Archive for Adderall

ADHD Medication: How To Decide

When it comes to making a decision about whether to use a medication for ADD/ADHD or not, many people struggle with this… There is so much misinformation out there, that people are worried about making the wrong decision, and whether they will be judged for it…

In this short video (taken from a presentation I did), I share with you the way to decide if you will take ADD/ADHD medication or not. And this applies whether you are dealing with child/teen ADD/ADHD, or Adult ADD/ADHD.

Please watch this short video, share your comments/thoughts below (and also forward it to friends/family who may appreciate it!).

What do you think? Do you agree with the message of this video?
Best,
Dr. Kenny

p.s. To learn a whole lot more about the safe and effective use of ADD/ADHD medication – take advantage of the special discount on the Medication Mastery Course (special ends on Monday December 5th at 11:59 pm Eastern time) [hyperlink family="Helvetica,Arial,sans-serif" size="20" color="1A12FF" textshadow="1" alignment="center" weight="bold" style="normal" lineheight="110" linkurl="http://medicationmastery.com" linkwindow="_blank"]Click Here To Take Advantage Of The Special Offer[/hyperlink]

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ADHD Medication Shortages: Has This Affected You?

It seems that the shortage of ADHD medication in the USA is lasting much longer than anyone thought it would.

In this article, it is explained that the shortage is related in part to the increased demand for ADHD medication, as well as the DEA controlling the amount of the active ingredient forwarded to the pharma companies to allow them to produce the medication.

It seems that the medications impacted are: Adderall XR, as well as generic Adderall, and generic methylphenidate.

The article referenced above has a quote from the director of the FDA drug shortages program. It’s interesting to me that the FDA has a program for drug shortages. It makes sense… and then the question is – what are they doing about this?

And why is it that it is predominantly the generic medications (which are cheaper and have less profit involved) which are having trouble with supply?

I’m really interested to hear what is happening on the ground out there. Please share your comments and experiences in the comments below:

  • Are you impacted by this shortage?
  • Have you been struggling to get the prescribed medication for yourself or your family member?
  • What have you done about it?
  • Have you had to purchase a much more expensive brand name product?
  • Have you taken less medication to ‘make your prescription last’?

Thanks for sharing your experiences. By sharing here, you can let people know what is happening – without it being ‘filtered’ by mainstream media.

Best,

Dr. Kenny

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Shortage of Ritalin and Adderall

It is just being reported (in April 2011) that in the United States, there is a shortage of supply for the medications Ritalin (methylphenidate) and Adderall (mixed amphetamine salts). This may mean that your pharmacy has trouble getting the medication into the pharmacy for you to pick up your prescription.

You can read more about it here.

Has this impacted you? What have you been able to do about it?

Best,

Dr. Kenny

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ADHD Medication: $4.2 Billion?

A recent news release came out sharing that the global market for ADD/ADHD medications is expected to reach $4.2 Billion (with a ‘B)  worldwide by 2015. It is projected to go up to $3.3 Billion by 2012.

Whenever I see statistics like this, I find myself having a mixed reaction.

On the one hand, I know that there are studies clearly establishing that there are more people who have ADHD and have not been diagnosed and treated, than people who have it and have been diagnosed and treated. So – seeing that the numbers will be up for pharma companies means that there is more awareness and people are getting a diagnosis and the help that they need.

On the other hand – these types of data can seem quite concerning. How many pills are there in $4.2 billion dollars of income? How many people are taking ‘mind altering medication’? That is certainly what the detractors from ADHD will say. Despite the validity of the diagnosis of ADHD, many still question it, and feel that it is not a valid diagnosis. And when they read this type of statistic, they conclude that ADHD really just a fabrication of the pharmaceutical companies to sell more medicine.

All in all, my perspective is this: There are a lot of studies (I mean a LOT) which show that medications work very well for ADD/ADHD. There are a LOT of studies showing the safety of the medication. There are also studies showing that medicines work best when they are part of a combination treatment. People taking medicines is not wrong, or a problem – in my opinion. The only time I see medications for ADHD as a problem is when people haven’t received a proper assessment and diagnosis – and then they are taking ADHD medication when they may not actually need it. If you (or your son/daughter) is taking ADD/ADHD medication after a thorough assessment, and it is being monitored by a doctor, then it is safe, and hopefully quite helpful.

