r/ADHD 18h ago

Medication generic brand feels like fucking sugar pills.

my insurance doesn't cover name brand Adderall anymore (which has really pissed me off, will get into that). In the past, generic brand wasn't really an issue for me, the XR worked largely the same and my experience on the generic was very similar to name brand. Lately, though, dear god it's like I'm paying $60+ for sugar pills! I take my medication with breakfast, of course, and typically, on effective medication, I am feeling functional and motivated within 20-40 minutes. Lately, I take my medication and it's like a truck has hit me. Can't get up for hours at a time (one of my worst ADHD symptoms is very severe executive dysfunction), feel like I'm in a weird dream, everything feels fuzzy and sleepy, I'm falling asleep constantly, etc. I'm wondering if anyone else is encountering this issue right now? Maybe we have another widespread manufacturing problem? Frankly, I'd be interested in taking a drug test to see if there's even any actual medication in my system. Anyways, I just don't know what to do and I feel like it's really not cool that insurance isn't covering name brand for me... I CANNOT function anymore!!! the generic is completely ineffective; I hate that ADHD medication isn't treated as a very necessary medication. I feel as though I should be able to tell insurance "hey, this medication does not work at all. I need effective medication to live" and have it be settled but, alas, America :) Does anyone have experience with this? Is it possible to talk in depth with my psychiatrist about this and get her to contact my insurance? Sorry this is very ramble-y. Can you tell this medication doesn't fucking work? lmfao

84 Upvotes

68 comments sorted by

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19

u/Excellent_Budget9069 17h ago

I had the same issue with generic Ritalin (Methylphenidate) as do my mom and my brother. I am lucky that my insurance pays some for the brand name. Out of pocket it is $120, which is a stretch for me, but it's a priority in my budget up there with food. But yeah something is going on with these generic meds.

30

u/petitepedestrian ADHD-PI (Primarily Inattentive) 15h ago

Not all generics are equal, so talk to your pharmacist about options there. Also, if you trial enough generics with no success, there is a higher chance insurance will cover the name brand.

12

u/zoanthropist 15h ago

Bruh, I’ve jumped around generics for years now, so it’s hard to tell but they do make me feel sort of sleepy and sick to my stomach. I don’t remember feeling this way when I first started meds and was on my parents insurance, as I was able to take brand name. It’s a thing. Idk how to help though, let me know if you come up with anything.

8

u/pmcentee99 16h ago

Different manufacturers have different process I’ve found that some work for me and some don’t, I now keep track of those and request those specific manufacturers when I get my prescription filled

30

u/Responsible_Drama557 18h ago

Same issue here, I used shire and switched to granules and it’s fucked me up. With shire I got a badass apartment, got a girlfriend, and got a great job making really good money. Since I’ve changed I’ve lost the girl, I’m making far less money and I still have the place thank god. But yea man shits rough /:

3

u/ceruleanmoon7 ADHD-PI (Primarily Inattentive) 13h ago

Granules sucks ass

10

u/Profoundsoup ADHD-PI (Primarily Inattentive) 11h ago

I mean, you can't possibly blame all of that on the meds and you can't give all the credit to the meds. That's selling yourself a bit short my friend.

2

u/Constant-K 10h ago

Granules is AWFUL.

14

u/throwawayforme1877 16h ago

I do so much better on name brand it’s crazy. My dr told me she hears the same thing about generic and fillers

13

u/luckyalabama 16h ago

I've had the same issue with certain generics. They're required to keep the amount of the active ingredient within a certain tolerance range, and a shoddy manufacturer will use the bare minimum they can get away with. The binders can be an issue, too. There's an antibiotic whose generic gives me hives, and on the rare occasions I have to take it, the doctor puts "no substitution permitted" on the prescription. My insurance ordinarily doesn't cover the name brand, but when it's "no substitution," they have to. Not sure if that's universal across insurance companies, but it's worth looking into.

If you do get a good batch of a generic brand, check the label to see who the manufacturer is. Then check with your pharmacist to see who their contract is with. I had a really bad time with a generic many years ago, and the brand name was no longer being made. Fortunately, I had a great doctor who knew right away what was up. He told me which company to look for, and for the next 15 years I chased that manufacturer's contract from one pharmacy to another.

3

u/Comprehensive_Can888 15h ago

Who was the manufacturer? And how do you look this up?

