Image: JoNel Aleccia
By JoNel Aleccia Health writer
msnbc.com
updated 4/14/2011 8:30:20 AM ET 2011-04-14T12:30:20

Nationwide shortages of popular drugs used to treat ADD and ADHD are sending parents scrambling, with some combing multiple pharmacies for the Adderall and Ritalin that keep their kids calm.

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Molly Taylor, 46, of Worcester, Mass., was turned away empty-handed this week when she went to pick up prescriptions of Adderall XR for herself and her 16-year-old son, Luke.

“They don’t have them,” an incredulous Taylor told msnbc.com. “You could be waiting several days, which would have a HUGE impact. If you can’t get it that day, it’s very, very difficult.”

In the past two weeks, federal Food and Drug Administration officials added the drugs methylphenidate hydrochloride and amphetamine mixed salts, the generic names for Ritalin and Adderall, to an expanding list of national drug shortages. Some distributors cite manufacturing delays and increased demand as the reasons; others offer no explanation for the shortages.

But the American Society of Health-System Pharmacists, which tracks drug supply issues, has listed the products in short supply for nearly a month, and there have been regional reports of spotty shortages even before that.

“We have been following this for a bit,” said Erin Fox, manager of the Drug Information Service for the University of Utah Hospitals and Clinics, which runs the ASHP list, adding later: “This is a frustrating one for parents.”

5.4 million children have ADHD
In the United States, an estimated 5.4 million children ages 4 to 17 have ever been diagnosed with ADHD, or attention-deficit/hyperactivity disorder, and 66 percent of those with current ADHD take medication to control the condition, according to the Centers for Disease Control and Prevention.

Last year, that amounted to 152 million units sold of Adderall and Adderall XR, the extended-release version of the pill, 35 million units of Ritalin and nearly 702 million units of generic ADHD drugs, with sales totaling more than $1.2 billion, according to data from Wolters Kluwer Pharma Solutions.

For millions of children — and adults — the stimulant medications ease the symptoms of ADHD, allowing them to control distracted thoughts and behavior well enough to participate in school, work and social life.

The drugs are taken daily, but when patients miss even one dose, the consequences can be swift, said Ruth Hughes, interim chief executive of the organization CHADD, Children and Adults with Attention-Deficit/Hyperactivity Disorder.

“The symptoms come back very quickly,” said Hughes, who is the mother of an adult son with ADHD. “If you start that spiral, within 24 hours you begin to get in the loop of negative feedback. It doesn’t take very long until it has a truly negative impact.”

The current shortages affect various doses of the medications supplied by several manufacturers of brand-name and generic drugs. That means patients who find they can’t get their usual prescriptions might be able to find a similar drug in a different strength, made by a different manufacturer.

However, because the drugs are tightly controlled by the U.S. Drug Enforcement Administration, prescriptions are doled out only a month at a time, and patients have to visit their doctors in order to authorize new drugs, which could be more expensive than the old ones.

“At the very least, it’s an inconvenience and there may be additional costs,” said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Steven & Alexandra Cohen Children’s Medical Center of New York. “Unfortunately, it’s going to be trial and error.”

The shortages could last weeks or months, according to manufacturers' notes to the FDA.

For some families, that may mean visiting multiple pharmacies, Adesman said. One CHADD member had to try 13 pharmacies before she could find the correct dose of her drug.

“In most cases, you’re not thinking ahead,” noted Taylor, the Massachusetts mom.

Fortunately, Taylor had squirreled away five pills apiece for her and her son, just in case of insurance delays or other emergencies. For a few more days, Taylor is OK. But once her stash is gone, she worries about how long it might take to replace the drug.

Without Adderall XR, her son’s concentration in sports and school may suffer. In many families, life becomes just generally more difficult.

“You don’t even realize how much of a spider web effect this is,” she said. “It affects everything.”

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