Generic ADHD medications can work differently—from the brand and from one manufacturer to another.
I have reported on this mounting problem since 2009. It remains urgent in 2026, especially with:
- Extended-release stimulants such as Vyvanse and Concerta
- Ongoing medication shortages
- Pharmacy Benefit Managers increasingly limiting which medications patients can access
To be clear: Many people do well on generic ADHD medications. Others experience significant problems. That’s especially true when they don’t know that their new generic is not truly “same as brand.” Hence, they look to other causes—and get far off-track.
Sometimes, the difference reflects an individual response to a particular formulation. Documented cases also exist, however, in which purported generics were later found not to be bioequivalent or therapeutically equivalent to the brand.
This article covers:
- What consumers need to know now
- What to do when a medication suddenly seem to “work differently”
- How the generic-medication story unfolded from 2009 through 2026 (selections from the “generic” archive)
Generic Does Not Always Mean “Exactly the Same”
Physicians and pharmacists often assure patients that a generic medication is “exactly the same” as the brand—only cheaper. That used to be more uniformly true than it is today.
A generic is expected to have the same:
- Active ingredient
- Strength
- Dosage form
But the finished product is not necessarily identical. Differences can include:
- Inactive ingredients
- Tablet construction
- Drug-delivery technology
Never are these distinctions more important than with extended-release medications. Especially the novel delivery systems. These include the “blockbuster” medications Vyvanse and Concerta, which marked a massive step forward over the old immediate-release choices.
The active ingredient is only one part of the product. For example, Ritalin and Concerta both contain methylphenidate, but the delivery system makes all the difference. It’s the delivery system that determines how that ingredient enters the bloodstream throughout the day. It can affect:
- How quickly the medication begins working
- How evenly it controls symptoms
- How long the effect lasts
And It’s Not All Down to “Patient Perception”
There are documented cases in which products approved and sold as generics were later found not to be bioequivalent or therapeutically equivalent to the brand medication.
One involved a purported generic for Wellbutrin XL 300. FDA-sponsored testing later found that it was not bioequivalent to the brand.
Another involved the first two purported Concerta generics in 2013-14. The FDA changed their therapeutic-equivalence ratings after evidence arose that they might not provide the same therapeutic benefits as Concerta. Then a new FDA chief in 2017 changed everything, and not for the better.
If we want the best results from ADHD treatment, we do best to be pro-active.
Why Generic Quality Matters in ADHD Treatment
Suppose you begin ADHD treatment with a generic and respond poorly. Several explanations are possible:
- The medication itself is not a good fit
- The dosage is wrong
- The specific formulation or manufacturer is the problem
Without trying the brand or another manufacturer, you and your prescriber might conclude that you cannot take that medication at all. That could eliminate a potentially useful treatment option based on incomplete information.
This does not mean everyone should reject generics. Many people do well with generic stimulants and generic atomoxetine, the generic form of Strattera.
But the manufacturer should be treated as part of the medication trial.
Pharmacies can change suppliers at any time. One manufacturer’s generic product might not work the same for you as another manufacturer’s version.
When neither the patient nor the prescriber recognizes the switch, however, they might assume:
- ADHD symptoms have worsened
- The dosage needs to increase or decrease
- Another psychiatric problem has “been unmasked”
That can lead to unnecessary medication changes or additional prescriptions. Most of all, it means you never get the treatment you deserve.
Why Extended-Release Delivery Systems Matter
Concerta provides one of the clearest examples.
Concerta is not simply methylphenidate in a long-acting tablet. Its proprietary OROS osmotic-release system controls how the medication is delivered over many hours. That system influences:
- The initial release and final cut-off
- The rising release pattern
- The duration of symptom coverage
Without a comparable delivery pattern, methylphenidate might:
- Begin more abruptly
- Continue erratically
- Wear off sooner
- Produce a rougher rebound
This is why a product can contain the same active ingredient and strength yet fail to reproduce the brand’s clinical effect.
The distinction also explains why Concerta’s former authorized generic was so important.
An authorized generic is the brand manufacturer’s own medication sold under a generic label. In this case, it was actual Janssen Concerta distributed through its Patriot subsidiary at a generic price. Before that, it was distributed by a generic manufacturer called Actavis, as part of a marketing deal with Janssen to forestall the Actavis generic.
