Archive for ADHD Medication Warnings/Safety

Methylphenidate Shortage in Canada

methylphenidate 300x200 Methylphenidate Shortage in CanadaMarch 12, 2014

There has been a recent shortage of the short acting Methylphenidate medication in Canada. This is listed on the website DrugShortages.ca (and you can visit that site to check if the shortage is still an issue).

Methylphenidate is a stimulant medication used to treat ADHD. It is the active ingredient in the following medications: Ritalin, Ritalin SR, Biphentin and Concerta. However, the only form of this medication which is impacted by the shortage is the short acting version. Specifically, the 10 mg tablets, and the 20 mg tablets.

This shortage does not impact the availability of the long acting versions of methylphenidate such as Biphentin and Concerta.

Although it’s generally recommended that the long acting medications (such as Concerta and Biphentin) should be used to treat ADHD, as they work better for individuals with ADHD, there are still occassions that doctors will use a short acting stimulant medication.

These could include:

  • Using a long acting methylphenidate medication in the morning and then taking a short acting in the evening when it has been a particularly long day (i.e. topping up the medication for night school)
  • When a teen sleeps in on the weekend and gets up too late to take a long acting medication, they may take a short acting mid-day on the weekend to have some stimulant treatment
  • There are some patients (in my experience this is very few) who don’t do as well with a long acting medication as they do with a short acting version

If you or your child is taking a short acting version of Methylphenidate, you may have a hard time refilling the prescription. The pharmacist will likely tell you that the product is ‘back ordered’. However, if the pharmacy still has stock on their shelves, then you should be able to fill the prescription.

Here’s what you can do if you are stuck and cannot refill your prescription for methylphenidate:

  1. Ask the pharmacist to call other pharmacies to see if they have stock on their shelves (i.e. they will be able to call other pharmacies in their ‘chain’ (such as Shopper’s Drug Mart) and if another pharmacy has stock, they may be able to get it for you)
  2. Phone other local pharmacies and see if they have stock on their shelves, and then take your prescription to that pharmacy (you would have to take an actual prescription, as pharmacies cannot transfer prescriptions for methylphenidate from one pharmacy to another).
  3. Check if your pharmacy can order in the 5 mg tablet of Methylphenidate. If they are able to, contact your doctor’s office and explain that you need the doctor to change the prescription to the 5 mg tablets because of the medication shortage.

If none of these strategies work, then be sure to see if you can take either of Biphentin, Concerta, or even Ritalin SR to see if they can help you. Alternatively, you may benefit from a trial of an amphetamine medication – such as Vyvanse, Adderall XR, or Dexedrine. That would be an issue you’ll have to discuss with your doctor.

Please share any experiences you’ve had – particularly if you have a strategy which could be helpful to others.

Best,

Dr. Kenny

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How To Tell The Difference Between Concerta and Generic Concerta

In Canada, there is a generic Concerta available. It’s called: Teva-Methylphenidate ER-C (it was formerly called: Novo-Methylphenidate ER-C). Many people have had trouble with this generic, and it is widely accepted by doctors in Canada and patients that the generic doesn’t work as well as the brand name concerta.

One question which has been sent in to me a number of times is: How do I tell the difference between the brand name Concerta and the generic Teva-Methylphenidate ER-C?

When someone isn’t medically trained, it can be very confusing. I have tried to explain to people over the phone (or in blog comments!) how to tell the difference. And then I thought of the saying: “A picture is worth 1,000 words”. I was able to find an image which clearly shows the difference between the two medications. I was able to get permission from Janssen (the maker of Concerta) to share this image with you.

To tell the difference between the brand Concerta compared to the generic, notice a few features:

  • The brand Concerta has the word ‘Alza’ typed in black on its side; the Generic Teva MPH ER-C does not have this typed word on it
  • The brand Concerta looks more rounded like a little soda can, compared to the generic which is an oval pill
genericconcertacanada 801x1024 How To Tell The Difference Between Concerta and Generic Concerta

Generic Concerta vs. Brand Name Concerta in Canada

Please share any comments below. And feel free to share this with anyone who may benefit from knowing about this.

Best,

Dr. Kenny

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ADHD Medication Free Webinar Training

At the end of March 2012, I did a webinar training for ADD Resources.org, called “ADHD Medication Update”.

I’m sharing the video here, and it’s broken into 4 different video segments:

1) Introduction – this is the introduction, and let’s you know what I’ll cover during the training.

2) This is the main teaching – during this session, I cover WHY we use ADHD medications, and help you to understand that there are really only 4 types of ADHD medication – a) methylphenidate medicines, b) amphetamine medications, c) non-stimulant atomoxetine, d) non stimulant guanfacine.

