ADHD Medicines – A Warning!

Warning: in this situation of Adderall shortage, some pharmacists are filling prescriptions with formulations of the medication other than that prescribed, and sometimes without notifying the doctor or the patient. The patient may begin to get new side effects or less efficiency without understanding why. Always check the label on your prescription.

At least 57 % of adult ADHDers will respond as well to methylphenadite (Ritalin et al) as to the amphetamines (Adderal et al), so maybe you can just try switching.

Added Information O the Day:

Checking the label and the pills is a good idea for any prescription.

Generic forms of any medication are almost always cheaper than the brand names (methylphenidate, Ritalin).  They are supposed to be just as good and usually are, but not always.  For example, they may contain the same medication but a different filler which can affect the rate of absorption.  Further, the generic versions may be different from different companies.  Pharmacies often change the company they are dispensing from to obtain the lowest price, and you may have problems from that change.  Fortunately, these various difficulties are uncommon.

doug

Quotes O the Day:

If I did all the things I’m supposed to do for my health I wouldn’t have time to do anything else.

Doug (tired and in a negative mood)

“It’s always something.”
Rosanna Rosanna Danna

Questions O the Day:

Or was it Rosanna Rosannadana?

Or Roseanne Roseannadanna

Or does it matter?  How much time do I need to spend researching this question?

Links:

Adderall Shortage

ADHD Medicines

More Adderall Shortage

About doug with ADHD

I am a psychiatric physician. I learned I have ADHD at age 64, and then wrote two ADHD books for adults, focusing on strategies for making your life better. I just published my first novel, Alma Means Soul. Your Life Can Be Better; strategies for adults with ADD/ADHD available at amazon.com, or smashwords.com (for e books) Living Daily With Adult ADD or ADHD: 365 Tips O the Day ( e-book). This is one tip at a time, one page at a time, at your own pace. It's meant to last a year. As a child, I was a bully. Then there was a transformation. Now I am committed to helping people instead abusing them. The Bully was published in January, 2016. It's in print or e book, on Amazon.
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17 Responses to ADHD Medicines – A Warning!

  1. Pingback: ≫ Medicamentos para el TDAH: ¡una advertencia!

  2. Anonymous says:

    Thank you Doug. I know there are a plethora of things I could/should be looking into. Right now, I am working on surrounding myself with Nature’s beauty, and doing things and being with people who make me happy.

    Liked by 1 person

  3. Martha Puryear says:

    Good One! ❤️

    Sent from my iPad

    Like

  4. Cindy Bahl says:

    Oh! And some health insurances have their own pharmacy systems or a company they have partnered up with that can mail you prescriptions. For example, mine works with Express Scripts.
    I can’t believe it, but I’ve even had them mail me a 90 day fill of my Adderall. I didn’t continue with this option because I became paranoid about someone might steal the package before I got home. (Our neighborhood was having an issue at the time.)
    But, my point is, that this option, if it is available to them, may prove to be helpful and should be looked into if they continue to run into shortages locally.

    Liked by 1 person

  5. Cindy Bahl says:

    Last note, I swear. I finally read the contents of those links you shared in this post. They were excellent articles that communicated well the impact of the Adderall shortage. I live in Kansas City, Missouri. And live in a suburb that isn’t too populous. So far (knock on wood) I haven’t had an issue. It might help if you go to a major pharmacy like CVS. Even then, each pharmacy is different within their system. But I’ve tried a few different pharmacies in my area and found one that is consistently on top of their game (for whatever I need).
    I have friends who live in Florida who are having issues with the shortage. And elsewhere.
    Again, excellent articles you pointed us to.

    Liked by 1 person

  6. Cindy Bahl says:

    Oh, and I wanted to add something else. Adderall isn’t just about helping you reign in your distractability or similar. I was initially prescribed it by a psychiatrist because I couldn’t think as well as I used to and my serious depression was proving over and over again to be treatment resistant, which is a big deal.
    It was a few years later a therapist realized I had ADHD (ADD for me). And suggested the psychiatrist up my dosage of the medications. Why? One of the reasons is because I was still drinking 10 cups of coffee a day as well to help me focus and think. The psychiatrist did and I’ve been on a high dosage since. (Though, through genetic testing, discovered my body is a fast processor of Adderall, which may be why I need so much).
    Looking back, I remembered that my first grade teacher tried to tell my mom I had ADD. This was 1977. Pretty insightful for a teacher considering what was known about ADHD at the time and the fact that girls having it wasn’t really know at that point. My mom told her I couldn’t have it. She had seen me sit down and focus on something for hours multiple times. There was no way I had it. But I did and didn’t get diagnosed until my 40’s. Very thankful I was finally diagnosed.

