Have you ever wondered how you can manage and treat ADHD? In this episode, Camille welcomes Dr. Ann Childress, the president of the American Professional Society of ADHD and Related Disorders and an internationally recognized expert in the treatment of ADHD who has participated in more than 180 clinical trials. 

Dr. Ann shares some of the different types of medication that are currently available for use in the market for ADHD and some of her advice on how to manage the medicine shortages by comparing bioequivalent. She also shares some tips and tricks on how to parent a child with ADHD.

If you’re interested in learning more about ADHD whether for yourself or for your children, tune into this episode to hear Dr. Ann’s advice on how to deal with ADHD and the different medications that are available for you.

Resources:

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Connect with Dr. Ann Childress:

Visit her website at: www.drannchildress.com

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ANN CHILDRESS [0:00]

I say every day is a new day. Somebody might be tired if they’re used to taking their medication, but if you stop taking your medication, you’re pretty much back to square one and we see that with the laboratory classroom studies.

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CAMILLE WALKER [0:20]

So, you want to make an impact. You’re thinking about starting a business sharing your voice? How do women do it that handle motherhood, family, and still chase after those dreams? We’ll listen each week as we dive into the stories of women who know. This is Call Me CEO.

[MUSIC]

Hey, if you’ve been hearing a lot of buzz about ADHD. Do you have it? Do your kids have it? We’re running out of medication. This episode is for you. We are going to be talking with the president of the American Professional Society of ADHD and she’s going to talk with us all about what to do with the shortages, what you can do as a parent to help your child in the times that they do not have their medication, and also ways to save money, so you can get the medication you need. Let’s go.

Welcome back everyone to Call Me CEO. This is your host, Cmaille Walker. And I’ve got to tell you this is a personal curiosity for me. It’s a little bit of a different type of show today because we are talking about ADHD, medication, what you need to know not only as an individual, but also especially for children.

Now, I have with me Dr. Ann Childress, who is an American Professional Society of ADHD and Related Disorders president elect. She is also a child psychiatrist and she is one of the best experts with doing over 180 trials on medications for ADHD.

And I don’t know about you, but everywhere I look online, whether it’s social media or things that pop up on the websites or TikToks, people are talking about ADHD, they’re talking about the shortage of ADHD medications. They’re talking about are you an adult with ADHD? And so, we’re going to dig into some questions that maybe you yourself are having. And I am so excited to have you here. Thank you so much for being on the show today.

ANN [2:21]

It’s great to be here, Camille. And I must have sent you an old file because actually now I am president of the American Professional Society of ADHD. And I’m the first woman president.

CAMILLE [2:33]

That’s so cool. I love that. Then yes, it was an old one because that is what I had written down. So, congratulations, that’s awesome.

ANN [2:42]

Thank you.

CAMILLE [2:42]

So, tell our audience about yourself and a little bit more about you and how you got into this field on being an expert in ADHD.

ANN [2:50]

I’m a child and adolescent psychiatrist. Adult psychiatrist first, we do our adult training, and then do child training. And I really got interested because ADHD is something that we can treat and we can treat well even though for the past 20 years, I’ve been doing research with new medications.

We have some great medications that came out on the market actually. Benzedrine, which is dextroamphetamine sulfate. Dextroamphetamine was actually on the market in the 1930s and there was this man named Dr. Bradley who was working with boys who were hyperactive, your typical hyperactive impulsive kids that you would think of now. And he actually gave the medications for headaches and the headaches didn’t get better, but their behavior got better. And so, people started looking at stimulants.

Ritalin, everybody’s probably heard of Ritalin. Methylphenidate actually first came out on the market in 1955. So, we know a lot about medications. They work well, but the first medications that came out on the market were immediate-release. And so, people would have to take them maybe two or three times a day.

And one of the criteria for ADHD is forgetting. And kids with ADHD often have parents with ADHD. So, trying to take medication multiple times a day is difficult. I’ve been for the past 20 years doing research with different stimulations that have different formulations that may kick in quickly and last longer so that people only have to take them once a day.

We’ve looked at different formulations because not everybody can swallow pills. So, we’ve looked at oral disintegrating tablets and liquids and chewables and patches. And we’ve also looked at non-stimulants too.

