This post reviews events in the news related to ADHD generic medication—as reported here at the ADHD Roller Coaster.
Since 2009, I’ve felt it important to educate readers about generic ADHD medications. That’s when the earliest version of this post appeared on. The distinctions between brand and generic—especially with novel delivery system drugs—remain relevant today, in 2023. In fact, they are even more relevant.
To save money, many people with ADHD take generic medications. Is this a good idea? That depends on the medication—and the person taking it. A medication such as Strattera does not depend on a fancy delivery system. In comparison to novel delivery-system drugs such as Concerta, Strattera lends itself better to a generic (atomoxetine). Even then, much depends on the generic manufacturer.
In This Post:
I recap events from 2009 to 2022, offering links to my other articles on this topic:
- 2009: Consumer Reports recommends avoiding brand ADHD medications (lest children get “hooked”)
- 2009: Major story questions “bio-equivalence” on a generic of psychiatric medication Wellbutrin
- 2014: Inspired by the FDA-downgraded generic of Wellbutrin, I opened an FDA MedWatch complaint. Generic users of these medications followed through by reporting any adverse events they experienced. The FDA downgraded the first two generics for Concerta.
- 2017: The circus comes to town with a clown car of Concerta generics.
- 2019: Journalist Katherine Eban’s book “Bottle of Lies” exposed practices of modern “Big Generic”
But First: Generic Not Always “Exactly the Same”
Physicians—and pharmacists—tend to assure patients that generics are “exactly the same” as brand. Only cheaper. Unfortunately, that is not always case—sometimes dangerously so. With ADHD medications, in particular, the most effective dosing tends to be precise.
For example, say you do best on 36 mg of Concerta. With the generic version, however, the effective ingredient legally has 20% wiggle room, up or down. That means you could get significantly more than 36 mg. Or significantly less.
To be sure: Some people do perfectly well on generic stimulants and atomoxetine (brand name Strattera). They do well to monitor the manufacturer, though. Pharmacies can change suppliers at any time. One manufacturer’s generic won’t necessarily work as another manufacturer’s generic. Most people—and their prescribers—won’t think about medication as the key variable. Especially if they believe “generic is exactly the same as brand.” They might look to every other factor but that.
Here’s a major reason you want to know about these potential differences. If you start ADHD treatment with a generic, to poor response, you cannot know if it was the generic that caused the problem. Perhaps you’d have done better with the brand version. If you never try the brand, you and your prescriber might conclude you can never take that drug. It’s not wise to eliminate options based on faulty data. Yet, I hear about this happening constantly.
1. Consumer Reports Slams ADHD Brand Rx in 2009
I first reported on this topic in 2009: Consumer Reports on Autos? Yes. On ADHD Medications? No!
Fast-forward to 2022: I help readers to stay current with the ongoing search for Concerta’s authorized-generic (the brand marketed at a generic price)—or at least finding ways to get brand more economically. The most recent post: Authorized Generic Concerta Update
Back to 2009: A Consumer Reports press release was the catalyst: Parents: Don’t rush Children to Adderall, Concerta, Strattera.
The magazine known for its reviews of cars and appliances was now issuing medical advice. Bad medical advice. First, i didn’t know any parents who were “rushing” their children to these medications. Most were extremely cautious—some to their child’s detriment.
Even more shocking, though: CR actually warned consumers away from brand-name medications for ADHD. Yes, you read that correctly.
Their rationale? Brand-name medications are too costly and unnecessary. But more importantly: Your child can get “hooked” on these brand medications? (But not the generics of them? Can you believe how ridiculous that is?) I explain more at the post.
Pharmacologist Joe Graedon, of The People’s Pharmacy2. People’s Pharmacy Tests Wellbutrin Generic
Later in 2009, The New York Times article (Not All Drugs Are the Same After All) backs up the points I made earlier in the year. Some snippets:
- “There is a gnawing concern among some doctors and researchers that certain prescription generic drugs may not work as well as their brand-name counterpart.”
- “Some specialists, particularly cardiologists and neurologists, are concerned about generic formulations of drugs in which a slight variation could have a serious effect on a patient’s health.”
Hundreds of consumers posted messages about problems with the generic drug Budeprion XL 300 on Joe Graedon’s People’s Pharmacy Web site. In other generic versions, it is called bupropion, the generic name for Wellbutrin. He then worked with an independent laboratory, ConsumerLab.com, to test the drug.
The lab found that Budeprion XL 300 released the active drug at a different rate than the brand name Wellbutrin XL 300. Mr. Graedon and the lab conjecture that the different dissolution rates might be to blame for the reported side effects and lower effectiveness of Budeprion. [That is exactly the issue with the latest clown car of Concerta generics.]