PBMs Add a New Barrier to ADHD Medication Access
Medication quality and shortages are only parts of the current problem.
Pharmacy benefit managers, or PBMs, increasingly influence which ADHD medications patients can obtain and how much they must pay. They are growing more restrictive by the day.
PBMs administer prescription benefits for insurers, employers and some government-sponsored plans.
They can help determine:
- Which medications appear on a formulary
- Whether a plan prefers a brand or generic
- Which drugs require prior authorization
They can also impose:
- Step-therapy requirements (requiring trials of “alternative” medications)
- Restrictions on which pharmacies patients may use
A patient might take the same medication successfully for years, only to discover at the next refill that:
- It is no longer covered
- A generic is now mandatory
- Prior authorization is required again
A brand medication might technically remain on the formulary while carrying such a high copayment that it is effectively inaccessible. This creates an irrational form of forced trial and error.
Finding the right ADHD medication, dosage and release profile can take months or years. Once treatment is stable, that stability should have value. Instead, a formulary change can erase years of progress almost overnight.
What to Do When an ADHD Medication “Changes”
Here is a brief overview of how we can start self-advocating.
1. Identify the Exact Product
Before leaving the pharmacy, record:
- Medication and dosage
- Manufacturer
- Date dispensed
- The tablet or capsule appearance and the lot number, when available.
Do not assume that each refill comes from the same manufacturer. Pharmacies can change suppliers without clearly calling attention to the change.
If a medication suddenly looks different, ask:
- Did the manufacturer change?
- Is the previous manufacturer still available?
- Can another pharmacy location obtain it?
Do not rely only on pill color. Appearances can change, and the same manufacturer might use different colors for different dosages.
2. Document What Changed
Track concrete effects for several days.
Record:
- When the medication begins working
- How well it controls symptoms
- When the effect begins wearing off
Also note changes involving:
- Appetite
- Sleep
- Mood or irritability
Pay attention also to rebound symptoms, physical tension, headaches, anxiety and unusual fatigue.
Keep other variables in mind. Medication response can also be affected by:
- Sleep deprivation
- Illness or hormonal changes
- Caffeine, stress or other medications
If you want to ask for a different generic, specific observations are more useful than simply writing, “It doesn’t work.”
For example, this gives the prescriber something concrete to evaluate.
The previous manufacturer provided about nine hours of smooth coverage. The new manufacturer begins working later, wears off after five hours and produces marked irritability in the afternoon.
3. Act on the Evidence
Bring your notes to the prescriber and ask the pharmacist to confirm whether the manufacturer changed.
Depending on the problem, you might need to:
- Request the previous manufacturer
- Ask the prescriber to specify a manufacturer or brand
- Seek prior authorization or a formulary exception
When insurance or PBM restrictions are involved, ask:
- Who imposed the restriction?
- What evidence is required for an exception and where is the form?
- Is step therapy mandatory?
Request answers in writing whenever possible.
Keep copies of:
- Denial letters
- Prior-authorization documents
- Appeal decisions
Bottom line: Do not assume that a sudden loss of effectiveness means ADHD symptoms have worsened on their own or due to environmental factors — or the dosage must increase.
A Short History of Generic Medication Problems
You can use the search term “generic” to find the entire archive here at the ADHD Roller Coaster. Meanwhile, here are some highlights.
2009: Consumer Reports Warns Against Brand ADHD Medications
Many of us trust Consumer Rep
orts for its assessments of everything from freezers to automobiles. But ADHD medications? Not so fast.
I first wrote about this issue after Consumer Reports advised parents not to “rush” children to medications such as Adderall, Concerta and Strattera. It also emphasized cheaper generic choices over brand medications.
Cost is a legitimate concern. But cost alone does not establish that two formulations will work equally well for a particular patient.
Incredibly, the warning also suggested that children might become “hooked” on brand medications. But how would generics containing the same stimulant would somehow carry a different dependence risk?
Read More Here: Consumer Reports: Bad Advice on Generic ADHD Medications
2009: A Wellbutrin Generic Fails Bioequivalence Testing
Hundreds of consumers reported problems with Budeprion XL 300, a purported generic for Wellbutrin XL 300.
Reported problems included:
- Reduced effectiveness
- A return of depression symptoms
- New adverse effects
Joe Graedon of The People’s Pharmacy worked with ConsumerLab.com to test the product. The results showed that it released the medication differently from brand Wellbutrin XL 300. FDA-sponsored testing later confirmed that Budeprion XL 300 was not bioequivalent to the brand.