It’s been a great ride. And the most, I think, gratifying thing is I have somebody who hasn’t been doing well in school and they come in after they’re treated. And I’m seeing and they’re running in, “Dr. Ann, look at my report card.” That is just a fabulous feeling for everybody. And I say, “I’ve never seen a pill do homework, so that must be you.”

CAMILLE [5:08]

I love that. I have chills everywhere, you guys, because oh my gosh, I’m getting emotional because I have a son who is that person and that it’s so easy for children, especially getting into junior high ages, wherein elementary school, it wasn’t much of a struggle, but then to feel like what’s wrong with me and why can’t I keep up and why can’t I do things I used to be able to do or however it manifests and at whatever age.

For us, it was more when puberty came along. And once we started the medication, which we were so fearful to do, and I don’t know why. I don’t know if it was something like I knew it’s a drug that could be abused if taken in mass amounts. I didn’t know if maybe it would be addictive or whatever those things are that you hear. It has just been life changing for my son.

And now, I look at my younger kids and I think I’m pretty sure I’m seeing earlier indicators before because now I know what to look for. And I’m looking at our society as a whole and how our brains are now being wired to have quick satisfaction and distraction. And do you think that there’s an increase in ADHD or are we just more aware that a lot of us are wired that way?

ANN [6:28]

It’s interesting because people will say, “Wow, look at the Center for Disease Control. The prevalence is increasing.” And that may be true with what they’re collecting with data, but when they go back and really look at the same criteria for studies that were done a decade ago, compare it to now, the prevalence isn’t really increasing.

I think we really are more aware of it and we’re expected to do things now. Before, if somebody wasn’t doing too well in school, maybe they would just stay on the farm or maybe they would be doing something where they could be up and moving around. And now, we have some jobs where you have to sit at a desk and you have to be able to pay attention. And that’s really a killer for a lot of my adult patients with ADHD.

Now, a lot of my adults actually are diagnosed after I diagnose their children because ADHD Is heritable. And a mom may say, “I had trouble in school, but I just thought I wasn’t very smart.” And people would say, “She’s an airhead. She’s always in la la land.” And we’ll do an evaluation and we diagnose them and treat them and things are different. I had one patient who had never read a book. And now, she reads all the time.

CAMILLE [7:43]

I love that. And I think that you bring up a good point because another piece of it is that a lot of times, girls or women do go undiagnosed longer because it’s not what we think of, I feel like hyperactivity, it may present itself differently in girls. So, what are some key indicators to look for there if you have a daughter who you think may have issues with this? How does it present?

ANN [8:07]

Sometimes, the girls are just as busy as the boys. But a lot of them are not. And a lot of those girls may not see it until they get to middle school or high school. If you're a smart girl, what you can do is you can get about half of what’s going on and piece things together and do pretty well.

And in elementary school, you usually have one teacher. And if you're a pretty nice kid, your teacher will help you and work with you and you may be able to get your homework turned in a little bit late or maybe the teacher will say, “Hey, Sally, don’t forget to turn in your stuff.”

But when you get to middle school, you’ll have six classes and each teacher has about 200 kids. So, if you find that, wow, my child is really struggling now, that’s something to start looking at is do they have ADHD? Are they having a really hard time organizing? Are they having a hard time keeping up? Do you notice that they’re having a harder time paying attention? And what may happen, my high school girls or my adults may come in for depression or anxiety because they feel overwhelmed and they’ve developed those comorbid symptoms secondary to their ADHD. And once we get the ADHD treated, those things get better.

CAMILLE [9:25]

I can see that. And I think that that’s really interesting because my daughter, I do see more of the anxiety play out where it’s like there’s too much and almost like a shutdown. So, I think that that's really important to pay attention to. For those parents who are listening right now or even for themselves, what is I guess the most effective, quickest, best way to get tested for ADHD?

ANN [9:50]

If you have some thoughts that, wow, I might have ADHD, they do have an adult screener, the ASRS. Actually, the copyright was handed over to WHO, the World Health Organization. So, people can go on and start with that, but I wouldn’t use that just to make a diagnosis. That’ll give you an idea. And maybe then, you can take it into your family doctor or your internist or whoever you're seeing.

