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Imagine how scary it would be for someone with attention-deficit hyperactivity disorder (ADHD) to suddenly find that their essential medication is no longer available at the pharmacy. It is a harsh reality for millions around the world who rely on these drugs to manage their symptoms.
England has seen a sharp rise in the use of ADHD drugs, increasing by 11% per year between 2010 and 2019. This significant rise in reliance on drugs, coupled with drug shortages, has left a staggering 97% of people with ADHD in the UK affected by the shortages.
Manufacturers are legally required to inform the Department of Health and Social Care of any potential disruption in supplies. Although they are not required to report the causes of the disruption. However, an increase in global demand due to a rapid rise in the number of ADHD diagnoses, manufacturing issues and delays in distribution are cited as the main reasons for the shortages.
There have been disruptions in the supply of the following ADHD drugs: methylphenidate, lisdexamfetamine, guanfacine and atomoxetine. These drugs come in different strengths and forms (tablet, capsule, liquid), and the availability of some strengths and forms is affected more than others.
You can get more information about the national supply of ADHD drugs via the Specialist Pharmacy Service. It is important to note that the national supply might not reflect the local availability of the drugs.
The thought of running out of medication can be terrifying. It might make you anxious and unsure about what might happen or what to do next. Understanding how drug shortages can affect you, and being aware of potential alternative treatments, can help tackle anxiety.
Getting a different drug
If you are low or have already run out of pills and can’t get a refill, speak to your GP about getting an equivalent alternative. It will avoid any potential disruption to your treatment and stop your symptoms from getting worse.
If an alternative is not available, as is the case with certain drugs, discuss with your GP using the current shortage as an opportunity for a trial period of stopping medication or taking breaks – such as on weekends or holidays.
Research shows that there is no significant difference in ADHD symptoms between those who take weekend breaks and those on a seven-day treatment.
Another option is to switch to another ADHD medication type that is in stock, but this isn’t a simple switch. It takes time for a person to adjust to a different drug and a dose that provides the maximum benefit with the minimum side-effects.
Switching to another medication means that you repeat the same exercise from scratch, and there is no guarantee that the new medication will work.
The alternative might not be the perfect substitute, but it may offer a chance to find stability amid the chaos of shortages.
Some people might experience withdrawal symptoms when stopping medication abruptly, such as irritability, fatigue, mood swings and changes in sleep and appetite. In particular, guanfacine, a non-stimulant ADHD medication, can cause severe withdrawal symptoms, such as an increase in blood pressure. So it is crucial to identify any disruption in supply well before the stock runs out so that the dose can be tapered before stopping it completely.
It’s important to work closely with your GP to ensure a safe transition.
Talking therapy is another alternative that can be used to control ADHD symptoms in the absence of medication. Research has shown that talking therapy is as effective as medication in improving ADHD symptoms and overall functioning levels. The downside to this alternative is the NHS waiting time, and it can take weeks or months to get the appointment after referral.
Hard to predict
Predicting when the supply of ADHD medication will go back to normal is difficult. The NHS said that the shortages would be resolved by December 2023, but that has not happened.
Takeda UK, one of the main manufacturers of ADHD drugs in the UK, says the supply issues will continue until April 2024. Even if that is true, it will take time for pharmacies to restock their shelves as recovery from shortages takes time.
Production of medications is not an instant process, and it may take time for the manufacturers to ramp up production to meet the demand. Market dynamics will also play a crucial role, as many people will attempt to replenish their supplies, which can also contribute to delays in restoring the widespread availability of ADHD drugs.
Communication is the key to navigating through these difficult times. Contact your doctor and use every avenue of support to explore the right option for you – or your child, if you are a parent of a child with ADHD.
A one-size-fits-all approach may not work in ADHD, as different people respond differently to treatment. You need to find an alternative that works best for you. It is easier said than done, but resilience and adaptation are what we learn from the story of drug shortages.
Muhammad Umair Khan does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.