The lesson applies directly to extended-release ADHD medications: the release mechanism can be central to the therapeutic effect.
Read More Here: Not All Drugs Are the Same After All
2014: FDA Downgrades Two Concerta Generics
ADHD Roller Coaster readers reported that products from Mallinckrodt and Kremers Urban Pharmaceuticals did not provide the same duration or therapeutic effect as Concerta.
I opened an FDA MedWatch complaint, and readers submitted their own reports.
The FDA later changed the products’ therapeutic-equivalence ratings from AB to BX. Th
ey were no longer recommended as automatically substitutable for Concerta.
The issue centered on Concerta’s proprietary OROS delivery system, which these products did not reproduce.
Read More Here: Victory! Concerta Generics Downgraded
2017: Clown Car of Concerta Generics Enters the Market
The FDA action ended the confusion—until 2017, with the appointment of a new FDA Chief by the new administration.
More extended-release methylphenidate products entered the market as Concerta generics, even though they did not use the original OROS technology.
Patients could receive a different manufacturer from one month to the next while the medication name and dosage remained unchanged.
Reported differences included:
- Shorter or insufficient coverage
- Rougher onset or rebound
- Increased irritability
Patients and prescribers often did not recognize the manufacturer switch as the key variable.
2019: Bottle of Lies Examines “Big Generic”
Investigative journalist Katherine Eban’s Bottle of Lies documented disturbing practices within parts of the global generic-drug industry. At previously unimaginable levels, manufacturing of both ingredients and medications is largely happening off-shore.
Her reporting described:
- Data fraud
- Manufacturing violations
- Efforts to mislead regulators
The book did not establish that all generic medications are defective. But it did demonstrate why unquestioning confidence in every manufacturer is not justified.Read More Here: Bottle of Lies Exposes Generic Drugs
2022–2023: Janssen Ends the Concerta Authorized Generic
Janssen ended distribution of its Concerta authorized generic through Patriot in January 2023.
Patients were left with three difficult choices:
- Accept another generic
- Pay more for brand Concerta (if that was even an option on their plan)
- Change medications
The decision came amid stimulant shortages, pharmacy inventory problems, and changing insurance coverage.
Read More Here: Janssen Quietly Ends Concerta Authorized Generic
2023–2026: Vyvanse Generics Disappoint Many Readers
The U.S. patent for Vyvanse expired in August 2023. Soon, multiple manufacturers began producing generic lisdexamfetamine.
Many readers hoped this would improve affordability and access. Instead
, reports included:
- Little or no therapeutic effect
- Shorter duration
- A rougher onset or comedown
Others reported fatigue, anxiety, irritability or different results after switching manufacturers.
These reports do not establish that every generic Vyvanse product fails for every patient. They do demonstrate, however, that “generic Vyvanse” is not one uniform product. The manufacturer matters.
2026: PBMs Further Restrict Access
By 2026, the problem extends beyond generic quality and medication shortages.
Pharmacy Benefit Manager, or PBM, decisions increasingly determine whether patients can obtain the product that works—brand or generic—as well as which specific generics they might access.
Coverage changes can force patients to:
- Repeat failed medication trials
- Accept an unsuitable generic
- Pay an unaffordable price for the brand
Read More Here: PBMs Restrict Access to ADHD medications
Report Significant Problems to FDA MedWatch
If you experience an unexpected loss of effectiveness, adverse effects or a suspected quality problem after a product change, consider filing a report through FDA MedWatch.
Granted, this won’t work as well as it did for us in 2013-14. Big Generic has flooded the market. Last I checked, 20 manufacturers for generic Concerta alone. This makes it exponentially harder to get “critical mass” on one product.
But the FDA does issue warnings to generic manufacturers who violate guidelines. (If they can catch them.)
A report needn’t involve hospitalization or a life-threatening event.
It can describe:
- Loss of therapeutic effect
- Unexpected adverse effects
- Unusually short duration
It can also include problems following a manufacturer switch or suspected defects in the tablet or delivery system.
Provide as much detail as possible:
- Medication and dosage
- Manufacturer
- Relevant dates
- Pharmacy
- Lot number when available
- Clear explanation of what changed
One report might not trigger action. A pattern of detailed reports can reveal a larger problem—as the Wellbutrin and Concerta histories demonstrated.