If you think your child might have ADHD, it’s important to talk with your teacher. Some teachers understand more than others and they may be saying, “Yeah, Johnny is really having a hard time paying attention or Fran, she’s just talking nonstop. I have to separate her from the other kids or Bobby can’t sit in this seat. He's standing up next to his seat.”

You can go in and talk with your pediatrician or your family doctor if they’re seeing a family doctor and say, ”Hey, I think my child might have ADHD.” And rating scales, there’s really no tests for ADHD. You don’t go in and get tested. ADHD is based mainly on history and you have to have a certain number of symptoms of either hyperactive or impulsive or both to be combined presentation ADHD. And they have to be present for at least 6 months.

And they have to cause impairment in a couple of areas. So, for example, I had a physician not too long ago. She has a son with ADHD and she says, “I think I have ADHD.” And we were talking. She’s really not impaired. She’s really not having trouble getting her work done. It’s not causing her problems in her personal life. And I said, “So, you may have some symptoms, but you don’t meet that impairment. Because we’re not going to treat something unless it’s causing a problem for you.”

CAMILLE [11:42]

I like that. So, like you said, it’s not that you need to fix something unless you really feel like something’s broken. You need to have something to help with implementing function and your ability to do all the things that you need to do. So, that’s a good reminder.

So, I’m curious too. Say that we have kids that are being diagnosed. It’s actually my husband works at a law firm and sees what prescriptions. He manages it as the business and looks at the health insurance and what’s being requested and ADHD medication has blown up in requests, which is problematic because for those of us who have loved ones or ourselves who need ADHD medication, there is a huge, huge shortage. So, let’s talk about that. What is happening and what can we do if we’re finding ourselves in that place?

ANN [12:36]

It is a big problem. And I just have a message that I need to take care of right now because I wrote a prescription for 40 milligrams of methylphenidate and the mom called me and said, “No, they don’t have 40s, but they have 20s.” So, I’ll try to write her for two 20s to see and I’ll do that right after this because if I don’t do it pretty quickly, somebody else will get the prescription. It’s like after Christmas sale, so much and everybody’s going in and if you don’t get there soon, you’re not going to get your medicine.

It started around October and it’s really not clear exactly what caused the shortage. I think there are a number of factors. One of the factors was there was a company called Teva and it started with Adderall. And they said they were having some manufacturing issues, I guess employee issues, they didn’t have enough people to package all this stuff, at least that's what I’ve read.

Other companies that we’ve had some clinical trials that were having a hard time getting started because they’re having a hard time getting all the ingredients that they need to manufacture their tablets. But with Adderall, so Teva started it and it was Adderall. I think it was the IR, it may have been the XR too, but now everything is short.

There also have been a number of other factors. And one of them is telemedicine. And what happened during COVID, there is a law, it’s called the Ryan Haight Act and basically, you have to have a doctor-patient relationship, prescriber-patient relationship before you can prescribe medication. And that was merely looked at as you had to see somebody as in you had to see somebody in-person if you had to prescribe medication to start with.

So, maybe you had to do the initial evaluation of a person before you could see them over the TV or over the computer monitor. While with COVID because it was an emergency and people weren’t able to come into clinics and we were all hunkered down, they relaxed those rules. And I think the emergency is going to stop with that in April.

But because of that, lots of people could get diagnosed and treated with medication without having been in to see their physician. While I do clinical trials, and so I get vital signs, so you want to get pulse and blood pressure and you want to get height and weight because medications can decrease appetite. So, you want to make sure your child's growing and you want to make sure their blood pressure’s good and all of that stuff.

So, you get a better evaluation if you're able to see somebody in-person. But be that as it may, lots of people were prescribing with telemedicine. And then, a number of totally telemedicine companies came on the scene and lots of people were prescribing stimulant medications. Now, some of those are being investigated by the DEA, so I think they've cut down on that. But again, more demand.

And what’s interesting because I thought with my own patients, people probably won’t be taking medicine because their kids are at home. Not so true, maybe they didn’t get that first refill, but a week or two later, they’re like, “Doc, I got to have the medicine and can we go up on the dose please?” Because they were all of a sudden, seeing what was going on with their kids in school that the teachers have been seeing.

So, one other thing, I know I’m talking, talking, talking, the last thing that has just happened is this year the DEA did not increase the amount of medication, the amount of stimulants that they’re going to let companies make, which means we’re going to be right where we are for a while.

