Adderall is in short supply, and the backlog is having a domino effect on other stimulants.

Welcome to the Carlyte Psychiatry Podcast, keeping psychiatry honest since 2003.

I'm Chris Aiken, the editor-in-chief of the Carlat Psychiatry Report.

And I'm Kelly Newsom, a psychiatric MP and a dedicated reader of every issue.

On October the 12th, 2022, FDA announced a shortage of instant-release adderol.

Like a lot of companies, Tiva Pharmaceuticals, the main manufacturer of generic Adderall,

had trouble hiring people.

The adoril shortage has had a cascading effect as patients switched to other meds to replace

it. Many of us are now counseling patients over amphetamine withdrawal symptoms, which include

mood swings, irritability, depression, headaches, jitteriness, intense fatigue, and gastrointestinal

distress. Stimulate withdrawal is not fatal, but it can have a very fatal consequence in

today's world. Many street versions of Adderol are laced with fentanyl, and that could lead to

unexpected deaths if patients turn to non-prescribed sources to get the med,

not to mention the risks of automobile and other accidents with untreated ADHD.

Tiva is still struggling with the manufacturer and expects the shortage to continue at least

until March 2003.

Part of the reason for the shortage is an increase in demand. During the pandemic, online practices

like cerebral and done took advantage of the relaxed prescribing laws to offer easy access to

controlled substances. Clinicians at these practices blew the whistle to the Wall Street

Journal last year,

with tales of pressure from upper management to prescribe stimulants and benzos without a proper evaluation.

The Department of Justice and the Drug Enforcement Agency have been investigating these companies,

...