We’ll cover how to make decisions around changing or adjusting medication, as well as a discussion about tolerance to ADHD medication

3) In the third video, I share some information on the ADHD Medication Shortage in the US, and strategies you can use to help yourself during this struggle.

4) In the fourth and final video, I share a summary of the ‘Ritalin Gone Wrong’ article, and share some responses to that.

I hope you enjoy the videos. Please feel free to pass them along, and type any comments in below.

Best,
Dr. Kenny

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Death From ADHD Medication?

A recent study was published in the Journal: Pediatrics, which shows that there is not an increase in cardiovascular death when kids or teens take ADD/ADHD medications.

This was a large study – observing 214,417 ADHD patients taking medication, and 965,668 control kids – not taking ADHD medications. They were observed over a period of 135 days for ADHD medication users, and 609 days in non-users. The specific outcomes which were being observed included sudden cardiac death, myocardial infarction (a ‘heart attack’), stroke, and cardiac arrhythmias (i.e. irregular heartbeats).

During the observational period – the rate of these events were very low in both groups.

In the group taking ADHD medication, there were 28 deaths (incidence 1.79 per 10,000 person-years) and 607 deaths in the control group (incidence 3.00 per 10,000 person-years). There were no validated cases of MI (heart attack) or stroke in the medication group and 11 cases in the group which wasn’t on medication.

This research supports previous studies which showed that kids and teens taking ADHD medications are not at increased risk for cardiac death. The sad reality is that there will be a small number of kids/teens who pass away from cardiac issues (i.e. a heart problem that no one knew about), and ADHD medications don’t seem to worsen that rate.

There is still a warning on ADHD medications – for individuals with structural heart abnormalities (i.e. ‘holes’ in the heart like an ASD or VSD), arrhythmias, or adults with unstable coronary artery disease. If you are concerned about this – by all means talk to the doctor, and a specialist if needed as well (like a cardiologist, or pediatric cardiologist).

Hopefully this study helps to reassure some people with ADD/ADHD who are concerned about this very serious side effect.

Best,

Dr. Kenny

p.s. this study applies to ALL ADHD medications – including: Adderall, Vyvanse, Concerta, Ritalin, Metadate, Biphentin, Strattera, Daytrana, etc.

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Who Needs ADHD Medication?

Let’s face it – medication treatment for ADD and ADHD is controversial.
It is often a really big decision about whether to start a medication or not.
One of the first questions is this:
Who even needs to take these medicines?
Another way to think about this is:
What is the rational for ADHD medication treatment?

I’ve created a free video for you to learn more about this.
You can see it here: ADHD Medication Mastery.

And when you click through to that site – you’ll be given the opportunity to sign up for free ADHD Medication updates. You’ll get more videos with useful tips to help you and the people that you love.

Click through to see the video now (while it’s still fresh in your mind).

Best,

Dr. Kenny

p.s. I’ll be giving you many free videos and lessons on ADHD Medication Treatment in the coming weeks – so make sure to take advantage of it!

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ADD/ADHD Daytrana Patch Recalled

Do you or your child take the Daytrana patch for ADD/ADHD? If you do you need to know that the company that manufactures this drug, Noven Pharmaceuticals, is recalling two lot numbers.

First, let me say that the problem is not due to product safety issues, but rather with the packaging itself. The foil packaging does not meet “release liner removal specification.”

In plain English it means that you may have problems opening the package. Check your prescription, if your box is labeled either lot number 2750211 or
2764111, you may want to call the company’s customer service line at 1.800.828.2088.

The company suggests you also call your local pharmacist.

The company says that the patch is perfectly safe to use unless you’re experiencing problems opening it, or you accidentally damage the patch while you’re opening it.

Peter Brandt, Noven’s, chief executive officer, said in a press release that the root cause of the problem has been identified and Noven is “committed to resolving the release liner issue.”

Representatives of the company say that if you aren’t experiencing problems opening the liners, then you should have no worries about the medication.

The clear patch is normally applied to the hip in the morning and worn for nine hours. Not only that, but the effects of the medication continue to be felt for another three hours after that.

To read the entire story, click here.

[tags] Daytrana, ADHD, Ritalin Patch, Medication Recall [/tags]

Medication Misinformation – A Chance For Advocacy

This week has been a busy week in the news for ADHD. A British TV show seems to have misinterpreted the conclusions from the multimodal treatment study. This has led to a media uproar about the fact that ADHD medicines don’t seem to work. (You can watch my youtube video on the ADHD Medicine story here).

Today, I saw an article in the British (online) Press, that an inquiry will be requested into how ADHD is diagnosed and treated in the UK. You can read the story here.

My initial reaction, I must admit, was frustration and concern. I was frustrated thinking that they are over reacting to mis-information, and concerned that this would interfere with the help for people with ADHD in the UK.

