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ADHD Medication Shortage 13th October 2023

Published: 16/10/2023 16:04

There are currently significant shortages of many of the medications we prescribe for the treatment of ADHD. This issue affects the whole of the UK, not just Scotland, and thousands of children, young people and adults are being affected by this. This shortage has been caused by multiple factors, including changes to manufacturers, reduced production of some medications, delays in distribution and increased demands on stocks of medication with rapid rises in the numbers of ADHD diagnoses made.  

  

We do understand that ADHD can be a serious and impairing condition and that ADHD medication can often form a vital lifeline for patients and their families. We appreciate that this is a trying and a stressful time with medications intermittently coming in and out of stock. Staff in CAMHS teams, GPs, pharmacies and wider NHS services do not have any control over this but will endeavour to provide more families with more specific information as we hear of updates.   

  

What are health services doing?   

Mental health services, general practice and community pharmacies will be working hard to make reasonable adjustments for each patient during this difficult time. Where possible health care teams will continue to try to provide your current prescriptions, however on a weekly basis some ADHD medications are becoming harder to obtain.    

  

Staff in community pharmacies, GP Surgeries and specialist services (CAMHS, CCH, Adult Mental Health) are receiving many calls per day from families who may be very anxious or angry regarding this issue. Please be patient with our staff as they try to return all calls made and offer advice as they are able. We would reiterate it is not the fault of health care staff that this issue has arisen nor do they have any control over it.   

  

Some medications are already depleted and are not available (see below). Other medications continue to reduce in supply and may be depleted and therefore not available in coming weeks. We expect difficulties with some medication may continue into 2024.  

  

We are currently experiencing supply issues with all doses of:  

  • Elvanse capsules  
  • Equasym XL capsules  
  • Xaggitin XL tablets  
  • Xenidate XL tablets  
  • Concerta XL tablets  
  • Intuniv (guanfacine) MR tablets  
  • Atomoxetine capsules  

  

Mental health staff, GPs and pharmacy staff cannot guarantee supplies of each of these medications, and for many there are no alternative brands available that can keep up with demand.  Switching every person’s medication to an alternative product is not an option at this time and is already leading to wider supply issues for all as it spreads out the problem. It is neither safe nor practical to change everyone’s medication on a frequent basis. We appreciate your support with this by minimising, where possible, multiple contacts across different services.   

  

Community pharmacies do not keep large stocks of ADHD medication due to the storage requirements which limit the space they have available.   

  

What can you do?   

  

Before contacting your GP Surgery or specialist service, please take the following steps:  

  

If you are unable to obtain your usual prescription from your usual pharmacy  

  

  • Please try an alternative pharmacy. It can be helpful to phone around and ask about stock in advance of trying to collect your prescription.  

 

  • Large chain pharmacies (such as Asda or Boots) have limited suppliers that they can order from however smaller, independent pharmacies may have more flexibility to source medications from different suppliers so it is definitely worth calling around.   

 

  • It is more helpful to call a pharmacy first to see what is available that is as close as possible to the medication you usually take. Once a medication is sourced please ask pharmacy staff if they can reserve the medication for you so that you can then promptly ask your GP for a prescription of what is available.   

  

  

If you or your child takes Methylphenidate or Lisdexamfetamine i.e. stimulants (Methylphenidate preparations include methylphenidate immediate release, Medikinet XL, Equasym XL, Xaggitin XL, Xenidate XL, Concerta XL; Lisdexamfetamine refers to Elvanse only):  

  • Reduce the number of days you take your medication to only essential days where possible (for example on school days only)  
  • If you take multiple doses of medication in a day consider reducing how often you take these where possible (for example reducing from 2 or 3 times per day to once per day)  
  • If you take more than 1 tablet or capsule at one time, consider reducing to 1 tablet or capsule each day.    
  • E.g. – methylphenidate instant release 10mg tablets, normal dose twice a day, try to occasionally take once a day when possible.  
  • This will still have some clinical benefit though not the same as taking your usual maintenance dose  
  • If you take a brand of methylphenidate ask your pharmacy/ GP if a different brand of similar medication can be sourced. This is not possible if you are taking Lisdexamfetamine (only available as Elvanse) but if your pharmacist can source some then either the original version or the adult version can be used.   
  • Speak with your local pharmacy first and request that they continue to try and order in all strengths of the medication you take. If they manage to source some of your medication, your GP surgery will be able to issue a prescription for whatever strength they have managed to secure.   

  

If you or your child takes Guanfacine (Intuniv):  

  • Abruptly stopping Guanfacine can be dangerous, as it can result in a sudden spike of high blood pressure. Therefore, you should not go “cold turkey” from Guanfacine.  
  • If you do not have enough supply to last throughout the shortage the dose will need to be gradually reduced to stop, by reducing by 1mg every 3 to 7 days.    
  • This would need to be done with support from your specialist team (CAMHS, CCH, Adult Mental Health), please contact your team for this. You will require closer blood pressure monitoring if you stop your medication very suddenly.   
  • Speak with your local pharmacy first and request that they continue to try and order in all strengths of the medication you take. If they manage to source some of your medication, your GP surgery will be able to issue a prescription for whatever they have managed to secure.  
  • Your child will also require re-titration once supplies return.    

  

If you or your child takes Atomoxetine:  

  • Speak with your local pharmacy first and request that they continue to try and order in all strengths of the medication you take. If they manage to source some of your medication, your GP surgery will be able to issue a prescription for whatever they have managed to secure.  

  

Non Medication Strategies:   

There are a range of interventions to help with the symptoms of ADHD which are not medication dependant that can be put in place at home and at school. Speak to your or your child’s teachers, health and/ or social care team if you need support with exploring these options.   

  

www.nhsggc.org.uk/kids/resources  

  

www.adhdfoundation.org.uk/resources  

  

www.youngminds.org.uk/parent/parents-a-z-mental-health-guide/adhd/  

  

Natural Remedies for ADHD Without Medication: Nutrition, Supplements, Sleep (additudemag.com)   

  

Once again, we are sorry that this news will cause some degree of uncertainty and distress. Please be aware that we will do what we can to try and minimise this disruption for all the young people we are working with.