Of course, the other benefit to the increase of prescriptions, is that likely this means that a lot more people are being diagnosed. Hopefully many of the adults with ADHD who thus far have had trouble getting the proper diagnosis and treatment.

So, here’s my question for you: when you see numbers like that – does it freak you out? Are you OK with it? Do you think it fuels the ADHD detractors?

Please share your opinion in the comments below.

Best,

Dr. Kenny

p.s. my goal is to provide information to people to make the best healthcare decisions they can make at the time they need to. That is why I have created some products on using ADHD medication safely and effectively, as well as some products on alternatives for ADHD. You can click through to those sites to learn more.

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Adderall XR: Doses and Duration

Adderall XR has the same composition of Adderall — mixed amphetamine salts. The difference between the two is that the XR version is placed in a 12-hour capsule, half of which is intended for immediate release and the other half for a delayed release.

The doses in which it comes are 5, 10, 15, 20, 25, and 30 mg. This makes it easy to adjust a dose and actually getting you a precise and tailored amount of the drug that will meet your specific needs. The capsules, by the way, can be opened and sprinkled on certain foods, like applesauce, should you or your child not be able to swallow pills.

The exact dosage your physician eventually administers you depends on a variety of factors, including your age, what other ADD/ADHD medications you’ve tried in the past as well as any other medications you’re currently taking for any other conditions.

It’s extremely important therefore that you answer your prescribing doctor honestly about any medication you’re currently using. If you are using something that would provide a bad reaction to the medication or you’re taking another medication itself that may interfere or react with Adderall XR.

The usual dosage for children six years of age to 12 years is 10 mg a day. Some doctors prescribe as much as 30 mg for the day, depending on the age and needs of the child.

For those between 13 to 17 years of age, the dosage starts at 10 mg. Your doctor may work adjust the dosage up as high as 20 mg every day. Adults — both female and male — usually receive 20 mg.

Your doctor will probably put you on the lowest dosage possible initially, and monitor your actions closely. As he sees your reaction on that amount, he’ll adjust the medication as necessary.

Studies Provide Positive Evidence

Several studies, conducted with Adderall XR, demonstrate the long-lasting medication does seem to perform as Shire, the manufacturer, intended it to. One study looked at the behavior of children taking the medication and another group who were not on this medication. Members of both groups suffered from ADD/ADHD.

Teachers noted significant improvements in the behavior patterns of those children who took the medication compared to those who were not taking the medication.

Another, similar study, examined teenagers and the use of Adderall XR. Those individual teens who had taken Adderall XR displayed a greater improvement in their ADHD symptoms compared to those who were not taking it.

But that’s not all. Adderall XR is also effective at the adult level as well.

Dr. Kenny

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Adderall: Dosing and Duration

Mention the phrase “attention deficit hyperactive disorder” and most people immediately associate it with the drug Ritalin. The two words seem to go and and hand with the other.

It might surprise you to know though that in the U.S. Adderall is actually the most commonly prescribed medication for this health disorder. Adderall and its sister medication Adderall XR share nearly 25 percent of the medication market. That means that for every four people taking some type of prescription drug — one of those people is taking a form of Adderall.

Different from several other attention deficit drugs on the market, Adderall is not a single chemical or drug, but a powerful bend of a combination of stimulants. Specifically Adderall is composed of amphetamine and dextroamphetamine.

The medical community believes this prescription drug works through the restoration of the balance of neurotransmitters in the brain, namely dopamine and norepinephrine.

ADD/ADHD isn’t the only health disorder that Adderall benefits, though it’s certainly one of the biggest. This medication is also administered to those individuals who suffer from narcolepsy. This is a condition in which a person suddenly and randomly just falls asleep regardless of the time of day or the activity he is pursuing.

Having said this, Adderall should be not used to treat tiredness or for those who don’t have an actual, diagnosed sleep disorder.

Adderall is taken by mouth upon arising in the morning — or at a time in the morning specifically directed by your physician. If more than one dose is prescribed than you’ll more than likely be instructed to take them about four to six hours apart. That’s the approximate duration of this prescription drug.

