I’m a senior journalist at MedShadow — a nonprofit foundation dedicated to promoting the safest use of over-the-counter and prescription medications — and we’ve recently published two articles about potential issues with switching between ADHD medications made by different manufacturers. When we shared these articles on social media, we received more than a thousand comments from patients expressing their struggles and frustrations they’ve experienced when being switched from medication made by one manufacturer to another. I’m working on an article featuring doctors’ perspectives on the issue, and I’m hoping to receive expert responses to the following questions: Is this something you’re seeing in your own practice? What do you do when a patient comes to you with concerns like these? How do you recommend patients handle medication switches? Anything you’d like to add?

I'll frequently take the time to remind my patients to reach out to me with any questions, and when I have space in my schedule, I'll proactively reach out to patients when they're making medication switches. In some cases, the only change is the name on the label, but in others, there are different side effects from the same medicine made by different manufacturers. The placebo effect is also a real thing, and can have an impact here. If a patient is struggling with a new medication, I prefer to know about it sooner rather than later so we can find a good solution together.

Good Day, Is this something you're seeing in your own practice? Yes we are. I see patients report to me that they notice changes in the way their ADDERALL or methylphenidate is working for them after a switch to a different generic manufacturer. Although generics are supposed to be equivalent we are finding that differences in release agents or fillers play a role in how the drug performs for the patient. What do you do when a patient comes to you with concerns like these? I approach it seriously. We go over their past prescriptions to find which manufacturer did the best for them. Also I will get in touch with the pharmacy or write out a new script that specifies that particular manufacturer. If that doesn't work out I will put in a prior auth or look at different forms of the medication. How do you recommend patients handle medication switches? Have them track any changes in the look of the pill, in their symptoms, in side effects. If they notice something is off they should bring it up to their provider and also ask the pharmacy which manufacturer filled the script. You can request a certain version if it is available and that the same version be used for future refills. Anything you'd like to add? We need to do a better job in the field of bringing to light that not all generics are created equal, especially with ADD and ADHD meds. Small changes in formulation can have large scale results. Patients should not have to fight each month for the same version of what works for them. If you decide to use this quote, I'd love to stay connected! Feel free to reach me at gregorygasic@vmedx.com and outreach@vmedx.com.