Dr. Mark Siegel
My 27 year old patient has been on Adderall since early puberty. A long working, successful bond trader, he credits his business success to Adderall’s achievements.
Recently, however, I have been unable to find the drug in stock, even after checking several pharmacies. As his work performance began to decline, the therapist told him to drink more coffee temporarily to cope without medication.
The patient had taken Ritalin in the past, so we tried generic Ritalin. methylphenidate, however, he reported that the new formula did not have nearly the same effect as Adderall. He still had a lot of trouble concentrating, so I consulted a psychiatrist and increased the dosage, which had some effect.
The psychiatrist I consulted told me that the story was not uncommon, lack of adderall Relatedly, there is a long-standing shortage of both long-acting and short-acting drugs for attention-deficit hyperactivity disorder (ADHD).
In a public letter dated August 1, the Food and Drug Administration and the Drug Enforcement Administration claimed that the main cause of the problem was “.Highest prescription rate ever” and lack of full production by manufacturers.
That’s definitely correct, but the problem is more complicated.
Treatment guidelines exist for children and adolescents with ADHD, but not for adults. The American Association of Professionals in ADHD and Related Disorders release those guidelines soonsaid Dr. Leonard Adler, director of the Adult ADHD Program at New York University’s Grossman School of Medicine.
Adler, co-inventor of the ADHD Self-Report Scale for Adults, said that primary care physicians like me could “adequately diagnose ADHD if they were based on evidence-based approaches such as blood pressure, pulse, and ECG.” and can be managed,” he said. ) surveillance. “
Europe, Canada and other countries have already introduced substantive guidelines. Australia will guide us. Decisions to be made include “who gets the meth and who gets the other stuff,” Adler said.
ADHD drugs are incompatible
Adderall is part of a group of drugs known as amphetamine mixed salts. Concerta and Ritalin and their generics are methylphenidates, another type of central nervous system stimulant. Medicines are not interchangeable. difficult to judge Physicians who have no specific training in diagnosing and treating ADHD can see how critical ADHD is to normal functioning.
As Adler said, you shouldn’t prescribe a drug simply because it improves performance.
I believe ADHD is on the rise for many reasons, including social isolation, pre- and during-pandemic socialization problems, the growing role of social media, and attacks of different types of stimuli.
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ADHD is combined with other mental health problems such as anxiety and depression, and patients may exhibit difficulty concentrating, difficulty concentrating, irritability, anger, anxiety, and lack of self-control.
Treatment includes cognitive-behavioral therapy, but more than 60% of patients use medication.According to recent data From the Centers for Disease Control and Prevention10% of children aged 6-11 and 13% of children aged 12-17 suffer from ADHD.
ADHD is underdiagnosed in minority communities
A shortage of available medicines combined with a significant shortage of trained mental health professionals is creating a medical crisis. While it may be true that ADHD is overdiagnosed in wealthy communities, there is also evidence that ADHD is underdiagnosed in poor socioeconomically disadvantaged communities. among minority communities.
Medicine shortages go beyond simple supply and demand issues. First, there is a shortage of active pharmaceutical ingredients available from China and India. The other is that generic drug makers such as Teva (Adderall) and Takeda (Vivance) have low margins and are unable to keep up with demand due to manufacturing problems and lack of sufficient incentives. be.
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What can you do accordingly?
Given the shortage of physicians with special training in ADHD and psychiatry, extending guidelines and training to more primary care clinicians is suboptimal, as Dr. Adler suggests. It is a measure of
At the same time, governments need to provide incentives to pharmaceutical companies to produce more needed medicines.
Don’t get me wrong. We shouldn’t jump on drugs as a shortcut, but we should use the right drugs when needed and prescribe them by properly trained doctors.
Dr. Marc Siegel, a member of the USA TODAY Contributors Committee, is Professor of Medicine at New York University Langone Health and Medical Director of Dr. Radio.his latest book “Novel Coronavirus: The Politics of Terror and the Power of Science” Follow him on Twitter: @DrMarcSiegel
