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REPORT: THE ADHD MEDICATION CRISIS

28th November 2023

ADHD medication has been out of stock for many since the  NHS issued a Patient Safety Alert on the 27th of September 2023.

The alert said that “the supply disruptions are expected to resolve at various dates between October and December 2023. 

The main ADHD medication provider Takeda has told us that they expect ADHD medication supply issues to continue until April 2024. We’ve been given a statement by Takeda and to ensure you are fully informed we are publishing it in full below.

Since the patient alert, as indicated to us, some medication has been manufactured and distributed. Takeda have indicated this intermittent disruption will continue with an inference that it will improve over time. We have asked for clarity on what that means in terms of medication for patients in the UK and what we should expect in terms of the availability of their medication during this period.

Our survey shows the vast majority impacted so far – with just 8% unaffected. Most people who receive ADHD medication have either had no medication or gaps in medication. Takeda report an expansion of their “intermittent supply” issues until April.

Our full report is on this page. You can also click the image to download a PDF version.

2023.11.28 Medication Crisis Front Cover

Statement from Takeda UK on their medication supply timings

The impact that these supply disruptions across industry are having on patients and healthcare professionals is our biggest concern. From a Takeda perspective in the UK, we are doing our utmost to resolve this issue as quickly as possible and also ensure supply continuity into the future.

Limited stock of different dose strengths across our ADHD medicines are becoming available at various times, however we are anticipating that there may be intermittent disruption until April 2024. For full clarity, this does not mean that no stock is available until April 2024, but that supply will be available on an intermittent basis. Therefore, we would suggest patients keep in close touch with their pharmacy so they are able to access medication as soon as it becomes available. In accordance with regulatory requirements, Takeda also continues to fully notify the Department of Health & Social Care of all stock shortages.

Should you like to speak with Takeda, and please contact us using the details provided below. If your questions relate to your ongoing treatment plan specifically, please speak with your primary healthcare professional or pharmacist.

Takeda UK Ltd.

Medical Information e-mail: [email protected] 
Med Info. direct line: +44 (0) 3333 000 181
Drug safety e-mail:  [email protected]

Takeda UK

A Department of Health and Social Care spokesperson said: “Disruptions to the supply of medicines used for the management of Attention Deficit and Hyperactivity Disorder (ADHD) have been primarily driven by issues which have resulted in capacity constraints at key manufacturing sites.

 “We understand how frustrating and distressing medicine shortages can be and we want to assure patients that we are working intensively with suppliers to ensure that action is taken to improve the supply position. Some issues have now been resolved.

 “We have issued communications to the NHS to advise healthcare professionals on management of patients whilst there continue to be disruptions to supplies. Patients are advised to speak to their clinician regarding any concerns they have and to discuss the suitability of treatment with alternative medicines.”

 Background:

  • Disruptions to the supply of medicines used for the management of Attention Deficit and Hyperactivity Disorder (ADHD) have been primarily driven by issues which have resulted in capacity constraints at key manufacturing sites.
  • Following notifications of supply issues by manufacturers, we issued guidance in September, in the form of a National Patient Safety Alert, advising healthcare professionals to not initiate new patients on the affected presentations until the supply disruptions resolve, to liaise with usual pharmacy dispensing services to establish availability of supply and to refer to ADHD specialists where appropriate.
  • There are currently supply disruptions affecting methylphenidate prolonged-release capsules and tablets, lisdexamfetamine capsules, guanfacine prolonged-release tablets and atomoxetine capsules, which are licensed for treating patients with Attention Deficit Hyperactivity Disorder (ADHD).
  • The affected products include the following:
    • Methylphenidate:
      • Equasym XL® 10 mg capsules
      • Xaggitin XL® 18 and 36 mg prolonged-release tablets
      • Xenidate XL®  18mg and 27 mg prolonged-release tablets
    • Lisdexamphetamine:
      • Elvanse® 20, 30, 40 and 70 mg capsules
      • Elvanse® Adult 30mg and 70mg capsules
    • Guanfacine:
      • Intuniv® 1, 2, 3 and 4 mg prolonged-release tablets

We have published a list of currently available and unavailable ADHD products on the SPS website, This will be regularly updated to ensure those involved in prescribing and dispensing can make informed decisions.