This means that you — or your child — will need to take this pill at least two times and probably three times a day. And be careful about a “before bedtime” dose. If you or your child should take these less than six hours before bedtime, sleeping problems may arise.

Be sure to take this medication exactly as prescribed. Your doctor has tailored your dosage to meet your specific medical condition and to your responses to previous therapy. At the outset of using Adderall, you may find that your physician is “fiddling” with your prescription. It may seem like fiddling to you, he’s actually making all the necessary adjustments — fine tuning your dosage you might say — that hopefully will give you precisely the correct amount for your daily needs.

Dr. Kenny

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Generic Adderall XR – New Formulations

Adderall XR went generic in the US in April 2009. I wrote an initial blog post about it here: Generic Adderall XR. You can also review the nature of generic medicines in an article here: Are Generics The Same?.

While my initial thoughts were that the generic Adderall XR was very similar to the trade brand (made by Shire), the comments on my blog post made it clear that many people are finding that the generic version of Adderall XR just doesn’t work as well as it is supposed to.

As DS writes:

“After the first week, I really felt a difference, but tried to put it out of my mind. My shoulder and rib cage is sore, I don’t sleep and I am snapping at people all day, all night. This is not the same drug mixture/compound. It cannot possibly be. I feel tired from the lack of sleep, moody/agressive/weepy (not me!), sore (for no apparent reason) and just plain out of sorts.

Has anyone had any luck figuring out why some of us are feeling this hell-ish effect from the generic version?

- Sleepless (and crabby) in Seattle

The original generic Adderall XR was produced by the pharmaceutical company Teva.

Now, two more pharmaceutical companies will be joining the production of Adderall XR:

  1. Impax Pharmaceuticals will begin to ship its own version of Adderall XR at the end of 2009/early 2010. You can read more about this here.
  2. Sandoz Pharmaceuticals just settled a law suit with Shire (the original makers of Adderall XR) to allow them to make a generic version of Adderall XR as well. It is not clear when their production and distribution will begin. You can read about this here.

Why Are These Generics Coming?

When a pharmaceutical company creates a new medicine, they get a patent for a certain number of years. They spend hundreds of millions of dollars to get their drug to market, and then they have a number of years to profit from their medicine, before it goes ‘generic’ and other pharmaceutical companies start to manufacture the medicine (and they sell it for less).

Even when a medicine is within its patent, the generic pharmaceutical companies start law suits to challenge the patents – i.e. to see if they can start to market the drug earlier, and increase their profits. It seems that the companies that are now manufacturing and selling generic Adderall XR have pursued the legal process to challenge Shire’s patent, and they are now in the position to start to manufacture and profit from this medicine.

What does this mean to you?

Well, although I initially thought that the generic Adderall XR wouldn’t cause problems for people – there are 94 comments on my original blog post which essentially prove me wrong – i.e. many people are struggling with the generic form of the medicine.

Here is where it gets complicated.

If you used to be on the Shire Adderall XR, and then the Teva generic comes out – your pharmacy or insurance gives you the ‘cheaper’ version. Let’s say it doesn’t work as well for you, but because of the finances, or your insurance’s policy, you work with your doctor, adjust the dose and make it work.

Now, your pharmacy, or insurance company may make a deal with Impax – to get their new version of generic Adderall XR. Now, the formulation is slightly different again. Translation – you may have a different response or reaction to the new version of the generic than you did to the first one. You’ll need to go to your doctor, advocate at your insurance, and see if you can get on the medicine which works best for you.

Of course, if you can afford it – you can always ask your doctor for a prescription for Adderall XR – No Substitution (this means that your doctor is insisting that you get the original adderall xr only). The thing is that your insurance can refuse to pay for it, even if your doctor is that specific.

This can be complicated for you, or your child if you take Adderall XR. Best to monitor your symptoms, and work with your doctor to find the best solution for you.

Please share your thoughts and comments below. Your input is tremendously helpful to thousands of other people who come to this blog and learn from your experience.

All the best,

Dr. Kenny

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Nascar and ADHD

Nascar driver Jeremy Mayfield has shared that he has ADHD, and takes the medication Adderall for it.

