Update on ADHD medication shortage in the UK

We are providing an important update on the ongoing ADHD medication shortages affecting the UK. This situation impacts several medications commonly used to treat Attention Deficit Hyperactivity Disorder (ADHD), leading to significant disruptions for patients. We acknowledge the challenges this shortage presents and are committed to providing support to our clinicians and patients.

Current Supply Disruptions

The Department of Health and Social Care (DHSC) has issued multiple alerts and notifications regarding these shortages:

• National Patient Safety Alert (NatPSA) : Issued on 27 September 2023, highlighting shortages of methylphenidate prolonged-release capsules and tablets, lisdexamfetamine capsules, and guanfacine prolonged-release tablets.
• Medicine Supply Notifications (MSNs) :
• Lisdexamfetamine (Elvanse) capsules on 13 February 2024.
• Guanfacine (Intuniv) prolonged-release tablets on 28 March 2024.

These notifications have superseded the earlier NatPSA and provide detailed updates on the supply situation. Prescribing advice is available from the following key resources listed in the NatPSA:

• NICE guideline [NG87]. Attention deficit hyperactivity disorder: diagnosis and management
• MHRA (2022). Methylphenidate long-acting (modified-release) preparations: caution if switching between products due to differences in formulations 

If you are taking any of these medications, please contact your ADHD medicine prescriber using the numbers below for advice about the most appropriate option for you.

The supply disruption of these products is caused by a combination of manufacturing issues and an increased global demand.

Please do not share your medication with anyone else.

If your needs are very complex, for example you have mental health problems, or your ADHD symptoms causes you severe difficulty, you can discuss this with your GP, and they may recommend a specialist consultant review. 

Anyone who is currently waiting to be started on ADHD medication will not receive a prescription until stocks are available. 

Current stock status:

• Atomoxetine Capsules : Available in various strengths (10mg, 18mg, 25mg, 40mg, 60mg, 80mg, 100mg).
• Dexamfetamine Tablets : Generic 5mg, and Amfexa 5mg, 10mg, 20mg tablets.
• Guanfacine Modified-Release Tablets : Intuniv 1mg, 2mg, 3mg, 4mg.
• Lisdexamfetamine Capsules : Elvanse and Elvanse available in multiple strengths.
• Methylphenidate Hydrochloride Tablets : Various brands and strengths.
• Methylphenidate Hydrochloride Modified-Release Tablets : Several brands available.
• Methylphenidate Modified-Release Capsules : Multiple brands and strengths available.

Update history

• 24 May 2024 : Updated supply overview for lisdexamfetamine and methylphenidate MR tablets.
• 23 May 2024 : Equasym XL 20mg capsules back in stock.
• 22 May 2024 : Guanfacine shortage resolved.

The medicines affected are:

Methylphenidate

• Delmosart 18mg prolonged release tablets
• Delmosart 36mg prolonged release tablets
• Xaggitin XL® 27mg prolonged release tablets
• Xaggitin XL® 36mg prolonged release tablets
• Xaggitin XL® 54mg prolonged release tablets
• Xenidate XL® 27 mg tablets  
• Xenidate XL® 36 mg tablets  
• Xenidate XL® 54 mg tablets 

Shortage of Methylphenidate prolonged-release tablets contains further information.

Lisdexamfetamine

The following active supply issues exist:

• Elvanse® 20, 30, 40, 50, 60 and 70 mg capsules
• Elvanse® Adult 30, 50, and 70 mg capsules  

Shortage of Lisdexamfetamine (Elvanse) capsules contains further information.

Atomoxetine

The following active supply issues exist:

• Atomoxetine (Strattera) 4mg/1ml oral solution

Shortage of Atomoxetine (Strattera) 4mg/1ml oral solution contains further information.

Frequently asked questions

How long will the shortage last?

At present, the supply disruptions are expected to resolve soon.

This is a national supply problem and all UK ADHD services; Paediatrics, CAMHS, Adults, and Pharmacies within the community and in hospitals are affected. 

Are there alternative medications available?

Other ADHD products remain available, they may not be suitable for everyone and may not be able to meet the increases in demand.

We know how important getting your medicines is. Our team are always happy to talk to you about your medicines and to explain why getting your medicine may be difficult now. We will also explain what that will mean for your treatment.

You may be offered the choice between taking a treatment break or changing your medication to one that is not currently affected by the supply shortage.

The change in medication may mean you are taking medication more often through the day, or that they are tablets instead of capsules.

Our service is working closely with primary care to minimise disruption.

Once the supply shortage has been resolved your medication will be changed back to the medicine you were previously prescribed, as clinically appropriate.

Please be aware that there may still be delays at pharmacies in obtaining the newly prescribed medication.

What should I do if I cannot get my ADHD prescription from the pharmacy?

If one pharmacy is unable to obtain supplies, please try a different pharmacy.

The following link will help you find pharmacies in your local area:  https://www.nhs.uk/service-search/pharmacy/find-a-pharmacy   

Pharmacies may use different suppliers or wholesalers to source medicines so availability will depend on whether each pharmacy’s suppliers have stock or not. Please try visiting independent pharmacies as well as the larger pharmacy chains, as their suppliers will differ.

Some larger pharmacy chains have stock checkers online you can access to determine which of their branches have the medication you have been prescribed. An example of a stock checker (other pharmacy chains may have their own versions) is included below:      

Boots stock checker

Where there is a known disruption to medication, supply levels can change quickly. This is why pharmacies in one area may be able to find a medicine and others may not.

Alternatively, it may be best to leave the prescription (FP10) with a pharmacy that could check wholesaler stock levels daily and place an order.

Is it safe to stop taking ADHD medication abruptly?

Please consult your local ADHD service or your GP (see numbers below) for guidance if you think you are running out of medication.

NICE guidelines recommend having regular treatment breaks from ADHD medications. It is not unusual to stop taking medication over the weekend or during school holidays.

Therefore, no harm should come from stopping the medication, but this should be done in a planned way.

If you have any further questions not answered above, please get in touch with the the team in your area:

London CAMHS

Kent and Medway CYPMHS

Essex (SET CAMHS) 

(Last updated 13 June 2024)