The Bottom Line: ADHD Generic Medications
Many generic ADHD medications work well. But they should not all be treated as identical to the brand—or to one another.
When a medication suddenly works differently, check:
- The manufacturer
- The formulation and delivery system
- Any new insurance or PBM restriction
Accurate records and detailed FDA reports can help protect both individual treatment and the broader medication supply.
I welcome your comments about generic ADHD medications, manufacturer changes and PBM restrictions.
To be notified of follow-up comments, check the appropriate box below.
—Gina Pera
63 thoughts on “Generic ADHD Medications: Events In the News 2009 to 2026”
I can’t believe how long you’ve been writing about this. I’ve tracked things right along with you and it’s so disappointing that things continue. I’m so glad you keep writing about this issue.
You mention Consumer Reports and I want to add that they lost my confidence years ago, not just for the pharmaceutical issues you mentioned. They misinterpret data and create unnecessary fear about affordable conventional produce and push organic foods without the science to back up their claims. Every year the Dirty Dozen posts come out, I cringe.
Hi Kristen,
I remember!! you were onto this issue way back!
Sorry, I am just seeing this comment now. I didn’t get a notification.
It’s quite stunning to see how things can evolve… When we don’t keep our eye on the ball.
That’s a real human weakness, not recognizing consequences until they slap us upside the head.
All the best,
Gina
Excellent ADHD article! I really appreciate the evidence-based approach and how easy it was to understand.
I feel validated, reading the articles and comments. My daughter and I took Aurobindo dexedrine for several years and did great. Then Aurobindo stopped making it. The pharmacy gave us Teva in the summer of 2020. It was noticably less effective, but we were able to get by. Then they only had Mallinkrodt (Misery in a bottle). We found a pharmacy that has Teva again now (June 2023), and my daughter gets hers filled there, but Teva is weak now and less effective. Sunrise and Teva are both weak. Pharmacy workers still say “it’s supply chain issues”, and I tell them It’s actually government restrictions on the pharma companies, but they still want their profit so they produce medicine with less of the active ingredient to keep their profits up .” And we just have to deal with it. What choice to we have? One pharmacist tries to get Teva now if I let her know in advance every time. I called Aurobindo and they said they would be making it again at a different factory. They are “original recipe” you know. This “shortage”, no matter who is causing it, is damaging people’s lives. I’m not even recognizable as the same person I was three years ago. My daughter lost her job and took a part-time position for now. It’s a different life.
Hi Ellie,
Happy to validate!
Misery in a Bottle…funny, not funny.
Generics have always allowed a huge “margin of error” in terms of how much active ingredient it contains. You can read about that in my other posts on generics.
But I just want to point out….it’s not simply “government restrictions on the pharma companies.” i know that’s often-repeated online but many things often-repeated online are wrong — or overly simplistic.
There is much more happening….things that were allowed to happen during the Trump White House years….that will be difficult to reverse. That will be possible only if consumers understand the full complexity of what’s happening.
You might want to read one of my latest posts on this general topic: https://adhdrollercoaster.org/adhd-news-and-research/pbms-restricting-adhd-medication-access/
cheers
Gina
I learned the hard way that generics aren’t the same as brand, or even as other generics. I’d been on generic Adderall for many years and it was fine until about a year ago.
I think the “Adderall Shortage” started earlier than has been reported. For as long as I can remember (admittedly not very long if you want reliable memory) my pharmacy has filled my prescription with Teva generic Adderall. Last May or June, it suddenly looked different. I looked at the label and the manufacturer was listed as Camber. I didn’t think much of it until 2 or 3 weeks into taking it.
I’m a primarily inattentive ADHD type and suddenly I was having symptoms like physical hyperactivity and talkativeness. I brushed it off because they weren’t a big deal and if I had more energy, that was a good thing! Only it wasn’t a good thing.
I got progressively more irritable, easily angered, had less ability to deal with setbacks, and my coordination started getting off (typical during a part of my cycle but it’s mild and resolves fairly quickly). By mid-July I started becoming violent, which is highly abnormal for me. By this point I was pretty suspicious of Camber’s generic, but that was literally the only kind I could get where I live.
