The stimulant shortage and what prescribers can do to help their patients
Introduction Heading link
For many pediatric and adult patients, the current stimulant shortage means significant disruption in daily functioning. As a result, there’s increased pressure on prescribers to problem-solve in order to continue to meet the treatment needs of patients who are impacted by ADHD.
To put this situation in context, an increase in stimulant prescriptions had already been on the rise for several years prior to the pandemic, especially in adults. The demand accelerated during the pandemic when parents started working from home and noticing more ADHD symptoms in their children and themselves. In some cases, struggles with working and learning from home may have mimicked true ADHD symptoms. Additionally, an increase in the availability and acceptability of telehealth during the pandemic increased access to mental health care, which led to more stimulant prescriptions.
Stimulant shortages are in part due to federal regulations which determine how much manufacturers can produce by limiting materials needed to make the medications. Unfortunately, even with the shortage, the DEA has not indicated that they will be increasing quotas. Simultaneously there are production delays at Teva, one of the drug’s major producers.
If your patients encounter difficulties in filling prescriptions for stimulants, Illinois DocAssist psychiatric consultants can offer free guidance. You can speak to a consultant during normal business hours by calling 866-986-2778 or scheduling a free consultation online.
Tips for prescribers…
1. Recommend that patients call various pharmacies to check medication availability before a stimulant prescription is submitted.
2. For patients who are covered by Medicaid, contact the pharmacy to determine what generic is in stock and make dosage adjustments as needed. Consult with Illinois DocAssist to determine dose conversions.
3. Consider switching from Adderall to other stimulants. While the Adderall shortage is now spilling over into other stimulants, Adderall is still the most scarce.
4. Consider other alternatives for treating ADHD, such as Strattera, Clonidine, Guanfacine, Bupropoin, Viloxazine. Request a consultation with Illinois DocAssist for guidance.
5. Note, that patients may describe feeling depressed, fatigued, and unable to function if without stimulant medication, especially if they stop rapidly.
6. Some patients may be at risk of using illicit, unregulated stimulants if they cannot fill prescriptions on time and should be counseled on potential dangers.