Kudos to Joe Graedon of The People’s Pharmacy for listening to his readers (despite his own longstanding support of generics) and reconsidering the issue!
3. FDA Downgrades First Two Inferior Concerta Generics in 2014
About 6 years later, I opened an FDA MedWatch complaint about the inferior Concerta generics trickling onto the scene. Two companies, Kudco and Mallinckrodt, produced their own generics. When readers started asking questions, so did I. See Sound Off: Users of Downgraded. Generics
I was confused. What was happening? A similar thing was apparent in Canada: Generic Concerta in Canada: Parallel Problems
I called a pharmaceutical patent attorney in hopes of getting an explanation. He said, paraphrasing, “What these two companies have done is genius! They’ve exploited loopholes in FDA guidelines.” I could barely respond, “Genius, if you’re a sociopath,” and hung up.
When I called the FDA, I spoke with a very helpful representative who suggested I open the MedWatch complaint.
The Delivery System: That Makes Concerta Concerta
We need to understand a bit about drug delivery systems. That is, how the medication gets from the pill into your bloodstream. It can make all the difference in how it works.
Without Concerta’s sophisticated osmotic-release system (OROS™), it’s active ingredient (methylphenidate) operates more like a generic Ritalin pill. The abrupt start and stop can feel like a “Ritalin Roller Coaster. Concerta’s novel delivery system eliminated the ups and downs in a smooth sustained delivery over 6-12 hours.
ADHD Roller Coaster readers and others followed through and filed their MedWatch complaints. In 2014, we won! (Victory! Concerta Generics downgraded.)
Mallinckrodt refused to accept the downgraded status, however, and threatened to sue the FDA. That went nowhere.
For some time after, some consumers were still forced to accept them as legitimately substitutable generics. That is, these pharmacies weren’t playing by the rules, to put it mildly. You can read the history in this post, where I also detail the difference between “true” and “authorized” generics: Consumer Q&A On Generic Concerta.
4. A Clown Car of Inferior Concerta Generics in 2017
What had been two inferior Concerta generics wreaking havoc soon turned to, oh, about 15 at last count.
What happened? What about our hard-earned victory and the FDA admirably protecting consumers?
The Trump administration named a venture capitalist as FDA chief, Scott Gottlieb, MD. During his short stint, he pushed through dozens of generics.
Gottlieb scorned FDA scientists’ concerns that some generic makers were exploiting loopholes in FDA guidelines. These loopholes allowed drugs with bare-bones formulation to claim bioequivalence for drugs with sophisticated delivery systems. That included Concerta with its proprietary osmotic pump, Alza’s OROS.
5. Bottle of Lies — “Big Generic” in 2019
Journalist Katherine Eban’s book blew the lid off modern generic-manufacturers’ non-savory (to say the least) business practices. Unconscionable stuff. See Bottle of Lies Exposes Generic Drugs
Here is an excerpt from her opinion piece in The New York Times:
My reporting on the generic drug industry over the last decade led me to four continents, and into the overseas plants where America’s generic drugs are made.
Interviews with more than 240 people, including numerous whistle-blowers, helped expose what was going on behind the boardroom doors at generic-drug companies.
Some companies have encouraged data fraud as the most profitable path to securing approvals from regulators, and have used deceit to hold the F.D.A.’s investigators at bay…
I welcome your comments on generic medications and ADHD.
To be notified of follow-up comments, be sure to check the box below.
—Gina Pera
I’m having a hell of a time figuring out how to get back on a medication that works for my ADD, while also trying to heal from a life threatening abcess that resulted in being on antibiotics for over a month and getting oral surgery and bone grafts. I picked up my Concerta refill the day of the surgery the first week of January, but it wasn’t Concerta. It was a Trigen generic that is not the layered barrel pill, and as I would find out, it does not treat my ADD symptoms AT ALL. All it seems to do is make me jittery and give me a headache. I am on a few other meds for anxiety and they are all generics so I didn’t think it would be a problem. And I assumed I was feeling terrible because of the oral surgery so I didn’t realize for several days that the medication isn’t working. Once I did, I contacted my psychiatrist and pharmacist who said I can’t get new meds for another month and that my insurance no longer covers brand Concerta so it will cost $400. I picked up brand Concerta in December for $10 and I haven’t changed insurance.
