What's Going on With Generic Stimulants?

"I open my emails to find yet another message from a patient about their amphetamine-dextroamphetamine (the generic form of Aderall) no longer working. Dr. Plutchik, my meds no longer seem to be helping. Can we discuss increasing my dose or trying another stimulant? This has become a frequent refrain in recent months. Something was affecting the efficacy of certain amphetamine pills despite being dispensed from mainstream pharmacies."

"So I started to ask my patients, Does the pill look different than usual? The answer often was yes, and then the detective work began. I had patients contact their pharmacies to identify which manufacturer made the ineffective batch of amphetamine compared to the previous amphetamines, which was effective. We were able to identify which companies had been providing amphetamines that were ineffective. I encouraged patients to report the problem to pharmacists as well as to request the generic version that previously worked."

Many patients reported sudden loss of effect from generic amphetamine-dextroamphetamine. Changes in pill appearance often accompanied loss of efficacy. Pharmacy investigations linked ineffective batches to specific manufacturers. Patients were advised to report issues to pharmacists and request previously effective generic versions. Some pharmacies reported limited supplier access and dispensed only certain generic manufacturers. Some generic amphetamine products appeared clinically ineffective for some patients. Generic medications must demonstrate bioequivalence for active-ingredient availability at the site of action, but inactive ingredients can differ and may produce different patient responses. Brand-name medications undergo extensive trials.

Read at Psychology Today