Patients question Adderall's efficacy

A growing number of patients taking Adderall, a drug for attention-deficit/hyperactivity disorder, are questioning whether the treatment works, The New York Times reported March 13. 

There has been a shortage of amphetamine mixed salts, the generic for Adderall, since fall 2022. The brand-name drug's maker, Teva Pharmaceuticals, has set a resupply date for March 2023, and a recent post from the American Society of Health-System Pharmacists seconded this release date for mid-month. 

But, "the Adderall isn't adderalling," one TikTok user said, according to the Times. A growing number of people on social media have said their ADHD medications are not as effective as they once were, and some are citing the shortage as the reason. 

On TikTok, videos related to the "ADHD meds not working" topic have more than 15 million views. Teva told the Times that all "manufacturing processes and practices are the same (and we continue to distribute the same brand and generic Adderall products)." An FDA spokesperson added that it has not noted any safety, quality or efficacy issues with these products. 

This is not a new phenomenon, Danielle Stutzman, PharmD, a psychiatric pharmacist at Children's Hospital Colorado in Denver, told the Times. Dr. Stutzman said about 25 percent of her patients have said in the last few years that their ADHD drugs seem less effective.

Experts said there are five potential reasons. It could be a tolerance buildup, or it could be because switching medications amid the shortage may affect a small group of patients, but this is unlikely because manufacturing differences among generics are minor. 

Some patients may be prescribed a different ADHD medication, such as Vyvanse, if Adderall is out of stock, the Times noted.

"What we've seen over the recent years is there's been a ballooning of available stimulants in the marketplace, and they're not all equivalent," Sandy Mitchell, PharmD, a clinical pharmacy specialist at Virginia Commonwealth University Health in Richmond, told the Times

A third reason could be because some patients temporarily stopped taking their medications as supply ebbs. The last two possible answers to the efficacy question are social disruptions to patients' lives and cognitive bias. 

Read more here.

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