I feel like the rug got pulled out from under me 2 weeks before I start back in my grad program, while I’m recovering from oral surgery where I’m not allowed to even exercise for 4-6 weeks to help manage ADD or anxiety. So now I’m supposed to figure out a new medication to take even though the one I was on worked really well for me at a moderate dose with virtually no side effects. My psychiatrist has offered no guidance on what other medications to try. And none of the savings programs for Concerta are eligible in California. And I’m under so much stress and completely out of the ADD meds that were both helping me be functional at all through my health emergency and helping with emotional regulation. I’m so overwhelmed.
Hi Corey,
That is just awful….a “perfect sea” of upset.
I’ve been covering this topic for many years. I hope you subscribed, to be notified of what might happen next.
I can’t say for sure, but your psychiatrist might be wrong. I cannot imagine, even in the current pharmaceutical dystopia, that you will have to wait 30 days to get the Rx you need to function.
This post (and comments) contains the latest. I suggest some MPH alternates.
I would call your insurance pharmacy benefit and ask if you can get another choice. And please, if you possibly can, do jot down your reactions in an FDA MedWAtch complaint.
https://www.accessdata.fda.gov/scripts/medwatch/index.cfm?action=consumer.reporting
If there’s any way you can postpone going back to school until next semester/quarter, that might be a good idea.
Meanwhile, check out the ones I mention in that post.
Also, I finally had it with the poor prescribing patterns — I mean REALLY had it — and created this take-you-by-the-hand course on learning about and optimizing ADHD sleep issues and medication. https://www.accessdata.fda.gov/scripts/medwatch/index.cfm?action=consumer.reporting1
Take care,
g
Thanks for this post. I found it after getting a note from my pharmacy that they are unable to refill my generic concerta due to a “nationwide shortage” and “issues with the active pharmaceutical ingredients for certain products.” After finding your posts, I looked at the type of generic I have been getting – looks like it’s made by Camber. It seems to work okay for me. I’m hoping that my doctor can rewrite the prescription for me to get the brand version, or I can find either the generic version I’ve been receiving or the brand version at a different pharmacy. Thanks for your very informative posts!
Hi Nicole,
You’re welcome!
Yes, a nationwide shortage…of most stimulants, it seems. I’m betting the DEA did not keep up with the COVID-related demand for ADHD diagnoses. 🙂
If your MD can request Camber, that might be a good thing….unless they don’t have it.
good luck!
g
Hi , I just want to also state that the generic mixed amphetamine salts should definitely be more consistent regardless of brand. Some of these pills like the white octagon with a 20 and M on the side…well they are horrible, and should be pulled off the shelf and destroyed. Because back to back …..the orange ones are like day and night better, never miss always hit. This was my recent experience, so I’m venting I suppose. Thanks
Hi Gavin,
I’m less familiar with the Adderall generics.
Sounds like Big Generic made out again — and patients lose.
Have you tried filing a MedWatch complaint? Here’s a direct link to the form.
https://www.accessdata.fda.gov/scripts/medwatch/index.cfm?action=consumer.reporting1
cheers
g
I am in the same situation with the exact same generic which is made by Mallinckrodt, except for me, it’s not just ineffective but is causing terrible side effects like I’ve NEVER experienced in my 20 years of being prescribed to Adderall!!! I have submitted a complaint with the FDA & in the process, I learned there are many thousands of complaints dating back to at least 2015 yet NOTHING has apparently been done!
Hi again, KK.
Are you sure there are thousands of complaints dating to 2015 (not older, because those are the ones that resulted in the FDA downgrading Mallinckrodt’s generic Concerta)?
Brand name Ritalin I’m told is discontinued. It worked wonderfully for over 10 years. The dr is now suggesting the generic. Not sure if it is working well enough to stay on. Looking for suggestions on what else to try. Not interested in Addreall, Vyvance, Concerta or Dexedrine. Open to other suggestions
Hi JM.
I thought brand Ritalin was off-patent years ago. Maybe Ritalin LA brand might still be available. I can’t check right now.
Meanwhile, I highlighted a few MPH options here. They are still brand and have savings programs./
https://adhdrollercoaster.org/adhd-news-and-research/a-new-ritalin-extended-release-liquid/
g
Well the comments here seem to confirm my suspicions about genetic Adderall (immediate release)…
I’ve been talking it off-label to treat a combination of tiredness/motivation and depression (in addition with Paxil; also generic) for so long now that I don’t exactly know when I first got on it… Would have to be around 2008 by the latest.
