Adderall deficiency linked to postponement of ADHD treatment for children
A national shortage of a common treatment for attention deficit hyperactivity disorder was linked to changes in stimulant prescriptions filled for children in recent years, a new study finds. Dispensing of prescription stimulants – a crucial treatment option for children with ADHD – fell sharply at the start of the 2020 Covid pandemic but has begun to recover, according to research in pediatrics. The Federal Drug Administration's October 2022 announcement of a shortage in the stimulant Adderall was followed by a plunge in prescription fills of the medication to children, pre-teens and teenagers. At the same time, however, the giving of other...
Adderall deficiency linked to postponement of ADHD treatment for children
A national shortage of a common treatment for attention deficit hyperactivity disorder was linked to changes in stimulant prescriptions filled for children in recent years, a new study finds.
Dispensing of prescription stimulants – a crucial treatment option for children with ADHD – fell sharply at the start of the 2020 Covid pandemic but has begun to recover, according to research in the studyPediatrics.
The Federal Drug Administration's October 2022 announcement of a shortage in the stimulant Adderall was followed by a plunge in prescription fills of the medication to children, pre-teens and teenagers. At the same time, however, the delivery of other types of stimulants grew.
Our results suggest that Adderall deficiency did not cause many children to stop stimulant therapy altogether, but did force some to switch to alternative stimulants. “
Sijia HE, MS, senior author, researcher at the University of Michigan Susan B. Meister Child Health Evaluation and Research Center
"This might be necessary if the switches may have led to worsened ADHD control. We need more research to evaluate whether any switches have led to adverse outcomes."
He and colleagues analyzed changes in stimulant use to children ages 5 to 17 between 2017 and 2023 using national data that captures 92% of U.S. prescriptions.
The research is believed to be one of the first national studies to assess trends in stimulant prescribing for children during the Covid-19 pandemic and Adderall shortages.
At the start of the pandemic in March 2020, researchers found that the monthly stimulant donation rate for children fell by nearly 455 children per 100,000 - or a decline of nearly 19% compared to January 2017.
After March 2020, this rate has slowly increased each month. In October 2022, when the Adderall shortage emerged, delivery rates for Adderall decreased while delivery rates for dexmethylphenidate, commonly known as Focalin, increased.
The authors found that changes in stimulant delivery varied by age and gender. For example, male adolescents ages 12 to 17 recovered at a lower rate than other groups. This December 2023 stimulant dispensing rate for male adolescents was 19% lower than expected based on pre-pandemic trends.
For boys ages five to 11, the stimulant dispensing rate in December 2023 was similar to expected.
The rate of stimulant dispensing was 9% higher than expected among girls ages five to 11, consistent with a previous study showing that children with ADHD diagnoses were more likely to be girls during the pandemic compared to previous years.
"A potentially optimistic explanation of these results is that they represent a reduction in the underdiagnosis and undertreatment of ADHD in girls" CS Mott Children's Hospital and the Susan B. Meister Child Health Evaluation and Research Center.
"It is also possible that symptoms of inattention have increased in girls during the pandemic, increasing their need for stimulants," Chua added.
Addressing the stimulant shortage for children
ADHD is the most commonly diagnosed neurobehavioral disorder among us children. Prescription stimulants are often a first-line treatment, making them the most commonly prescribed controlled substances to children in the country.
The rate of stimulant discontinuation among children may have changed during the Covid-19 pandemic as many children have transitioned to virtual learning, Chua says.
Additionally, access to in-person healthcare has been disrupted, potentially reducing the ability to diagnose and treat ADHD, although Chua notes by a policy allowing stimulant prescriptions to be provided via telehealth without an in-person visit.
The FDA pointed to both manufacturing problems and unprecedented demand for stimulants in the U.S. – particularly among adults – as factors that led to the 2022 Adderall shortage.
Chua said policymakers could consider increasing limits on stimulant production to ensure children do not face barriers to accessing stimulants, even as demand for stimulants continues to rise among adults. It also highlights the need to ensure appropriate stimulant use for adults, including the development of guidelines for the diagnosis and treatment of ADHD in adults.
“Our results indirectly show how demand for a class of drugs among adults adversely affects access to these treatments for children,” he said.
"It is critical to address the shortage of stimulants because so many children rely on them. Untreated ADHD symptoms can impact children's health and learning."
Sources:
Hey, S.,et al.(2025). Prescription Stimulant Dispensing to US Children: 2017–2023. Pediatrics. doi.org/10.1542/peds.2024-068558.