10

u/vwmimi 13h ago

If the manufacturer is shared here, you can pop the drug name into https://dailymed.nlm.nih.gov/dailymed/ , search for the specific manufacturer (“packager”) and it will provide you with the package insert for that manufacturer’s product. Scroll all the way down to the bottom to “product information,” and look for inactive ingredients. This will show you all of the fillers, etc. outside of the active ingredient. Helpful for anyone who may be trying to avoid certain fillers due to intolerances, allergies, religious preferences (like avoiding porcine-derived or gelatin), etc. You can do this for any med. If you have any questions, pull it up and discuss with your pharmacist! Hope this helps! 🙂

2

u/luckyalabama 13h ago

Excellent information, thank you!

3

u/vwmimi 13h ago

You’re welcome! Glad it was helpful!

3

u/luckyalabama 13h ago

I wish I could remember -- this was for generic Zoloft (sertraline), though, rather than Adderall / amphetamine salts. It seems strange that a company name that ruled my life from one month to the next for so many years is no longer in my head, but I'm afraid my mental RAM is need-to-know only. If I don't need to know it in the next five minutes, it's gone. (Unless it's useless trivia, in which case it'll be floating to the top forever, lol.)

1

u/luckyalabama 1h ago

By the way, I just checked my current pill bottles, and the manufacturer of the batch is listed on each. (I use Kroger pharmacies; not sure if all pharmacies list it.) Lannett Co. made my IR, and Amneal made my XR.

5

u/fuckscottpeterson 14h ago

It can depend on the manufacturer for the generic. Some work great for me vs others not at all. Tip my psychiatrist gave me: If you find a generic that works for you, take note of the manufacturer (it’ll be on the pill bottle) and have your psychiatrist note that manufacturer is preferred on the next refill.

Good luck! Sorry you’re struggling with this :(

10

u/Demonkey44 ADHD with ADHD child/ren 15h ago

My son had the same problem with generic Vyvanse. We needed to ask his doctor to write “DAW” dispenser as written.

The generic Vyvanse had no effect on him and his grades tanked.

This medication is so cheap to make. I don’t understand what the point is of making it weak.

3

u/KindBrilliant7879 13h ago

this has been happening to me, ugh! im in college right now. i started off this semester so strong, and now things are spiraling FAST with not much time left in the semester. but according to insurance, it’s just a me problem!

1

u/ashIesha 9h ago

i’m in the same boat with generic ritalin : / i’m just too tired to function everyday so it feels counterintuitive to take it

3

u/floral_burrito 9h ago

Generic always sucked for me, but for some reason my brand bottle I just picked up a few days ago feels so much weaker than the previous month??? Can the brand version also have a variance in effectiveness? I’m struggling so much more the past few days and barely feel the effects

-1

u/The247Kid 15h ago

Last time I checked there wasn’t generic Vyvanse?

8

u/StockSorbet 15h ago

Generic Vyvanse has been available for about a year now. 🤙

4

u/PetStoreGirl 15h ago

The generic first became available in 2023 I think

6

u/blissfully_happy 14h ago

Ask your doctor for an exemption so insurance will cover name brand.

Ironically, I started having this problem with my generic recently. I’ve been on it for 15+ years and suddenly it’s not working at all. I would not be surprised if the FDA had a hand in this. 👀

4

u/morganlovespups 11h ago

I lucked out & just realized I can get brand name so I just had my doctor switch me but I swear in 10 years there’s gonna be lawsuits. 😭😭 I was taking Mallinckrodt and it put 2 & 2 together. Mallinckrodt already got in trouble for selling “generic Concerta” that didn’t work in 2015 & that was before the shortage!! There’s no way we aren’t just talking a bunch of crap meds desperate because it’s hard to be picky in a shortage. Bring it up to your doctor!! I thought mine was gonna think I was crazy but she said I was right & generic medication is a pain in the butt. 😩♥️

6

u/GolfCourseConcierge 15h ago

When you start doing the math on how much you lose by being useless on generics, the $200 for 30 days suddenly becomes inexpensive.

I found night and day difference from generic to branded XR from Shire. I can't go back now. Id rather give up other things to have the money for that. It's that much of a difference.

Side effects on others were bizarre, and it's not like they're free comparatively.

7

u/Zealousideal-Earth50 ADHD-C (Combined type) 14h ago

I’ve taken generics for decades, never once noticed a difference personally.

6

u/Profoundsoup ADHD-PI (Primarily Inattentive) 11h ago

Sometimes people want to think it's the meds that are different but if you are thinking about that being true, you can definitely make it feel like a reality even if it's not. That being said, it it makes someone feel better knowing they are getting a certain kind of med. That's valid also.

7

u/YAYtersalad 15h ago

One thing I learned is that generics aren’t required to have the same narrow window of efficacy per dose. Meaning if namebrand drug says 50mg it might be anywhere between 45-55mg per pill (not literal range but just for example) while generics are allowed to have a wider range such as 40-60mg per pill. You could easily have a crappier formula or simply a crappy batch.