Me ever taking it only came down to pure chance, as my friend had been prescribed it for… well I’m not sure, irrelevant I guess, but I just couldn’t get going one day while helping him, and he gave me one… After many years of trying various different antidepressants with little help to my mental health, this was a light switch being turned on… not just in terms of my depression, but also my inability to wakeup and get going each day – up until then I never really considered I had a medical issue with tiredness, as I was only in my late 20s at this point. [I’ll dive back into this later…]
I think I started on 20mg but frankly that sounds low… Regardless, over the years, I eventually crept up to taking 40mg, then 50mg and had been taking that dosage for probably the last 6 or so years, having landed on a really good regimen. Truth be told, I’m not sure how necessary my Paxil was anymore, but continued on it simply because of the lovely “Lighting Bolts In Your Brain” withdrawal effects!
[note: I’m skipping a frustrating period of supply issues at local Tennessee Walmart Pharmacy I was plagued by (started ~2017), ultimately having to switch JUST my Adderall over to WalGREENS Pharmacy]
…….THEN…. THE CoViD-19 PANDEMIC HITS…….
[relevant info: I had gotten the Moderna vacc. but no boosters, and only in Aug of ’22 did mom and I get CoV due to a lapse in prevention routine at the cabin; she had J&J and boosters]
Things were fine for me and mine, as frankly, it impacted our lifestyle zero, since we all were homebodies anyways. Although, I started to notice something, probably around the June (2020) – Mind you this is only obvious in *hindsight* and at the time I thought nothing of it – which as we went to our cabin in July into August, meant I couldn’t use Walgreens because of an inability to get a written script for it like usual (government crackdown on abuse; understandable). So my Adderall was through Walmart for this refill. This meant a different generic manufacturer, one that up until then I actually DISLIKED.
CONTEXT: I had been taking the oval peach (citrusy tasting) pill, and had found those worked _better_ compared to what Walmart had started to switch to, which was a round pink (‘unflavored’) pill.
Well, now, those round pills actually had a noticeable impact FOR THE BETTER!
This is when I started hypothesizing that the Silly Chain issues must be impacting the pharmaceutical manufacture industry, and that perhaps somewhere along the chain, ingredients in short supply and instead of… you know…. not making money hand over fist by being unable to keep up the same volume, they’d just “cut” their supplies — illicit drug trade tactic entering the legitimate drug market. (again, whether it’s a drug manufacturer choice or an ingredient supplier choice, is anyone’s guess)
I brought it up to my prescriber, and I love the lady as she’s helped me the most of all those so far in TN, but I got the whole “they can’t do that due to strict guidelines” shtick.
Fast forward a year (2021) and this only had gotten worse. Oh, and Now both generics (round pink and oval peach) are ‘junk’. Being convinced that it’s a “me problem” we to now and 50mg barely does squat. We bumped me up to 60mg, no difference. On my own, I’ve tried just 30mg, also 90mg, and admittedly… even tried 120mg, virtually *no discernable difference.* Which anyone on a stimulant knows, is… odd, to say the least.
Until today, I thought maybe this was a vaccine induced problem. Or, since during these last 2 months things have gotten EVEN WORSE, that maybe it was CoV related. I’ve lost virtually all motivation, and interests, or care of anything. In other words, arguably as though I’m not even taking Adderall! Except I know there’s some trace amount in there since if I was off it, I’d genuinely want to sleep all day (I know this, as one provider I had to see for ~6mo, refused to refill me, saying “coffee is all she needs and she has ADD” [yea, I explained that it only says ADD in my chart for legal reasons, not because it’s my diagnosis], which resulted in roughly 20hrs/day of sleep… god she was a wench…)
Now I’m convinced that it’s neither, and basically my hypothesis is looking more like a valid theory….. Not that it does me a bit of good
No, though. I haven’t tried the non-generic, to see if that will help. I’m a bit reluctant to ask what that would cost, even though it’s over a century old «looking at you, insulin fiasco»… We were going to switch me to something new, Trintellix(sp?) and Ridulxi() but one would’ve been $1000 and the other $600! ♂️
Anyways, I am but a shell of what I was this time last year…
WHICH IS A SHELL OF WHAT I WAS, A YEAR PRIOR TO THAT!
The only thing keeping me going at this point is my soon to be 14yr old dog
[While rest assured, the sentiment IS appreciated, you don’t need to reply to this Gina. The sole intent of my rambling here is only to contribute to the amounting body of evidence, insofar as things not being what they may seem, nor what they had been (which apparently, sadly, was already “in a bad way”), NOR what they *should* be. Writing all of this at least documents yet another person’s needless struggle – needless because it is squarely the result of someone’s greed/incompetence/negligence/oversight/undersight/but-likely-all-of-the-above as a result of, or exacerbated by, the pandemic.]
Hi Clint,
I understand your point. Psychiatric generics, in particular, are tricky. Sorry you are grappling with this.
