Since last fall, federal agencies and doctors have warned about shortages of medications that are part of the treatment for people diagnosed with attention deficit hyperactivity disorder (ADHD), an unresolved supply problem that has a worrying outcome in Puerto Rican patients, especially in children, adolescents. and young people.
In October 2022, the Food and Drug Administration (FDA) announced a shortage of mixed amphetamine salts, the main ingredient in the drug Adderall, a drug used to control the symptoms of ADHD. Although some companies tried to reduce the delays in the production of the drug, the fact is that there is not enough supply to continue to satisfy the demand of the US market through these producers, Robert M. Califf, warned the new- or only on August 1, commissioner of the FDA, and Anne M. Milgram, director of the United States Drug Enforcement Administration (DEA).
“As leaders of the FDA and DEA, we recognize the important role that prescription stimulants play in the treatment of conditions such as attention-deficit/hyperactivity disorder or narcolepsy. The lack of availability of certain drugs in new- These months have been known to be frustrating for patients and their families,” officials said in the publication, explaining that while the agencies do not manufacture drugs, they do not require a pharmaceutical company to it can.they work with those involved to prevent the impact of the shortage.
But, what is the scenario in Puerto Rico, especially with the child population?
In an interview with Primera Hora, child and adolescent psychiatrists Dimas Tirado Morales and Eric Martínez confirmed that the lack of medicine has become felt on the island and, although there is progress during the ting -hot – attributed to the fact that at this time many parents. and mothers choose not to treat their children – the reality is that when school returns the situation becomes worse again with an increase in demand.
“It improved over the summer, because many patients were off the medication, but now that they’re back in school, they’re starting to have problems (in the classrooms) and parents are making appointments to get back on the medication. . In fact, the shortage is a nightmare in Puerto Rico and in the United States and I know this because I also work in (the city of) Philadelphia. The problem here is that, above all, there is a terrible stigma of these drugs. There is an impression that many people use them to abuse, sell or transfer them, but in the case of children and teenagers we are talking about a drug that helps a lot in their quality in life. So, parents find themselves in this problem of lack and they are disappointed because it has a great impact on the health of their children… I have a mother who went to more than 10 pharmacies looking for medicine and when she found It’s in another municipality, the one they had available was of other milligrams to that prescribed,” explained Tirado Morales, who provides private consultations and hospitals in the west and southwest areas of the island.
According to the Centers for Disease Control and Prevention (CDC), an estimated 6 million children and adolescents between the ages of 3 and 17 have been diagnosed with ADHD, which equates to 10% of the child population. However, it is between 6 to 11 years of age (10%) and 12 to 17 years of age (13%) that many cases are diagnosed, precisely when they go to school. Males (13%) are more likely to be diagnosed compared to females (6%).
Tirado Morales emphasized that patients with ADHD should be re-examined by a psychiatrist and not all of them need medication. But for those who need the drug, their performance in their daily life will be affected if it is stopped suddenly.
“But there are many who benefit from drugs known as stimulants and, commercially, they are available under names such as Aderall, Ritalin, etc. There are other treatment alternatives, but we know from studies that stimulants are the first line of care for children and adolescents with ADHD,” said the psychiatrist.
On his part, emphasized by Dr. Martínez is another problem with the scenario: “It’s not just a lack and I’ll tell you that there’s nothing left inside. The reform (Plan Vital) and other medical plans cover these patients with cheap or generic drugs, when they know that there are more sophisticated treatments that are administered only once a day and are more effective. But because it is expensive, they do not administer it to children. So they were left without one and the other due to lack of supplies. ”
“This shortage problem started in the pandemic when it affected the production of these and other drugs. The situation is that, if these children stop taking these drugs – and even more so now that they have started to schooling – the risks of dropping out of school, behavior problems begin, and there are cases that end up in hospitalization because of their deterioration. , “said Martínez, director. in the special mental health unit of the San Jorge Hospital, in San Juan, the only institution in Puerto Rico that cares for partial or intensive hospitalization of children between 5 and 12 years old.
Pediatrician Glory Serrano expressed herself in a similar way a few weeks ago through Facebook, warning about the lack of medicines, while giving advice to parents.
For example, he reiterated the importance of consulting a doctor and asking for a prescription before returning to school. In that sense, he made a reservation that some pharmacies with medical plan covers only accept prescriptions from psychiatrists or neurologists.
Serrano also emphasizes observing any side effects that patients show when consuming medications, especially if their doctor replaces what they used before.
“Always offer breakfast before taking medicine, because it suppresses appetite,” said the child’s doctor.