I tried going to another pharmacy in early August, hoping I’d get lucky, but it was Camber again. I punched myself (mostly my head) while I drove home, sobbing. Things really spiraled after that and the shortish version is: I had a psychotic breakdown because of Camber’s generic Adderall. I still have no idea what about it affected me that way.
Oh Vanessa, that is horrifying.
What a dreadful double-whammy…..being given a stimulant that makes things worse — including the ability to self-observe and maybe problem-solve.
This is why I’ve warned about generic ADHD Rx for many years. MDs and pharmacists too often tell us, “Generics are always exactly the same.”
No. No, they aren’t.
I suspect your experience had less to do with the “Adderall shortage,” though, than PBMs (Pharmacy Benefit Managers) constantly creating havoc. I finally have good information to share on that. Look for a post soon.
take care,
Gina
P.S. Please file an FDA MedWatch complaint, if you can. It doesn’t take very long, and you’ve already written the negative outcome here.
I’m not sure what the previous manufacturer was for my Amphetamine XR but my pharmacy switched to Camber’s generic this month, 1/25, and I feel almost no effects compared to the medication I had last month.
Hi Kyle,
I encourage you to note exactly what is different. If you want to make a case for getting the brand again, you’ll need to document why the cheap imitations don’t work.
Also, that stinks.
I’ve written recently about the introduction of a Vyvanse-like product, but in a patch worn on the skin: Xelstrym
It might be that will work well for you. And there is no junk generic for that — yet.
good luck
g
You’re not alone Vanessa and so many of us have been suffering since this shortage. Teva used to be the best generic, but something or things have definitely changed with their formula and not in a good way. For the first time in years, I received Camber’s generic Adderall and took it once and went the rest of the month without their garbage. Couldn’t focus, made me very anxious, depressed, sick to my stomach and had me emotional and crying!! So so tired of this monthly generic Russian roulette and can’t do it anymore. Going to try Teva’s non generic version and if it’s just as bad now as their generic version, I’m done. Will talk to my Dr about switching me to a different ADHD medicine, just no clue which one to do with
Hi Nicole,
That’s rough. It can be hard enough to get the prescription, get it filled, etc… but then to have it be a junk generic….
If you know for sure that you do better in the amphetamine class, you might want to check out Vyvanse or Mydayis. But if you’ve never given the methylphenidate class a good trial, you might want to head in that direction.
Look for those that are still on patent (e.g. Journay PM), so you don’t get stuck with a junk generic.
I provide in-depth guidance on ADHD as a “Physical” issue in my third training, in my Solving Your Adult ADHD Puzzle system.
If you’re sleep is not great, you might want to also focus on improving that. Stimulants don’t treat sleep deficits, and sleep deficits can increase side effects.
https://ginapera.adhdsuccesstraining.com/course-2-physical-strategies
Good luck!
Gina
Oh my goodness, I just realized the same thing with the Camber!! It did not help with my ADHD symptoms at all, my house was way messier than normal, I was talking impulsively, irritable, and I would have a horrible afternoon crash and would need to take a nap. Like absolutely could not keep my eyes open and crash. I thought I was having medical issues and needed my labs run. My friend was trying to convince me I was depressed. I picked up my script which happened to be Lennet generic and it was like night and day difference. I haven’t needed a nap and I actually have some executive function back and have been cleaning things I let get out of control the past month. Only a few days in so I’m hoping no negative symptoms come up with this generic.
I am so sorry you’re going through this and you are not alone. I hope for you and everyone else out there something is done to prevent this huge variance in products.
Hi Ana
Thank you for detailing your experience.
My main motivation for warning about this is exactly as you describe. We’ve been told these generics are “exactly the same“ as brand. So if we start feeling unusual symptoms, we wouldn’t think to attribute it to the change generic manufacturer. We would think something else is going on with us physically.
And if our regular physicians don’t know this, we could go down some very dangerous paths.
I’m happy you learned about this.
Gina
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
Pingback: ADHD Roller Coaster: "Is It You, Me, or Adult A.D.D.?" · A Recap: Consumer’s Guide to Generic Concerta
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
Pingback: ADHD Roller Coaster: "Is It You, Me, or Adult A.D.D.?" · An Update on Generic Concerta
Pingback: ADHD Roller Coaster: "Is It You, Me, or Adult A.D.D.?" · What’s Up With Generic Concerta?
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