But then I thought about it…

The truth is… this may lead to more resources and funding for behavioral and non-medication treatments for ADHD. That is a good thing! (Since the best treatment for ADHD is a combination of non-medication and medication approaches).

So, I now consider this positive, and a chance for advocacy.

My suggestions for our British friends (who are advocates for ADHD) is to get actively involved in this process so that the members of the inquiry (if it happens) will have the proper information. This will help children, teens and adults with ADHD.

It would be a tragedy if this inquiry led to more widespread misinformation and restrictions on the access to medications. Hopefully, this will lead to a better understanding of ADHD and access to more resources and comprehensive treatment.

Please share your thoughts and comments below.

Dr. Kenny

Are ADD/ADHD Medications Used Too Much?

I am writing this short post to share with you an article that I wrote which is featured today in Google News and Yahoo News (as well as many other sites…).
I talk about the issues of prescriptions for ADD and ADHD, and share that you can get access to my free report: The State of ADD/ADHD Medication.
To see this story on Yahoo News, visit here.
Enjoy,
Dr. Kenny
p.s. I have been receiving emails from people thanking me for the special report. I am so glad that people are finding it helpful, because I put a lot of hours into it! Will you share your thoughts on it? Either leave a comment on this blog, or email me (if you are one of my subscribers!)
[tags]ADHD Medication, ADD Medication, Concerta, Adderall, Vyvanse[/tags]

Drugs for ADD/ADHD: Good or Bad?

Does the health care system have your
best interest at heart when it comes
to treating your ADHD?

Here are some shocking facts about ADHD.

* 1.5 Million Adults take stimulant
medication for ADD/ADHD. 10% of them are
over age 50.

* More than 20 Million Children Worldwide
have been diagnosed with ADHD, but only 5-
10% of children suffering with ADHD are
estimated to be diagnosed at all.

For lots more fascinating facts about ADHD,
read my special report, which you can get
here:The State of ADD/ADHD Medication.

* ADHD is poised to become the world’s
leading childhood disorder treated with
medication.

* Global use of ADHD medications rose
threefold from 1993 through 2006.

Are all these prescriptions necessary?

I’m an ADHD doctor. See my surprising
answer in my special report, which you can
get here (hint – the devil’s in the
details):
ADHD Medication Special Report.

* The production of Adderall and Dexedrine,
medicines used to treat ADHD, has risen
2,000 % in nine years

* 2004 revenues for ADHD medication were
over $2.4 billion in the U.S.

The drug companies have YOU in their
crosshairs.

But you are not a statistic.

Your best defense against becoming just an
ADHD number is becoming educated and
learning all you can about ADHD.

You can start with this special free report that I’ve just
released for you:
The State of ADD/ADHD Medication.

Best regards,

Dr. Kenny Handelman, MD FRCPC

P.S.
The fact is, your ADHD treatment plan is
controlled by a health care system that may
not have your best interests at heart. YOU
can take control by educating yourself. Is
that the way it should be? Perhaps not.
But learning about ADHD isn’t as hard as you
think. Take the next step with my fr.ee
report:

Get Your report here:

——————————————
ADD/ADHD Medication Special Report <– Click Here Right Now
——————————————

[tags] ADHD, ADD, Medication, Concerta, Adderall, Vyvanse, Ritalin, Strattera, Metadate, Biphentin [/tags]

FDA To Study Cardiovascular Risk of ADHD Medication

When it comes to ADD and ADHD medication, there have been a number of new warnings that have come out in the past two years. I would suggest that one of the most serious is the concern that ADHD medication can cause heart attacks, strokes, or sudden death.

Ultimately, the current warnings reflect the fact that if someone has a congenital heart defect (i.e. they were born with a physical problem with their heart), have high blood pressure, a family history of sudden cardiac death, etc. then ADHD medications may provide an increased risk, and should either not be used, or should be used with the advice of a cardiologist.

The FDA (US Food and Drug Administration) announced that it will conduct the largest study to date on the cardiac safety of ADHD medications. It will pair up with the AHRQ (Agency for Healthcare Research and Quality). They have a database with over 500,000 children, and adults who have taken ADHD medications. This study will help to establish whether there are measurable cardiovascular risks in people taking ADHD medication. The results will likely take approximately two years to become available.

To read more about this study, click here.

When referring to the ADHD medications, these include: Adderall, Adderall XR, Vyvanse, Ritalin, Ritalin LA, Concerta, Metadate, Daytrana, Methylin, Dexedrine, Focalin, and others.

What should you do about this information? If you have any concerns, contact your doctor, and discuss them. And appreciate the fact that we will know more about the safety of these medications in a couple of years.

Dr. Kenny
[tags]ADHD Medication, FDA, Vyvanse[/tags]