    Sorry, I do that. Go on and on without making my point. I’m guessing another aspect of my ADD.
    My point? Adderall can help with treatment resistant depression as well. I’ve tried going off of it on my own. Even when I move past the withdrawal phase, I still feel a huge difference in my depression. It isn’t the only thing I take for depression but I’ve since realized it is one of the medications I need to stay on for it.
    I just hate the idea of anyone without ADD thinking that Adderall and similar are just bonus meds to help us and not critical to our functioning in the world.

    Liked by 1 person

    • Cindy
      yes, the stimulants can help with depression, but aren’t first line treatment. Treatment resistant depression is not that common fortunately and obviously is hard to treat. it can take a lot of trial and error to find the key. Fortunately also there are new meds and new non med approaches that seem very promising.
      Good for your teacher. I regret making the same mistake as your mom with a child who could focus on some things. I didn’t understand ADHD back then.

      I don’t think genetic testing is quite ready for clinical use yet, tho it shows a lot of promise. I can see it could help in treatment resistance, like yours, but so could have just a trial of raising the dose.

      yes, there is still a lot of frustrating misunderstanding of these diagnoses and of the meds – for ex, antidepressants don’t make you happy, they can take away the depression that is preventing any possibility of happiness. And treating ADHD can help us function and thus head off depression.

      thank you for your valuable contributions
      best wishes
      doug

      Liked by 1 person

      • Cindy Bahl says:

        Oh, the genetic testing? I didn’t explain it very well. My current psychiatrist submitted a request for a pharmacogenomic psychotropic test to analyze how my genes my affect outcomes with medications commonly prescribed to treat depression, anxiety, ADHD, and other mental health conditions. The results are guidance only. Nothing is dictating what the patient should be prescribed. The company is very clear that genetics make up only one part of the puzzle for the patient.
        She went through the company Gene Sight. https://genesight.com/

        Information on their report and what they test. There should be a link within this page to view a sample report.
        https://genesight.com/product/

        I talked to Gene Sight prior to doing it. Discovered even if my insurance covers it, I could pay up to $330 out of pocket. Thankfully, mine covered it 100%. Gene Sight also has a financial assistance program. This is for patients with or without commerical insurance.
        Link to the cost and some tools for it – https://genesight.com/cost/

        Correction on my previous comment – It does not test for Adderall, I believe. The report notes that there are no proven genetic markers for Adderall. But on most other meds, there are.

        The results were interesting. It tells me that I might find I have to have a higher dose of certain meds and lower of others, or if I can use it as prescribed. Or if there are drug interactions (they provide a chart).
        They also look for the MTHFR C677T mutation. If a patient has it, they may need B6 supplementation as well. They also test genotypes and phenotypes. On the product link, scroll down and it shows you what they test for.

        At the bottom of that list, it states it also tests COMT as additional information only.
        However, what I found out the Met allele of the Val158Met polymorphism in the catechol-o-methyltransferase gene impacts more than I initially realized.
        On NCBI, there are a ton of articles about it.
        (1) This one is how it has been linked to internalizing symptoms (depression & anxiety) in adolescents and adults.
        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5288403/
        (2) This one talks about how effective pain meds may be for a cancer patient. But I would assume this would translate to anyone taking those meds for pain management.
        https://pubmed.ncbi.nlm.nih.gov/15927391/

        You would understand all of the above much better than me. But I still love learning about it. Long, long ago, I thought about being either a doctor or psychiatrist. Ultimately, I chickened out. The number of years in school was too much. It all worked out in the end for me. But I still have the fascination with the human body and brain.

        I could go on about the genetic testing. And forgive any grammar and spelling mistakes above. I didn’t proof the text before posting it. Hope you (or someone reading this comment) finds the above information helpful (or interesting?).

        Thanks,
        Cindy

        Liked by 1 person

        • cindy
          thank you for this extensive information. i am sure you understand it much better than i do. i may do a post commenting on genetic testing and if so would certainly include or reference your comment if i do unless you object. my current understanding is that the tests can primarily tell you which meds are most likely to give you side effects, and maybe if you are a slow or a fast metabolizer. i think they have a lot of promise to be more helpful but right now don’t seem worth the cost or effort unless you aren’t’doing well, as your story illustrates. I have lot to learn.
          thank you again
          doug

