Shortages of the ADHD drug Adderall are expected to continue for months, forcing families to scramble for ways to deal with their children's attention deficit hyperactivity disorder (ADHD).
The shortage has caused headaches and hassles for parents like San Diego mom Jackie Meader, who has been "flustered, rushed and out of sorts" since her 16-year-old son's prescription ran out about a month ago.
"He's telling me he's having trouble at school, can't focus. He's struggling, and it's not just a matter of not being able to focus on things. He's having trouble staying awake," Meader told KGTV News in San Diego.
An abrupt halt to Adderall treatment can cause physical symptoms like lethargy and fatigue, but some kids might become jittery, said Dr. Anish Dube, chair of the American Psychiatric Association's Council on Children, Adolescents and their Families.
It also might cause the child to feel hungry and eat more, since stimulants tend to decrease appetite, Dube said.
But mainly, kids who are off their Adderall are likely to have their ADHD symptoms return, Dube said.
"Particularly if Adderall had been effective in helping with these symptoms, when you have it being stopped, then you might have a return of the original symptoms that the child had," Dube said.
The FDA first declared a shortage of the immediate-release formulation of Adderall on Oct. 12.
The agency said that Teva Pharmaceutical Industries, one of the main manufacturers of Adderall, "is experiencing ongoing intermittent manufacturing delays." Those delays are due to labor shortages, news sources have reported.
But the shortages are mainly being caused by demand outstripping supply, Dube said.
"What I understand is that the main makers of Adderall had continued to produce Adderall based on quantities that were adequate in previous years," Dube said. "But prescriptions for Adderall have increased, and that's been behind the shortage."
Other companies are continuing to churn out ADHD medications, but demand for Adderall and other ADHD drugs has been surging for years.
Stimulant prescriptions for ADHD more than doubled between 2006 and 2016, alongside dramatic increases in ADHD diagnoses, according to a 2018 paper published in the journal PLOS ONE.
There are alternative drugs available to treat ADHD like Ritalin and Concerta, and parents should talk with their doctor about those options if Adderall isn't available, Dube said. It's also possible that other formulations of Adderall are available that might help their child.
Parents also would do well to let their teacher know if the kid is suffering a return of ADHD symptoms, Dube said.
"You might want a young person to be in front of the class," Dube said. "You might want the teacher to be checking in with them more frequently or to give them a diary or reminders for homework."
At home, parents can help their kid keep a regular routine by breaking up tasks into smaller chunks of time, with frequent breaks, Dube said.
Parents who haven't been affected by the Adderall shortage should have contingency plans with their family doctor, Dube added.
"It's important for parents to keep an open dialogue with their physicians so that if something like this does happen, what are we going to do?" Dube said. "Because each patient is different, each person is different, and their circumstances are different. And where they're going to experience functional impairment the most is going to be different.
"So it's important for folks to plan with their doctors about if there's a shortage, what are we going to do to manage this best -- and to include the young person in that planning," Dube said.
The Cleveland Clinic has more about ADHD medications.
SOURCES: Anish Dube, MD, MPH, chair, American Psychiatric Association's Council on Children, Adolescents and Their Families; KGTV News; PLOS ONE, Nov. 28, 2018