The following ADHD products have been resupplied since October 2023: [NOTE FROM ADHDUK. RESUPPLY MEANS STOCK AT SOME POINT AS COME THROUGH [AS WE WERE TOLD IT WOULD] NOT THAT IT IS NOW IN STOCK OR WILL REMAIN IN STOCK. WE HAVE REQUESTED BETTER CLARITY ON EXPECTED SUPPLIES FROM TAKEDA]

    1. Elvanse Adult 50mg capsules
    2. Elvanse 50mg capsules
    3. Elvanse 60mg capsules
    4. Atomoxetine 10mg capsules
    5. Atomoxetine 18mg capsules
    6. Atomoxetine 25mg capsules
    7. Atomoxetine 40mg capsules
    8. Atomoxetine 60mg capsules
    9. Atomoxetine 80mg capsules
    10. Atomoxetine 100mg capsules
    11. Atomoxetine (Strattera) 4mg/1mL oral solution
    12. Equasym XL 20mg capsules
    13. Equasym XL 30mg capsules

Supply issues with ADHD drugs are not confined to the UK. We have added ADHD products containing, methylphenidate, lisdexamfetamine, guanfacine, atomoxetine and dexamfetamine to the export restriction list to protect available supplies for UK patients. [NOTE FROM ADHDUK: THE MAIN MEDICATIONS IMPACTED ARE NOT MANUFACTURED IN THE UK SO THE EXPORT RESTRICTION IS FAIRLY MEANINGLESS. SIMILAR TO PUTTING AN EXPORT RESTRICTION FOR CHAMPAGNE ON JANUARY 2ND] We continue to monitor the entire picture before considering removing any of these products from this list.

We are working intensively with manufacturers and asking them to increase supply for the UK. Manufacturers have responded to our call to action and have increased supplies and adjusted future demand forecasts to meet the current growth in demand for the UK. We will continue to work closely with individual suppliers to ensure stock continues to be made available and they are able to meet the growth in demand.

The production of medicines is complex and highly regulated, and materials and processes must meet rigorous safety and quality standards. Supply problems can arise for various reasons such as manufacturing issues, problems with the raw ingredients, sudden spikes in demand [NOTE FROM ADHDUK: ADHD MEDICATION IS TRACKED PUBLICLY BY THE NHS [AND US] AND HAS BEEN GROWING PREDICTABLY DURING RECENT YEARS. THERE IS NO SPIKE IN DEMAND AND THE GROWTH IN NEED SHOULD BE CELEBRATED AND THE GROWTH PREDICTABILITY MEANS IT IS NOT A REASON FOR THIS ISSUE] and batch failures.

The department has well established processes to manage and mitigate supply issues and continues to work with the respective manufacturers and all relevant stakeholders to ensure that the supply disruptions are resolved as soon as possible.

5th December 2023, Department of Health and Social Care

We report the findings of our survey about ADHD medication, which shows the failure of government advice and the devastating impact of the loss of ADHD medication to people with the condition. Over 38% of respondents (details below) who take medication for their condition have had suicidal thoughts or an increase in suicidal thoughts since the start of the crisis.

The Government continues to utterly fail those with ADHD. The failure to take ADHD seriously has resulted in waiting lists of up to 10.5 years for adults and up to 5 years for children. We today find out that despite Government promises to work and resolve this with manufacturers the ADHD medication crisis is extending to April 2024. With no real assurances, it won’t extend further. We’re calling for the government to put in place a support for those impacted – to help them keep their jobs, preserve their education, and fundamentally to ensure we don’t lose anyone to suicide.” 

Henry Shelford

CEO and Co-Founder ADHD UK. Personally impacted by the medication issues.

Survey Results

Survey from 18th November 2023 to the 27th November 2023. Total respondents: 1054

(Please note that individual questions have different numbers of people answering)

    • 94% are dissatisfied with the government’s response. When asked “Do you agree with the following: I am satisfied with the government’s actions during this ADHD medication crisis”.
    • 97% have been impacted by the ADHD medication supply issue.
    • Only 15% of people (with an ADHD prescription) were actively contacted by their GP (as required by the National Patient Alert). 25% have still had no contact. 11% had their prescriptions stopped to force them to contact their GP. This has made the situation worse as individuals, instead of automatic renewal, were forced to join the morning race for a GP appointment.
    • Only 13% of people with an ADHD prescription are satisfied with their GP’s actions. The majority are dissatisfied.
    • The vast majority have had their personal medication impacted. Only 8% have had uninterrupted medication. 27% have had no medication since the supply issues started, 33% have had long gaps and 25% have had short gaps.
    • 70% have rationed their medication (taken days without or taken partial pills).
    • 91% of those who take ADHD medication are concerned on the impact on their job with 44% overall concerned they may lose their job.
    • 92% of those who take ADHD medication and in education are concerned about the impact on their grades and future prospects.
    • 75% of those who take ADHD medication and in a relationship are concerned about the impact on their relationship. With 28% thinking they may lose the relationship
    • ADHD has a much higher suicide rate than the baseline with 1 in 10 men with ADHD trying to take their own lives and 1 in 4 women with ADHD trying to take their own lives. Our research shows an increase in individuals with new suicidal thoughts or increased suicidal thoughts of over 38%.