Still, you might do well to learn more about ADHD management, and know if you actually have it before continuing with any type of Adderall.
Even if you do have ADHD, Adderall might not be the best long-term choice for you. Moreover, the Paxil might be working at cross-purposes with it, too. That is, diminishing its effect. The Paxil is a generic, too, right? So something could have changed with that as werll.
Yes, the Paxil withdrawal can be nasty but it’s possible for many people. Many report reducing is ever-so gradually over time. Not abruptly.
You might look into Vyvanse, which is also an amphetamine but more “simple” than Adderall and, it seems, users are less likely to habituate over time. Last I checked, there’s a savings program, too, and it has no generics. Yet.
good luck
g
My pharmacy filled my dextro script with Mallinckrodt this month, and it is just complete garbage. I get some side effects like racing heart and sweating with zero cognitive benefits. My brain feels like I took nothing or worse. So frustrating. The dextro helps my depression and anxiety as well as ADHD. It’s a problem to get pills that straight up don’t work. It’s a struggle to even get out of bed and focused enough to get dressed and off for work in the morning. Have not had this issue with other generic brands ever, and have been taking dextro several years or so with good results. I’m submitting a complaint to the FDA. It’s that bad.
Good for you, Lyn.
“Big Generic” is getting away with murder. Perhaps, in some cases, literally.
Politicians of all stripes are clamoring about lowering drug prices — and so that gives Big Generic the edge.
It’s up to consumers, it seems.
good luck
g
I had the opposite experience & effect with Mallinckrodt over the past 30 days up until I just switched back to the peach Teva 30s two days ago. For me (in comparing the two generics to one another) the white “M 30” Mallinckrodt Adderall pills were much better than the once great Teva’s. Teva 30s were all I took twice a day for the past 10+ years and they were always the best. However, that’s no longer the case now in 2022/2023. I am 100% positive that Teva has made changes to their formulation and not for the better folks. So, I encourage anyone who is currently prescribed 30mg Adderall to seriously consider trying the generic manufactured by Mallinckrodt. I will be asking my pharmacist very nicely to order only the Mallinckrodt 30s for me moving forward. Good luck to all. My finger’s are crossed for Teva stepping it’s quality back up to what is was not long ago and for Mallinckrodt to continue their improvements.
Hi Thomas,
For years, the Concerta authorized-generic (brand sold as a generic) was made available through Actavis and Watson — then finally Teva, as Teva purchased those companies. Shortly after that purchase, though, Teva launched its own generic.
I wonder if something similar had happened with Adderall.
good luck,
g
I just did the same but I’m wondering what good our complains will do (if any) considering there appears to have been thousands of complaints filed regarding this exact brand since at least 2015!
It’s just WRONG!!!!
Hi KK,
Not exactly. 🙂
Did you read point #4 of the post?
It was people filing FDA Medwatch complaints that downgraded the first two generics as non-bioequivalent.
g
Just dropping a note here that Mallinckrodt continues to be a terrible brand for ADHD meds in 2022. All of the local pharmacies near me switched to it as their generic for Dextramphetamine Sulfate ER, and worse than being ineffective, it actively makes my ADHD symptoms worse when I take it. I get stuck hyper-focus on the wall for 4+ hrs feeling like a zombie after taking a 10mg dose that would let me feel normal and able to switch my focus at will on the Teva equivalent.
Nathan, thanks for the update.
I remember Twitter-shaming the Mallinckrodt CEO. That and Kremers-Urban introduced the first two Concerta generics. We worked hard to get the FDA to down-grade them — and rightfully succeeded.
But he grandstanded at every opportunity with his threats to sue the FDA, etc… His tax-haven company sociopathically exploits FDA loopholes on novel-delivery system bioequivalence guidelines …. and then wants to sue. Shew.
g
Nathan ,this is what I noticed. Teva the orange dexedrine worked so much better than adderall ,no matter what brand adderall. It was without side effects ,no harshness and was able to focus be motivated etc all that I lacked before dexedrine. But it’s hard to get Teva (I think it’s Teva I had) dexedrine apparently I went through two genetics malinkrodt and lannett which both were not affective , actually they were counter productive. Then I got ZENZEDI I thought ok I will give it a chance …well it is like Teva in a way it is dexedrine any way. But it does not help my frontal lobe function the way Teva did. I feel I’m missing something veith ZENZEDI even. Amazing, yet true. I would certainly vlime to go on the teva again. The large orange pills. Only thing that works.
Matthew, it’s good to hear I’m not the only one with a similar experience. It helps.