This disclosure has come in a ’roundabout’ way. This relates to the reports that Mr. Mayfield was suspended from driving due to finding amphetamines in his urine during a random urine drug screen. Mr. Mayfield has explained that he takes Adderall medication for ADHD, as well as Claritin D. This issue is before the courts. You can read the news updates here.

While Mr. Mayfield is going through a rough time right now, I am happy to hear that he has openly disclosed his diagnosis of ADHD. This can lead to advocacy and support for the many kids diagnosed with ADD or ADHD each year.

I do wonder how many of the Nascar drivers have ADD or ADHD?

Although there is research which shows that people with untreated ADHD are at risk of more accidents while driving, my clinical experience in ADHD suggests that people with ADHD often excel at ‘extreme sports’. Whereas driving to the store at 40 miles per hour may be boring, driving on a Nascar track at speeds in excess of 200 mph can be exciting and can command one’s attention. And as Mr. Mayfield explains – he is taking an ADHD medication while driving.

I do hope that things work out well for Mr. Mayfield, and that he uses this situation as a springboard for advocacy for ADD/ADHD. I hope that he can be a role model for the thousands of boys (And girls!) diagnosed with ADD and ADHD each year.

What are your thoughts and experiences? Please share them below.

Best,

Dr. Kenny

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Price of ADHD Medication: A Concerning Trend

As the economy’s downturn is affecting businesses and families alike – it seems that Big Pharma has a plan to keep themselves thriving in this economy.

Quite simply: Raise prices.

A news report shares that Big Pharma are raising their prices to improve their income. Included in the example is Eli Lilly’s Strattera – a non-stimulant medication for ADHD.

I’m not sure if the same thing is happening with other ADHD medications, which are manufactured by other companies.

This is a very concerning trend – especially as people may be under-insured, or uninsured. The medication costs are often prohibitive – and if one needs the medication to survive at work and to keep one’s income, this can be quite a bind.

What has your experience been? Have the costs of your prescription gone up?

Please share your comments below.

** As further explanation – the information above refers to prices in the US. I have recently published two articles showing that the trend in Canada is that in fact the prices are coming down – particularly for Strattera and Adderall XR. You can read more details here: Strattera Price Drop in Canada, and Adderall XR Price Drop in Canada.

Best,

Dr. Kenny

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The Dollars and Cents of ADHD

A press release just came out today – publicizing a report which is available for purchase about the nature of the pharmaceutical market in ADHD. The press release documents that the ADHD market is worth $3.85 billion per year, and will have a compound annual growth rate of 1.2% over the next 10 years. They document that the adult ADHD ‘market’ is largely untapped, and they predict that it will likely be twice as big as the pediatric ADHD market.

I have to say that I always have a mixed response when I read statistics like this.

On the negative side – this type of data makes it seems that the pharmaceutical companies are just trying to make sure that more prescriptions are written, and they see people with ADHD as just consumers of their drug and ‘dollars and cents’. Additionally, these data help to fuel the ‘ADHD nay-sayers’ to talk about how ‘over treated’ and ‘over medicated’ ADHD is. (I can hear them saying – ‘almost $4 billion dollars of drugs sold per year???’).

On the other side – this type of just report documents facts…
It’s been documented that it costs over $1 billion USD to bring a new medicine to market. The fact that there is a profit in the ADHD market – and an opportunity for companies to expand sales in the future – means that there will be more research and thus more new treatments introduced in the coming years.

This is ultimately good for people with ADD or ADHD.
New treatment options coming out in the future is a good thing…

In summary – although this type of statistic can be shocking to some – I believe it is important to know that it means that the pharma companies will be willing to invest new monies into ADHD research and treatments.

The danger here is how this statistic can be sensationalized, and how people can get too fixed on the ‘medication only’ treatment of ADHD.

Please remember that the best approach to treatment of ADHD is multimodal – meaning including medication with non-medication approaches (including behavioral therapy, parenting supports, academic/occupational support, coaching, alternative approaches, etc.).

To read a special report that I wrote about ADHD Medication, please visit: Medication Mastery.

Please share your thoughts in the comments section below.

Dr. Kenny

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