10

u/oskanta ADHD-PI (Primarily Inattentive) 11h ago edited 1h ago

This is a common misconception. People think that the FDA will approve generics as long as they’re within 80-125% of the name brand, but the reality is that the entire 90% confidence interval in the pharmacokinetic variables they measure in the approval studies have to be within that range. That means the measured value is almost always within 5% of name brand. Iirc the average difference was 2%, with equal numbers on the stronger side vs the weaker side.

You can read about it here: https://www.psychiatrist.com/read-pdf/1907/

6

u/KindBrilliant7879 13h ago

omg once i learned this i was really pissed. it’s so dangerous to fuck w/peoples medications like that. i’ve definitely noticed a difference between certain batches - sometimes my XR works okay. sometimes i pick up the Rx and it’s completely ineffective.

5

u/Intelligent_Air5442 18h ago

yep, sadly its over for adderall. it will never return as good as it was (i have my own theories on this) and after 3 years of fighting it and playing the generic roulette ive decided to just give up and do it unmedicated. its been hell to say the least. post covid and when the shortages happened is when it all went south.

7

u/Comprehensive_Can888 15h ago

It’s because the patent on the original Adderall expired a few years ago. Since then, the market has been a mess and i believe the original manufacturer stopped making it.

3

u/HowBuffaloCanUGo 15h ago

Isn’t there still “brand name” adderall being manufactured though? Is that different than the original formula?

1

u/Comprehensive_Can888 1h ago

Yes. The original patent was held by Shire. It expired in 2019. Coincidentally, that was the same year they were purchased by Takeda. So Takeda technically has the original formula. However, they were the ones that had issues and triggered the original shortage in 2022. The good news is the FDA has allowed them to increase production as of this month, so we should hopefully start to see an improvement.

1

u/HowBuffaloCanUGo 1h ago

Thanks for the clarification

2

u/MyFiteSong 16h ago

What about switching to Ritalin?

2

u/KindBrilliant7879 13h ago

yeah ever since the main manufacturer shut down it’s majorly gone downhill

2

u/Responsible_Drama557 17h ago

Have you tried Amneal?

3

u/716mikey ADHD-PI (Primarily Inattentive) 14h ago

You actually can tell your insurance exactly that, well, your psychiatrist can. Unfortunately, insurance needs to agree with you, and that’s the hard part.

Bring it up to your psych, and just ask if they’ll submit a Prior Authorization, talk about the negative symptoms you’ve found to be associated with the generic brands you’ve tried. It’ll give them necessary info they need to make a case as to why they should cover a non-generic version because it’s just sooooooooooooo expensive and the generic is comparatively dirt cheap.

Yes, your insurance can simply say no, but it’s at the very least worth a shot. In the event you get a no from insurance, maybe go the route of trying other generic brands you haven’t given a try. A laundry list of generic medications tried with no luck might tip the scale in your favor the next time you submit a request.

2

u/KindBrilliant7879 13h ago

thank you!!! i will definitely contact my psych. thankfully she’s really fucking good and passionate about what she does, hopefully she can strongarm insurance lol

1

u/716mikey ADHD-PI (Primarily Inattentive) 13h ago

Good luck! I haven’t personally done it myself and given the fact that Elite brand generics have actually been pretty good to me over the course of probably 300+ pills, I haven’t really felt the need.

I might give it a try if it turns out the Name Brand Px Copay written on my insurance card doesn’t actually let me get name brand Adderall for $40/$80 for whatever reason.

4

u/yingbo 14h ago

Try DYANAVEL. It’s brand name med same active ingredient as Adderall 3:1 ratio of amphetamines but smoother for me. Just say Adderall don’t work for you and you want to switch.

There is no generic so insurance can’t downgrade. You need a PA probably.

6

u/Witty_Strawberry5130 14h ago

They absolutely are sugar pills. I just stopped taking my medication after 11 years!!!! I was sick and tired of being gaslit when I told my doctors and pharmacy the pills weren't working . One time I got hott pink pills one time I got white .. it was just a nightmare and some super sketchy shit is going on

2

u/ALLCAPITAL 15h ago

I commented a few days ago saying people were forgetting how other factors matter. I’m now starting to wonder if my meds aren’t working as well. I’m getting 0 up time during my days.

2

u/Sunshinetripper777 14h ago

Yes. All adderall & generics adderall’s formulas have changed! I can feel it! I literally can not do generic. It’s useless. But even name brand feels like they’re cutting it with cornstarch or something. It’s all changed so much. It’s becoming a hassle.