I just got my latest RX, so now begins the struggle to get someone to actually fill it with Teva.
I’ve had some mild success by halving my dose of the Mallin Dextroamphetamine ER (you can get capsules that match the size of the RX, and use those to divide it up), which suggests that perhaps part of the problem is the release mechanism. Even with this, they’re still nowhere near as effective, however, so I’d only call it a last-ditch resort if you can’t get ahold of another brand that works for you.
You’re definitely not alone, Nathan.
You might already know all this, but FYI on generics:
https://adhdrollercoaster.org/adhd-news-and-research/generic-drugs-bottle-of-lies/
Gina
I am relieved to find I am not the only one noticing this manufacturer’s version of generic Adderall is terrible. Within the first day of treatment I knew immediately something was very wrong. I have been taking this for years and have been struggling terribly over the last two months. I even called the pharmacy today to report the issue, it has been THAT bad for me. They told me to report an adverse effect to the manufacturer and a google search found Nathan’s post above. Wow.
Hi J, Yes, I’ve been warning about this for at least a decade — probably more.
Pharmacists and physicians tend to mislead us, either out of their own ignorance or…some other reason.
I hope you can get the generic that works better for you.
Gina
Interesting little tidbits, literally: The online pill ID for this manufacturer’s generic version shows a peach or orange appearing tablet. But my tablet is actually white–different from all the other generics I have ever had, they have always been peach/orange.
When you look at the tablet very closely, there are just tiny tidbits of peach/orange granules; just makes me think of a very ‘watered-down’ tablet; lots of filler cutting the tablet down to the very minimum of acceptable +/- target mg or probably less even acceptable range. Has been a really terrible nearly-three-month stint for me.
My provider was kind and allowed an early fill but pharmacy has been out of supply, so the early fill is of little help. Can’t believe a pharmaceutical company can make such a poor quality medication; I have learned a big lesson!
I am a physician and had ZERO clue about how a generic could be so tremendously bad. Only now can I understand what my patients have mentioned about generics not working vs brand name. My idealistic brain has always had the conviction that the manufacturers always adhered to a level of quality and that quality control was guaranteed by processes and third-party checks in place for patient safety. What an eyeopener for me.
Hi J,
I’m glad you can better understand your patients now! 🙂
One ADHD specialist-prescriber wrote to me recently about the Concerta generic issue. He wished that the other prescribers in the clinic where he works would pay attention to this.
I think it was true at one time…..that generic manufacturers adhered to a higher level of quality.
But in the past 10 years, at least, “Big Generic” has exploited every profitable loophole imaginable. It’s deplorable—and shocking.
Thanks for your comment,
Gina
I was taking 15mg adderall pills by Teva they worked great. Walgreens and cvs just switched to elite pharmaceutical. They are sugar pills. I have narcolepsy. They don’t do anything not even if I take multiple pills. This is horrible and playing with people’s lives. How do we know what will work. I filed a complaint with the fda
Sorry to hear that, Katie. You can’t know what will work….until you try it. And that’s the problem.
See if your prescriber can specify Teva.
g
Hello, I’ve been on ADHD meds for over half a year now and I have been having tons of issues with generic medications.
I was prescribed Adderall as a kid and it was always clear as day when the meds start working. In a way where you notice your ADHD symptoms lessen quite a bit and you want to get your day started.
With these generics I’ve been taking now they literally feel like placebo pills. I had to switch over to dextroamphetamine and the first generic was helping, then the pharmacy changed to aurobindo manufacturer and I swear these do nothing.
You would think that taking higher doses of strong stimulants would be even slightly noticeable but no they aren’t. I’m going to talk to my doctor to try and get name brand Zenzedi but idk how it will cost with me using the Oregon health plan.
The thing that bothers me the most is the thought they might actually be producing poor quality ADHD meds and it isn’t a personal chemistry thing. There are tons of people who get very helpful benefits from these meds in controlled doses and I would hate to think they ruined all of that for them just because it’s a medicine that “could” be abused.
They are doing this tightening down thing for pain patients with opiates and so maybe they are clamping down on stimulant meds too. If that’s the case that’s so messed up, innocent people are getting effected by this war on substances, deal with the people who abuse it on the street not the genuine people who need it to function and go through the legal process to do things right and don’t abuse their prescription.
You can look up online and so many people are writing about terrible experiences with generic Adderall/dexedrine. So many people are describing it that it concerns me that nothing is being done about it. Shouldn’t they be looking out for the patients? If they aren’t getting therapeutic effects then shouldn’t that be a concern to the quality of what they make?