          Liked by 1 person

  7. Cindy Bahl says:

    I’m so glad you brought up the fact that a generic may not affect a person the same way as the brand version. And that even generics can differ from one company to another. Or, if the company changed how that made that generic? That has happened as well and affected patients. The thing is, I’ve heard from a lot of people that both their psychiatrists and the pharmacists don’t believe them when they say something is wrong, the med is now causing issues. Which makes those poor people feel like they are being a hypochondriac or something else. And it makes the patient feel powerless with those professionals tell them that. When I see this brought up on discussion boards, I try to comment and let them know that not all generics are alike. And, again, even the same company can change their formula for a generic. Because usually no one else in that ADHD forum realizes this and provides advice that assumes all meds are the same.
    With all that said, I’ve been very lucky (so far) to not be affected by different versions of generic Adderall.
    I’m so glad you brought this up. It’s so important for those who takes meds for ADHD to know about this.
    One thing I didn’t know about? Where you said “For example, they may contain the same medication but a different filler which can affect the rate of absorption.” I wasn’t aware that absorption could be impacted as well. I just knew that some people were having some bad side effects when switched to another generic for their med. So, I’m glad you said this! I learn something new with every one of your posts.

    This quote is so true:
    If I did all the things I’m supposed to do for my health I wouldn’t have time to do anything else.
    I’ve thought about that in recent years while beating myself up for not doing everything perfectly, including with my health. But, slowly, came to the realization that attempting to do my best without constant negative self talk IS part of being healthier. Still a process, though, to believe this fully (and at all times).

    I love the humor you infuse in all your posts! I laughed out loud on the exorcism one. I’m still smiling about that. Feels so true when you meet some people!

    Liked by 1 person

    • Cindy
      good for you for letting more people know about these medication problems. when symptoms or side effects change it is important to question the med. hope you have good strategies for countering the negative self talk, it is so harmful.
      thank you for the support
      doug

      Liked by 1 person

  8. mags says:

    Doug, Thanks for this newsletter, I am always happy to see it, and find it helpful, funny, and interesting. It is a highlight of my email box!

    I have a few comments about my own life with ADD, that I want to share. I hope my tone comes across as self-reflective, and self-revealing, and that perhaps, as an older, long-term sufferer, I might share something helpful to someone else. To be clear, I am not saying anything against your work, nor am I saying you have not addressed this stuff already. I am just sharing here something that is starting to crystallize for me, when examining my life. Thanks for this opportunity.

    I, apparently, have a “really bad” case of ADD, at least according to my long-term friends. Not my favorite idea, and it was not explained, so who knows what that might mean?

    By my own observations, I am also seen as somewhere between the village idiot, and a genius, depending on, well, “stuff”.

    For some years, I had a successful science career, but got derailed. It’s, of course, complicated. I got laid off, had a crushing loss of confidence, and became more and more subjugated in my relationship of 30 years, to the point where I snuck away, leaving to save my life. Literally. So I lost most everything I ever worked for, and will never recover, at 65 y/o.

    My point is that, in addition to early childhood loss, abuse issues, etc, my ADD played a role in my ultimate decline.

    I did not always avail myself of resources, and made some decisions with some serious, long term consequences. I can’t really parse out what thing caused what effect, but suffice it to say, the conglomeration of my life’s difficulties worked together, sometimes to unfortunate results.

    I think, when we look at the impact of this brain insufficiency, condition, whatever, we need to acknowledge that life is complex, and complicated, and many of us already have very impactful life-events that can dovetail with ADD, and can exacerbate, or be exacerbated by, ADD.

    I do not believe we each have the same capacity to successfully use all the tools, tricks, hacks, and aids out there. We cannot all reach, and sustain, great heights. And I think, as a truism, it is worth sharing. Just something to ponder.

    Additionally, I also experience the cascading effects of low self-esteem, over the decades, and I believe there is, at least for me, a cumulative impact, aided by my ADD brain.

    I have many regrets, and some resentments, and some feelings of defeat, etc. And I grow tired of the constant struggle to adapt to life’s twists and turns. I’m guessing that these feelings are probably not unique to me.

    I wish I had a nice bow to wrap this all up, but, well, ADD.

    Thanks, I really do appreciate this forum to share my struggles.

    Maggie Lais

    Liked by 2 people

    • maggie
      i am so sorry for the struggles you’ve had. you give a good description of the process – things are cumulative and often in feedback loops. our ADHD causes problems which lower our self esteem and morale, which makes it harder to cope with our ADHD, and so on. And as you point out, ADHD isn’t the only kind of problem a person can have in life, but it does make everything harder.
      congratulations for getting out of a bad relationship – that can be hard to do too.
      (I am biting my tongue and I guess my fingers to avoid offering unrequested advice here, which is so rarely helpful. I hope your sharing will be helpful to you.)
      Thank you for sharing
      best wishes
      doug

      Liked by 2 people

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