Australia, and those diagnosed with ADHD, are facing drastic shortages in their stimulant medication that provides key lifestyle and cognitive aid.
Generic versions of essential ADHD medications like Adderall, Vyvanse and Concerta remain in varying degrees of shortage across the globe. It has been an international pharmaceutical issue since August of last year and has only worsened since.
The latest Vyvanse shortage in Australia is set to take months to regain sufficient supply with American company Takeda pharmaceuticals and the United States Drug Enforcement Administration (US DEA) at the epicentre of the shortage.
The US DEA refuses to raise manufacturing limits of the key ingredient, lisdexamfetamine, only produced by Takeda which is the key cause of the shortage.
Production issues and the increase in diagnoses rates are part of the narrative of the shortage’s causes. Supposedly, the Adderall shortage in the US which began last year triggered the current shortage due to alternative prescriptions offered.
According to the Department of Health and Aged Care, the shortage of the 30mg Vyvanse dosage, was set to resolve in early March but due to ongoing production issues it is now predicted to return March 30. However, the most common 40mg and 60mg dosages are not set to be resolved until late April.
According to Health Direct, an Australian government funded national health advice service, approximately 1 in every 20 Australians have ADHD. In a departmental briefing in October of last year, the report said that ADHD medication prescription rates have increased by 16.7% over the past decade with a significant jump in annual growth rate between 2020 and 2022 of 26.7%.
To better understand the impact of the shortage, it is important to know what these medications are and what they do.
There are two forms of the stimulant medication — short acting and long acting. The short acting medication can last anywhere from 3-5 hours according to dosage and type of medication like Aspen (dexamphetamine) or Ritalin (methylphenidate). The long acting medication lasts between 8-12 hours and different variants include Vyvanse (lisdexamfetamine) or Concerta (extended-release methylphenidate).
Each medication targets and increases two chemicals in the brain, dopamine and norepinephrine. Dopamine impacts concentration and motivation whilst norepinephrine addresses impulsivity, inattention and memory problems. The medication has varying degrees of dosage according to the requirements of your diagnosis and can only be prescribed by psychiatrists.
For many students and employees, these medications are a crux for a healthy work day and a source of executive function, much-needed dopamine and channelled focus.
As a student, taking medication like Vyvanse which is a long-acting 8-12 hour aid, is a significant factor in maintaining productivity and balanced mental health. Another concern that weighs in is the expensive costs of psychiatrist appointments to get a new prescription and seeking out alternative options to the shortage not only feels out of reach but could put patients and families out of pocket.
A local Terry White pharmacy in Bexley North spoke to Honi Soit about how their practice has been dealing with the shortage. Choosing to be unnamed, the pharmacist told us that alternative arrangements such as “purchasing remaining supplies of 60mg and turning it into a drinkable solution for rationing” has been one option that patients opt for as well as “purchasing 20mg and then taking several tablets according to psychiatrist direction.”
In Australia, the option for pharmaceutical companies to buy generic lisdexamfetamine to produce the medication is not available because Takeda owns the patent for Vyvanse. This means that the production and maintenance of steady supply in Australia is entirely reliant on the regulations and status of the US DEA who are facing a shortage of their own.
As it stands, all dosages of Vyvanse production are set to return to supply by April 30 however as we’ve seen in recent weeks, that finish line keeps on changing.