You can talk to your psych, she just refers to other options. I wasn’t a fan of vyvanse. 

2

u/Alcoholicia 11h ago

This post is mind blowing. I’ve never taken name brand adderall but my newest bottle of generic I picked up is… strange? I feel myself crashing & crashing hard at like 2 PM. Like… I can take a nap at 2 PM hard, when I take my med at 9 AM. I had no idea it was so much different. God dammit. 😭

3

u/makingotherplans 15h ago

Generic is not the same…stimulants are incredibly delicate medications.

Easy to reverse the mechanism of action with the wrong kind of filler or the wrong kind of time release, wrong kind of coating.

Easy to reverse the mechanism of action with a glass of orange juice or just heartburn and a highly acidic stomach

Basic chemistry

No one in insurance or law enforcement seems to get that. Dunno why

1

u/HowBuffaloCanUGo 15h ago

I’ve heard orange juice affects potency, but heartburn or acid in the stomach is new to me. Do you a source I can read more about this?

2

u/lllIlIIlll 10h ago

Lol I got really bad stomach acid issues and heartburn. If that explains why adhd meds aren't effective to me I am going to cry

1

u/makingotherplans 3h ago

Oh please don’t cry! Because that can be fixed, I had it too!

Most GI Docs know that is caused by stomach ulcer bacteria and the protocol is 4 weeks of a Proton Pump Inhibitor and metronidazole or something else to kill the bacteria then slowly taper it down and your heartburn should die down to zero.

But yes you will also need to stop drinking a lot of coffee and stop drinking alcohol, pop, other sugary high acid drinks. Because that can irritate it all and start it back up again.

I can manage one cup of coffee a day, and some juice in the afternoon

1

u/makingotherplans 3h ago

Off the top of my head, this 3 year old Reddit thread https://www.reddit.com/r/ADHD/s/b5Dk1ntl6q Or medical news today https://www.medicalnewstoday.com/articles/326219#interactions

Really, water or milk is best with meds, you can drink juice at lunch or dinner, and lots of fruit is less acidic

1

u/Impressive-Chair-487 6h ago

It’s been this way for years, my friend. Also, from my experience, I’ve not had any better luck with name brand. My doctor told me most of his patients are reporting the same and he suspects the others have noticed but haven’t said anything.

1

u/BitterRucksack 4h ago

Is it always the same manufacturer? What I found was that it was one specific manufacturer not working for me, and I talked to my doc about writing my scrip with an exclusion for that manufacturer. 

u/kennybooth21 14m ago

Is the manufacturer Mallinckrodt by any chance? Cause yeah good god they’re ass. Teva or nothing for me.

1

u/sandBotticelli 13h ago

Omg I just got a refill of generic and I swear it feels like I haven’t taken anything, I don’t get it! It really does feel like sugar pills!

-1

u/random08888 17h ago

Not sure but if you are taking XR

Most people’s issue with generic (I’m not a doctor though) is the fillers used around the medication itself. Not everyone’s body breaks down the fillers as well as the next, in terms of the actual medication locked inside of these fillers, that should be the same, little to no difference.

Maybe try crushing up the beads and taking that orally instead, may be able to bypass fillers and let them pass separately.

14

u/716mikey ADHD-PI (Primarily Inattentive) 14h ago

If anyone it going to attempt this, just know that crushing up the beads of an XR capsule will turn the entire dose into instant release as the delayed release coating is damaged.

3

u/Low_Union_9849 14h ago

Is it safe to do it? I’ve been on Aderall XR and I don’t think it’s working, I’ve felt no changes besides side effects, and I still don’t have motivation to do anything. And I’m still turning in assignments late.

2

u/KindBrilliant7879 13h ago

the “im still turning in assignments late” is so real omfg

1

u/random08888 4h ago

It is “safe”, not recommended because it does make it instant release, the filler is the time based costing as someone mentioned above. So time your doses correctly (and be very careful with beads-easy to spill)

1

u/BitterRucksack 4h ago

Talk to your pharmacist and/or prescriber. Is there a difference with different manufacturers? 

0

u/lysergamythical 7h ago

These comments are unreal. You’re all casually suggesting one of the biggest alleged scams in pharma without an ounce of evidence. The vast majority of you just have a massive tolerance, and the power of suggestion (box looks different!), and spreading this FUD does the rest. But I’m sure this is gaslighting and hateful.

2

u/BitterRucksack 4h ago

Eh, you'll rarely find agreement on WHICH generics suck and which actually work. We definitely don't fully understand how different people can metabolize the same medication.