    We are calling for the government to:

    • Create a national commission to recommend a strategy for medication supply issues like this one. The ADHD medication supply issue is not a solitary event. These issues are collectively common. We are calling for the government to create a strategy to identify those most in need and get medication to them. 98% of our respondents agree. 
    • Accelerate the Access to work disability job support system for those impacted by the ADHD medication crisis. Help people keep their jobs by adding those struggling without ADHD medication to the priority queue for Access to Work support. The priority queue is around a 2-week wait. The non-priority queue is 5 months. People need help now – not in 5 months. 
    • Create a support package and strategy for schools. 
      • Commission the Department of Education to issue guidance to exam boardsThere are exams in January and an impact on the summer exams. Exam boards need to know what adjustments to make and the government needs to ensure a budget to implement those adjustments.
      • Commission the Department of Education to produce a support package for schools. 

    ADHD UK Press Contact Information: Click here

    ADHD UK Background information on ADHD: Click here

    Appendix : Detailed Results 

    Do you agree with the following: I am satisfied with the government's actions during this ADHD medication crisis.

    Strongly agree
    Agree
    Neutral
    Disagree
    Strongly disagree
    Total
    Individuals
    27
    2
    30
    129
    765
    953
    Percentage
    3%
    0%
    3%
    14%
    80%

    Have you been impacted by the ADHD medication supply issues?

    97% of people with an ADHD diagnosis have been impacted by the ADHD Medication Supply issues.

    No
    Yes
    Total
    Individuals
    28
    831
    859
    Percentage
    3%
    97%

    Do you agree with the following: I am satisfied with my GP's actions during this ADHD medication crisis. 

    Only 13% of people with ADHD medication are satisfied with their GP’s action.

    Strongly agree
    Agree
    Neutral
    Disagree
    Strongly disagree
    Total
    Individuals
    29
    82
    283
    150
    310
    854
    Percentage
    3%
    10%
    33%
    18%
    36%

    How has your medication been impacted?

    No medication since supply issue began
    Long gaps
    Short gaps
    No gaps
    Total
    Individuals
    230
    282
    214
    73
    861
    Percentage
    27%
    33%
    25%
    8%

    What actions have you taken?

    I've rationed by medication
    I've spoken to my pharmacist
    I've called around multiple pharmacies
    I've taken out of date medication
    Total
    Individuals
    603
    550
    587
    84
    861
    Percentage
    70%
    64%
    68%
    10%

    Do you agree with the following? I am concerned about the impact of this crisis on my job performance

    Strongly agree
    Agree
    Neutral
    Disagree
    Strongly disagree
    Total
    Individuals
    404
    135
    22
    5
    24
    590
    Percentage
    68%
    23%
    4%
    1%
    4%

    Do you agree with the following? I am concerned I may lose my job because of the ADHD medication crisis?

    Strongly agree
    Agree
    Neutral
    Disagree
    Strongly disagree
    Total
    Individuals
    404
    135
    22
    5
    24
    590
    Percentage
    21%
    23%
    28%
    22%
    7%

    Do you agree with the following? I am concerned I about the impact on my grades and future prospects from the impact of this ADHD medication crisis.

    Strongly agree
    Agree
    Neutral
    Disagree
    Strongly disagree
    Total
    Individuals
    153
    22
    5
    1
    9
    190
    Percentage
    81%
    12%
    3%
    1%
    5%

    Do you agree with the following? I am concerned about the impact of this crisis on my relationship.

    Strongly agree
    Agree
    Neutral
    Disagree
    Strongly disagree
    Total
    Individuals
    163
    228
    61
    45
    23
    520
    Percentage
    31%
    44%
    12%
    9%
    4%

    Do you agree with the following? I am concerned I will lose my relationship due to the impact of this medication crisis.

    Strongly agree
    Agree
    Neutral
    Disagree
    Strongly disagree
    Total
    Individuals
    56
    91
    117
    148
    108
    520
    Percentage
    11%
    18%
    23%
    28%
    21%

    ADHD has a high rate of suicide. ADHD UK has been lobbying that there should be a scheme to identify those most at risk of suicide and a scheme to get medication to them. Do you support this?

    Yes
    No
    Total
    Individuals
    807
    20
    827
    Percentage
    98%
    2%

    Are you having suicidal thoughts, or increased suicidal thoughts, as a result of the ADHD medication crisis? [Those who are taking ADHD medication]

    No
    Yes
    Total
    Individuals
    593
    362
    955
    Percentage
    62%
    38%