Dear Benjamin,
Yes, yes, and yes. Yes to everything you write. Your concerns are why I, writing a non-profit blog, have spent so much time writing about these issues — and have been the first to write about many of them. Because it is overwhelmingly important!
People with ADHD — and all people taking medication for anything — deserve medications that work as well as the brand’s original clinical trials show that they do. These medication make all the difference in a person’s ability to function in so many areas of life, including education, employment, driving, relationships, avoiding addictions, etc.
Many factors have contributed to the rise in these inferior generics. Most of them, as you can imagine, involve money.
I wrote about this first in 2009, when Consumer Reports magazine stepped way out of its lane to recommend generic medications for ADHD instead of brand.
https://adhdrollercoaster.org/tools-and-strategies/consumer-reports-on-vacuum-cleaners-maybe-on-adhd-medications-definitely-not/
I wrote about this more recently in recommending an excellent book on the rise of “Big Generic” (Bottle of Lies) and the rise of offshore generic manufacturers (e.g. Aurabindo):
https://adhdrollercoaster.org/adhd-news-and-research/generics-bottle-of-lies/
Since 2014, I have been reporting upon the inferior generics to Concerta, a game-changer among ADHD medications for many millions of people.
Here is the most recent piece: https://adhdrollercoaster.org/adhd-medications/authorized-generic-concerta-update-6-1-19/
When the first two inferior generics came out, I rallied readers to report adverse effects to the FDA. After speaking to a very helpful FDA representative, I opened a MedWatch case. That is where the public can report problems with medications. We succeeded.
https://adhdrollercoaster.org/tools-and-strategies/victory-concerta-generics-downgraded/
The FDA was in the process of updating guidelines for the generics of medications with complex delivery systems (e.g. Concerta) and also those where dosing must be more precise than the current bioequivalent standard for generics (e.g. all ADHD medications).
THEN new occupants of the White House appointed a FDA chief who overrode FDA scientist’s concerns and pushed through hundreds of generics. That included about 11 of the current Concerta generics that are throwing so many lives off the rails. Then he high-tailed it back to the Heritage Foundation, an ultra-right “think tank.”
Actions have consequences, including how we vote.
I hope that you can find the medication that works best for you. It might be that you benefit from one of the newer brand-name formulations, many of which have savings programs.
Good luck! Be sure to subscribe if you’d like any updates on this topic.
g
Omg I thought it was just me! I tell people all the time I could take my Adderall and then go laydown for a nice nap. I have definitely thought the same thing like They were giving me placebo sugar pills. Or should I say salt… I’ve tried the X or the short term, lots of different things but never the name brand. I’m on a fixed income I can only imagine how much it would cost. If they came over And stayed with me for a week they would see what I’m talking about. SMH
Hi Robin,
You know, there might be reasons beyond the Adderall being a generic that lead you to feel nap-prone.
Are you otherwise sleep-deprived?
g
Hi! Love this blog and I was looking at the big Generic Concerta/Ritalin post you made. Do you think you’d ever consider making a similar post about Adderall generics? I have had lots of issues with them as well, and others have too. Do you think much of the same logic applies? And do you think manufacturers that are good for Methylphenidate generics would also be for Adderall? I’ve never seen such an in depth post or article on this subject and I’m very interested in it.
Hi Maggie,
I’m glad you find my work helpful. Thanks for letting me know!
Yours is a good question.
The reason I focused only on Concerta is because millions of people had responded very well to Concerta and had been taking it for years.
Then there was this sudden entry of “true” (not authorized) generics that started sending lives off the rails. It was an emergency.
It’s taken an enormous amount of time over the years, first lobbying the FDA to downgrade the inferior generics and then trying to keep up with the new White House administration laying waste to FDA scientists’ concerns about lack of true bioequivalence with the NINE (last count) new generics for Concerta.
Did I mention this isn’t a paying gig? 🙂 Not even advertising (too distracting).
But I have done a bit of research this morning and found that there seem to be some authorized generics of the other stimulants. I’ve put a call into one company, distributing an authorized generic for Adderall XR. As of 2016. Don’t know current status.
Stay tuned for updates!
g
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I take 10 mg Dexedrine tabs and it comes in 3 brands (barr, something called Zenzedi and Mallinckrodt)… 2 of them last longer so my dosing at the max is still 80 mg but my doctor allows me to do a 30, 30, 20 regimen because they both are also weaker. (barr and zenzedi)
The ones I usually get are the white diamond shaped 10 mg Mallinckrodt and those are more potent feeling mentally (not euphoria wish but the amount of focus I can use) and they wear off fast so I need a 4th dose.
