Generic ADHD Medications: Events In the News 2009 to 2022

ADHD generic medication news 2009 to 2022

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 this post first appeared on this topic. The distinctions between brand and generic—especially with novel delivery system drugs—remain relevant today, in 2022.

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:

  1. 2009: Consumer Reports recommends avoiding brand ADHD medications (lest children get “hooked”)
  2. 2009: Major story questions “bio-equivalence” on a generic of psychiatric medication Wellbutrin
  3. 2014: Inspired by the FDA-downgraded generic of Wellbutrin, I opened an FDA MedWatch complaint
  4. 2017: The circus comes to town with a clown car of Concerta generics.
  5. 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.

Consumer Reports ADHD medications

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

[advertising; not endorsement] [advertising; not endorsement]

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 Pharmacy
Pharmacologist Joe Graedon, of The People’s Pharmacy

2.  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!

downgraded concerta generics gina pera

 

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.

clown car of concerta generics

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.

Generic medication investigation

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

32 thoughts on “Generic ADHD Medications: Events In the News 2009 to 2022”

  1. 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.

    1. 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

    2. 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.

    3. 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.

    4. 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.

    5. 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

    6. 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.

    7. 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

  2. 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

    1. 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

  3. 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?

    1. 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

    2. 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

    3. 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

  4. 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.

    1. 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

  5. Pingback: ADHD Roller Coaster: "Is It You, Me, or Adult A.D.D.?" · A Recap: Consumer’s Guide to Generic Concerta

  6. 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

    1. 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

    2. 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.

  7. Pingback: ADHD Roller Coaster: "Is It You, Me, or Adult A.D.D.?" · An Update on Generic Concerta

  8. Pingback: ADHD Roller Coaster: "Is It You, Me, or Adult A.D.D.?" · What’s Up With Generic Concerta?

  9. 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

  10. 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

  11. Terry Graedon

    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

  12. 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.

    1. 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

  13. 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!

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