CAMILLE [16:30]

Geez, that’s unfortunate. It’s good that a lot of people found ways to be treated. Maybe they were nervous to go into the office and they found other ways to get in there, but yeah, such an increase. You would think that that would be respected and allowed to be filled more. That’s really interesting.

I was going to say, so for just what you were just saying about that client that just reached out to you or that patient, we've had to do that same thing where we can’t get our 36, but we can do a 30. We even had family that went to Mexico and they found methylphenidate that we were able to get a backup stock where we’re saying, “Just take it on weekdays and save your weekend doses.” But what I found is that if we don’t do weekend doses, my son can be more short or more angry. And is that normal? I don’t know. It’s almost like he gets grumpier when he doesn’t have it.

ANN [17:31]

Okay. So, if you think about inattention and then attention deficit hyperactivity disorder, their hyperactivity and impulsivity are in that hyperactive section. And if you think about behavioral impulsivity, they blurt out. They’re talking when they’re not supposed to. Then think about emotional impulsivity because it goes along with it. It’s not one of the core symptoms of ADHD, but they go zero to 60. Get upset about something and wham! They’re off the charts. But then, it’s like, “Hey, let’s go to McDonald’s or let’s get some ice cream.” And then, it’s whoop, right back down.

CAMILLE [18:15]

Yeah, how did you know? That’s what he loves. He likes ice cream.

ANN [18:18]

But they have short fuse and the medicine makes their fuses longer often.

CAMILLE [18:24]

Yeah, that makes sense because I’ve told him I notice a difference on the weekends. So, we’ve started using that backup stock even though the pills that we got from Mexico are only 20 mg or it’s 10. I think they’re 10s. I’m like, “Just take two.” And so, it’s not even a full dose, but it’s enough to help so that he’s just not as short or grumpy or impulsive with behavior or emotion that way. So, that makes a lot of sense. I’ve witnessed that firsthand. So, what are some other ways or options or medications available that we can do in the meantime with this shortage?

ANN [18:59]

A lot of people went from Adderall amphetamine to methylphenidate. So, now, there’s a methylphenidate shortage.

CAMILLE [19:05]

Which is where we are, yes.

ANN [19:10]

And there was a company called Patriot that was making what they called the authorized generic for Concerta, which means it’s like the same thing they have. And Patriot stopped making medication their authorized generic in January. So, now all of those stores like Costco that were caring Patriot can’t get Concerta.

And what often happens is especially the big chain pharmacies, they will have a distributor that they get medication from. And their distributor, they make the deals with whatever company is making a generic medication or medication. And so, they have a contract for six months or a year with Company X and then afterwards, Company Y.

So, when your pharmacy, your CVS or your Walgreens is out of medication, it’s because their distributor doesn’t have it. And maybe Company Q has it, but they don’t have a contract with them. And if the pharmacy actually wants to try to get medication from somewhere else, it’s usually more expensive and they lose money. They eat the cost. So, they don’t want to do that.

So, methylphenidate, we’ve had a hard time finding it now, but there are for amphetamines, there are branded medications. There’s lisdexamfetamine, which is Vyvanse. Sometimes, people can find the branded Adderall. It’s hard to get in your insurance though and they don’t have any coupons. There are a couple of other medications that are branded. One is called Adzenys and it is bioequivalent to Adderall XR, while the generics are supposed to be bioequivalent. And what does bioequivalent mean? Your audience is probably going, what is she talking about?

CAMILLE [20:59]

We’re getting a little science nerdy right now. So, you need to break it down.

ANN [21:02]

Okay. So, bioequivalent means that if your branded medication, your branded Adderall is right there at 100%, to be bioequivalent, they can have a concentration of medicine that would be bioequivalent at an 80%-125%. So, one month you might get something that’s 80%. And then, if they switch to another brand, it might be 125%. So, you’re like, wait a minute. That’s a third more medication. So, one month, I don’t feel like my medicine is working very well. In one month, that’s too much.

And that’s because with stimulants, the concentration makes a big difference. And actually, the concentration makes a big difference in how well the medication works for you and that’s my area of expertise. I do these laboratory classroom studies where we can watch kids in real-time do math and I can see how well their medication’s working at any point in time.

