What happened to adderall? What is the next best thing?
November 6, 2011 12:27 PM   Subscribe

Shire pharmaceuticals has stopped manufacturing adderall & the generic version (amphetamine salts) as I cannot find it at any pharmacy anymore. What is the best alternative? Usually I can only afford generic.

I can't tell if this is a patent controversy or why on earth the company would stop making such a lucrative drug that so many people like myself need. I'm afraid to spend money to go to the doctor for this as I had to go to nine pharmacies last time to track it down. Each pharmacist I speak to say that the manufacturer has stopped producing it and they wouldn't know when they would get more, possibly 2012. I need to know, what is the equivalent (I've heard nothing but awful things about vyvanse) and why on earth this happened? On the internet it seems people across america are experiencing the same thing.

My job has already seen the effects of suffering as I have to be constantly multi-tasking and/or focusing on one task for several hours at a time.
posted by JJkiss to Health & Fitness (10 answers total) 5 users marked this as a favorite
I don't know what the cause is, but my doctor contacted me about it, saying he would write a new prescription for Concerta. Concerta works basically the same way, especially if you are taking an extended release version.
posted by provoliminal at 12:35 PM on November 6, 2011

Are you sure about that (the "they've stopped making it" thing)? I checked the FDA Drug Shortage website and Shire says that for extended release amphetamine mixed salts "[p]roduct availability for all dosage strengths is adequate." That's as of 10/31; I don't even see them listed on the immediate release list. There are also several other manufacturers listed, and their customer service phone numbers are there too. And no one's reported amphetamine mixed salts on the "drugs to be discontinued" list.

Anyway, there are lots of alternatives, though none of them work in quite the same way as Adderall does (Concerta is the extended release version of Ritalin, from what I understand.) And I love Vyvanse - works far better for me than Strattera did (though I'm also bipolar so the odds of them ever giving me Adderall are... remote.)
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 12:46 PM on November 6, 2011

Asked my local legal drug dealer (pharmacist that is):
They are having some sort of issue with acquiring the active ingredient in order to make the tablets. The next best thing that's fairly cheap is generic focalin, the generic name is methylphenidate. He should discuss things with his doc before any changes to his meds are made.
posted by pyro979 at 12:49 PM on November 6, 2011

ProCentra is a liquid dextroamphetamine available everywhere. I have heard of a number of adults switching to this despite it being in a liquid dosage form (usually aimed at pediatric patients and those with esophageal disorders). Adderall is a mix of four amphetamine salts, including dextroamphetamine; the dextroamphetamine isomer is thought by some to be the driver of Adderall's behavioral effect. So, by this analysis, you are getting the best of Adderall in a widely-available liquid form, at least until Adderall is again available.

(I am a neuroscientist; I am not your neuroscientist. Please ask your practitioner or pharmacist.)
posted by Punctual at 1:42 PM on November 6, 2011 [2 favorites]

Adderall is a derivative salt of dextroamphetamine, brand name Dexedrine. I have taken them both, (and ritalin and its derivative Concerta) and if you can't get your adderall I recommend dexedrine. My shrink, in fact, just wrote me for the dex because of the shortage.
It's available in generic, both the standard and extended release forms.

Memail me if you want more anecdata about the differences in how the two work.
posted by ApathyGirl at 3:46 PM on November 6, 2011

[personal knowledge / single data point only]

Vyvanse is just dextroamphetamine hooked up to lysine so that the powder is inert (can't snort/cook/inject it) until it hits the gut and gets hydrolysed. In addition, this process takes some time so it acts as a sort of extended release.

(My experience is that it isn't nearly extended enough- adderall was "flatter" in its curve.)

Anyway, it should work as well or better for ADD symptoms. The levo-amphetamine in Adderall isn't supposed to have much effect on ADD.

A cynic might say Shire isn't working too hard on solving the shortage since they make Vyvanse too.

But I doubt it is pure market manipulation, or else one of the generics would have ramped up production to balance the market. (Unless Shire is the manufacturer of the precursor that is supposedly in shortage...) As much pain as it causes, the correct response to increasing demand in the face of a supply crisis is to raise the price to stop hording and to push people to other alternatives. Assuming they are being honest with their claims of having nothing to do with the shortage...
posted by gjc at 4:38 PM on November 6, 2011

I recently had a pharmacist tell me that the DEA was squeezing some of the manufacturers because blah blah drug paranoia blah blah abuse of prescription drugs. Thinking about them looking out for the good of society like that distracted me so much that I ran a red light and plowed into a truck hauling gasoline while in front of a day care center. I'm not sure how true this actually is. It was prefaced with a "My boss told me something about..." type of introduction, but it seems believable.

Other than Adderall XR, it should be off patent and while I'm not sure what starting materials are called for in anyone's approved production scheme, it's not a complex molecule requiring exotic or hard to synthesize materials, so if a shortage of GMP precursors is the issue, it shouldn't last that long.
posted by Kid Charlemagne at 6:59 PM on November 6, 2011

I've heard all sorts of contradictory things to explain this, most of which are referenced in some form upthread. I've heard that Barr had its hand slapped for not keeping good enough counts of pill production. I've heard that Shire is manipulating the market. I've heard that the DEA is messing with the predictability of allotments to pharmacies. I've heard that the corporate HQ of some pharmacy chains have decided not to deal with certain manufacturers for unexplained reasons. I've heard contradictory information from different branches of the same pharmacy and different pharmacists at the same branch, even, as to whether it's completely unavailable, on backorder, or just out of stock.

There is easier availability for some dosages than others. If you can get a sympathetic pharmacist to tell you which dosage-sizes they can get, possibly you can have your doc adjust your scrip accordingly. Also, being a regular customer at your pharmacy helps -- I've had pharmacists call around to find another location with meds in stock for me.

I get pretty cranky when pharmacists blithely suggest sundry other drugs. I had a bad experience with Concerta and thus am very wary of trying a bunch of other allegedly-similar drugs. I have one that works, thanks, and I already devote quite enough time to the requisite controlled-prescription pickup nonsense without gambling on a month's worth of needless frustration.
posted by desuetude at 10:42 PM on November 6, 2011

Try different pharmacy chains, they may buy their generics from a different manufacturer. Aside from Barr and Shire, Corepharma also makes a generic Adderall.

And yes, talk to your doctor about perhaps prescribing different-sized pills. For example, instead of x pills in 10mg, go for x*2 pills in 5mg.
posted by clorox at 5:21 AM on November 7, 2011

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