• Posted January 27, 2025

Adderall Shortage Sparks Scramble for ADHD Alternatives

Adderall shortages have prompted doctors to switch kids with attention-deficit/hyperactivity disorder (ADHD) to other forms of stimulant medication.

Adderall prescription fills for children and teens plunged after the U.S. Food and Drug Administration (FDA) announced a shortage of the drug in October 2022, researchers reported in a new study published today in the journal Pediatrics.

But at the same time, prescriptions for other types of stimulant drugs used in ADHD treatment increased, according to study results.

“Our findings suggest that the Adderall shortage did not cause many children to stop stimulant therapy altogether, but it did force some to switch to alternative stimulants,” lead investigator Sijia He, a researcher at the Susan B. Meister Child Health Evaluation and Research Center in the University of Michigan, said in a news release.

It’s too soon to tell whether these alternative stimulants wound up being a good or bad thing for children with ADHD, He noted.

“This would be potentially concerning if the switches may have resulted in worsened ADHD control,” He said. “We need more research to evaluate whether any switches led to adverse outcomes.”

More than 11% of children will be diagnosed with ADHD at some point during their lives, and prescription stimulants are considered a first-line treatment when drugs are required, researchers said in background notes.

Stimulants are the most widely used ADHD medication, according to the U.S. Centers for Disease Control and Prevention. As many as 80% of children have fewer ADHD symptoms when taking these meds.

For the study, researchers analyzed trends in stimulant prescriptions among children between the ages of 5 and 17, using national data that captures 92% of U.S. prescriptions.

Results showed that the monthly stimulant dispensing rate to children declined by nearly 19% in March 2020, at the start of the COVID-19 pandemic, compared to January 2017.

After that, the rate slowly edged up every month until the Adderall shortage was announced in October 2022, researchers said.

After that, dispensing rates for Adderall decreased while rates for a substitute drug called dexmethylphenidate (Focalin) rose, the study says.

The rates of stimulant dispensing varied by age and sex, researchers found:

• Boys 12 to 17 were less likely to take stimulants, with a rate 19% lower in December 2023 than what would have been expected based on pre-pandemic trends.

• Boys 5 to 11 had stimulant rates similar to what would have been expected.

• Girls 5 to 11 had stimulant-dispensing rates 9% higher than expected.

The results among girls are consistent with prior research indicating that first-time ADHD diagnoses were more common in girls than boys during the pandemic, researchers said.

“A potentially optimistic explanation of these findings is that they represent a decrease in underdiagnosis and undertreatment of ADHD in girls,” senior investigator Dr. Kao-Ping Chua, a researcher at the University of Michigan Health C.S. Mott Children's Hospital in Ann Arbor, said in a news release.

“It’s also possible that symptoms of inattention in girls increased during the pandemic, increasing their need for stimulants,” Chua added.

Adderall fell into shortage due to both production issues as well as an unanticipated demand for stimulants in the U.S., particularly among adults.

“Our findings indirectly demonstrate how increased demand for a medication class in adults may adversely affect access to these treatments for children,” Chua said.

“It’s crucial to address the shortage of stimulant medications because so many kids rely on them,” he concluded. “Untreated ADHD symptoms can harm children’s health and learning.”

More information

The U.S. Centers for Disease Control and Prevention has more on ADHD treatments.

SOURCE: University of Michigan, news release, Jan. 27, 2025