I also take in reality 5-30 mg, depending on the brand for specific situations. I think the flexibility of the IR Dexedrine is that it will teach myself the skills because it was 100% pills as a kid
HI Mat,
Everyone has to figure out what works best personally.
In general, though, it’s best to keep the medication at a steady level in the system — not up and down all the time.
The brain and body has to go through all kinds of adjustments to accommodate medication in the system, so it’s best to keep things stable.
best,
g
Hi Matt, I’ve been taking Dextroamphetamine Sulfate 10mg IR for 12 years ago 40mg /day is considered the maximum allowable dosage, pretty universally. Also, unfortunately KVK, Aurobindo, and others have gotten into the mix, creating more inconsistencies between brands. I have always taken Teva Barr, occasionally take MALLINKRODT. The latter is definitely less immediate and potent for me, but recently there are many complaints about MALLINKRODT ADHD meds. I am beginning to believe that the raw ingredients being supplied to manufacturers is of a lower quality. A bread company doesn’t grow its own wheat and a computer manufacturer doesn’t manufacture it’s micro chips. The raw ingredients’ quality impact the final product.
That’s an important point, Robert. Thanks for mentioning it.
It seems about 25% of raw ingredients are made in China and India. According to this from the FDA:
Safeguarding Pharmaceutical Supply Chains in a Global Economy.
Gina
Gina
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This is a very, very interesting and very important post Gina – thank you for talking about this.
I suffer from SSRI withdrawal syndrome after taking a prescribed generic SSRI. It has lasted nearly 3 years and has only let up for short periods of time. I wonder if it will ever go away. However, I have no way of knowing if this is due to ‘generic’ or not, but it would be interesting if there was a study conducted by those with SSRI withdrawal syndrome or discontinuation syndrome to find out how many were taking the ‘real’ stuff and how many were taking the ‘generic’ stuff. Lately, I may have found some hope, but then again maybe not. It seems the SSRI may have triggered migraines. I had a history of migraines from my youth, but only 1 or 2 attacks a year. Since the SSRI I get the attacks almost daily or rather an attack can last for prolonged periods of time. Checking my vitamins it seems that I also have low magnesium levels in my blood which could be a culprit, so with that I have taken magnesium the last few days, but it seems to be getting worse. Hopefully this is a worse before better scenario but regardless of what I have tried nothing has really ‘worked’ – so I think it is very, very important that generics get thorough testing with comparisons to the originals. Again, I don’t know if it is because of a generic, but I would be interested in finding out – not that it would help me now, but it might help others.
Thanks,
Bryan
Hey Gina,
Happy New Year! Great post, – right on with the caution.
Just thot your readers might be interested in some additional ideas on how to adjust IR [immediate release] products – so will send along this link to an article I did awhile ago on thinking scientifically if generics are your only alternative -http://ezinearticles.com/?ADD-ADHD-Medication-Treatment—7-Tips-to-Solve-Immediate-Release-Confusion&id=1739408
Hope these suggestions help! Best to you and all of your team over here.
Chuck
Gina,
Thanks for such a thoughtful post. It is frustrating that there is no good way of sorting out drugs that work from drugs that don’t other than trial and error. Some generics seem to be just fine; we do get a lot of reports that others are not providing the expected benefit. If only the FDA were able to monitor such medications, consumers could have a lot more confidence.
Terry Graedon
I mentioned this to my doctor, regarding my generic Ritalin, but she disagreed. It’s an awkward position. This is the doctor who diagnosed my ADD, and I’m grateful to her. I’m also grateful to you for suggesting other options. When I’m more sure of my footing, I’ll be sure to press the issue.
HI Mark,
I wonder what she could disagree with. In general, generics aren’t as reliable.
Maybe your doctor feels your generic Ritalin is working just fine for you. How would she know, though, if you’ve tried nothing else? Do you feel that your medical treatment is as good as it gets?
Of course, inexpensive generic Ritalin can be a huge help to people who don’t have insurance and can’t afford otherwise. But if one has insurance coverage and can afford the co-pays, I can’t imagine why any physician would prefer generic medication for ADHD. It’s just reckless, IMHO.
Gina
Hope it is helpful! I think esp for people with ADD/ADHD that cycle of starting something and not being able to sustain it is huge. Working with adult ADD clients is what helped me really realize that the routine is a real secret. Best of luck!
Wow interesting post. I need to do some more research on this stuff since I always believed generics to be identical as well. Fascinating.
Hi Will,
Thanks for visiting. I’m preparing for facing the New Year (and maybe new resolutions) by reading your blog post:
http://willmeekphd.com/item/the-secrets-of-changing