The Kid's Doctor: Generics or brand-drugs best for ADHD?
Sunday, December 28, 2014


 When I begin a child on medication for ADHD, I typically start with a brand-name drug over a generic.
Photo by Fotolia 
By Sue Hubbard, M.D.
  If your child takes medication(s) for ADHD (Attention Deficit Hyperactivity Disorder) you may be noticing that your insurance company has started denying coverage for these prescriptions or encouraging you to use a generic version of the medicine(s) your child takes. As such changes have become more prevalent, many parents are calling, asking what they should do.
  Medications for ADHD have never been inexpensive, and for some families, especially those without insurance coverage, they are cost prohibitive. For a child who's been diagnosed with ADHD, it's known that a combination of medication and behavior modification offers the best outcome.
  When I begin a child on medication for ADHD, I typically start with a brand-name drug and do not use any generics. I explain to parents that although I'm a believer in generic drugs, and use them frequently, I want to make sure that any effects of the drug (positive or negative) are indeed due to the medication and not influenced by a difference in a generic drug. 
  Once a patient has been on medication and is doing well, if there is a generic available, I'll often prescribe it in order to make treatment more cost effective.
  Over the years, patients have told me they don't feel that the generic version of their given ADHD medication is working well. While these are anecdotal reports, they have not been uncommon. In such cases, some of my patients have opted to pay for the more expensive brand-name medication.
  The U.S. Food and Drug Administration just released an interesting article stating that studies have recently found that generic versions of the drug Concerta (produced by two different manufacturers) "may not provide the same therapeutic benefits for some patients" as does the branded medication. 
  While Concerta has a "drug releasing system" that provides 10-12 hours of extended effectiveness, it seems that the generic drugs may release more slowly, and the diminished release rate may not provide the same effect for the patient.
  So, if your child is on ADHD medications and you've tried a generic version and were concerned about its effectiveness, now is the time to discuss the issue with your doctor. This may not be the case for all patients, of course, but it's certainly worth knowing that there's now data on the subject.
Dr. Sue Hubbard is an award-winning pediatrician, medical editor and media host. "The Kid's Doctor" TV feature can be seen on more than 90 stations across the U.S. Submit questions at The Kid's Doctor e-book, "Tattoos to Texting: Parenting Today's Teen," is now available from Amazon and other e-book vendors.
This column was printed in the December 28, 2014 - January 10, 2015 edition.  

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