Adderall page.
The company describes its authorized generic products compared to “regular” generics.
If you would like to learn more about authorized generics and find a list of authorized generic products and their manufacturers, here is a link.
The Adderall Shortage:
What can readers do about the Adderall shortage? Going through withdrawal is not acceptable! The prescribing physician may be able to offer a different medication to treat ADD until the shortage is resolved. This is not a perfect solution, though, since there are differences between drugs like amphetamine and methylphenidate. The physician may also be able to help you get a pharmacy to dispense an authorized generic like the one from Prasco.
