As the shortage of medications to treat attention deficit hyperactivity disorder (ADHD) drags on, some relief may be on the way: The U.S. Drug Enforcement Administration (DEA) has approved a production increase for branded and generic versions of Vyvanse (lisdexamfetamine).
“I was surprised to see the news, and I feel that every little bit will help,” says Jennifer McWilliams, MD, the division chief of pediatric psychiatry at Children’s Nebraska hospital and medical center in Omaha. “With that said, the shortages are so widespread that I don’t anticipate it will have a huge impact.”
“As people were forced to switch from Adderall to different medications, there (was) a domino effect of shortages,” Dr. McWilliams says. “That will take a while to undo.”
ADHD Drugs Are Considered Controlled Substances
And manufacturing quotas and production shortfalls are only part of the problem, says Lauren Hoffman, PharmD, a pharmacy clinical specialist in psychiatry at University Hospitals Cleveland Medical Center and Case Western Reserve University in Ohio.
“Production issues with some of the amphetamine products was sort of the tipping point a few years ago that set this cascade in motion,” Dr. Hoffman says. “But this is in conjunction with historic rates of ADHD diagnoses and medication prescribing. It has been both a supply and demand issue that has led to the current state of the market.”
Insurance Challenges With ADHD Drugs
Insurance can be another part of the problem, says Ann Childress, MD, a clinical associate professor in family medicine at the Kirk Kerkorian School of Medicine at the University of Nevada in Las Vegas. Insurance often only covers generic versions of drugs like Vyvanse and Adderall — and those are both in short supply in the Las Vegas area right now, Dr. Childress says.
“Brand name medications have been more consistently available,” Childress says. “Sometimes a call to a patient’s insurer will be enough to get authorization to fill a month’s supply of brand name medication.”
Beyond this, patients are going to need to keep doing what they can to work around supply issues that come up as shortages persist, McWilliams says.
“The shortages seem to be impacting all the different stimulant medications, just to varying amounts and at varying times,” McWilliams says. Some patients can switch from one medication to a different ADHD drug depending on availability — and it’s worth asking your doctor if this can work in your specific situation.
“For other patients, however, this causes side effects, or the other medications simply aren’t as effective,” McWilliams says. “For those patients, we have been using nonstimulant medications for ADHD treatment more often, as well as incorporating different strategies like fidget toys.”