Now, Adzenys, actually they are bioequivalent to Adderall XR. Their bioequivalency’s really tight. It’s within just a few percent of that 100%. So, if you're getting something like Adzenys, it’s an oral disintegrating tablet, you probably won’t notice a difference as far as blood levels. But one of the things that's neat about these oral disintegrating tablets and there are some extended-release liquids that are out, one is Dyanavel XR and there's also a chewable tablet, more science nerdy stuff, both methylphenidate and amphetamine are positively charged. The stuff called polistirex and it’s negatively charged, these little tiny particles. And so, opposites attract.

So, then they’re these little particles and some aren’t coated, so they’re released immediately. And some are coated with different levels of thickness that gets holes in it and the medication diffuses out in your gut. But rather than a few hundred particles like there is in an Adderall tablet, they're actually beads and there may be a few hundred beads released immediately and a few hundred beads 4 hours later.

While even though they're bioequivalent and their blood level curves look pretty similar, what happens with these medications like Adzenys is there are millions of particles. And so, they’re continually released. So, sometimes people will switch from Adderall to say Adzenys or Dyanavel. And they’re like, “I like this medicine better. I don’t feel that kick that I feel when I take that Adderall.”

And that’s because there are so many more of those particles. And then, when you swallow them, again the medication is positively charged and we have a lot of negative ions in our gut. So. it just diffuses and just leaves that bond with the polistirex and just is absorbed.

CAMILLE [24:15]

That’s so fascinating. I know that when we first got the tablets and realized that there is this teeny tiny microscopic hole where medication is being released over time, it’s so fascinating. They didn’t tell us in the beginning that the capsule actually isn’t absorbed. That comes out. Yes, he found it.

ANN [24:36]

He found it in the poop?

CAMILLE [24:36]

Yeah. He’s like, “I don’t think that I’m absorbing my medicine because it’s coming out.” And I’m like, “What?” So, yeah, and I didn’t know. They didn’t tell me that that’s what it was and I think that science is so fascinating that it can be released that way. It really is incredible.

So, we’re dealing with this shortage. We’re trying to stay on top of it as best we can. I’m probably going to have to have you write out those medication names because I’m sure those listening are thinking the same where I’m like, wait, what did she say and how is that spelled? Because medications can be tricky like that. But for those who are dealing with the shortage, let’s talk about what we can do as parents to help mitigate or lessen the symptoms when we’re dealing with the shortage in those in-between times.

ANN [25:21]

One of the things that you can do whether you’re taking medicine or not, I think it’s really important to have a structured household. And that’s one of the things we talked about during COVID when the kids were staying at the home and the first few months, they didn’t even go to school.

But hey, even if Johnny is not going to school, he needs to get up at school time. He needs to get out of his jammies and into his clothes and eat his breakfast and brush his teeth. And you try to make things as normal as you can because that structure is very important for all of us, especially if you have ADHD.

And I try to get people to go to bed at the same time. 8 o’clock is not a sexy time to go to bed or 9 o’clock if you’re a teenager, but I try to keep them from staying up too late on the weekends and getting up around the same time in the mornings to help with that structure. That will help a lot.

If they’re doing homework, which it’s hard, my son doesn't have ADHD, but I can tell you I was not the parent he wanted to do homework with because I’m just not that patient. I just have to say that. So, it’s always daddy that they wanted to do homework with.

Make sure there aren’t any noises and distractions. You want a quiet place. Although you don’t want to send them up to their room because the teenagers know where all the other websites are. And so, they’re clicking from website to website. So, you want to keep an eye on them, but you want to keep things quiet and isolate them as much as possible. You don't want the TV blaring and a whole bunch of noise going on when they’re doing their work.

Other things that are good for kids with ADHD and adults too are sports. So, if you can get them into sports and they find a sport that they like. I think about people like Michael Phelps. His mom didn’t want him to take medication and she got him into swimming and look what happened. He won gold medals.

CAMILLE [27:19]

Yeah. I think what’s really interesting too, at least from my personal experience, is finding a personal solo sport. It worked really well for my son where I know that ADHD runs in my husband’s family a lot and they’ll tell you, “Sports is what saved me.” So, it was anything team sports too or lifting weights. For my son, he loves boxing. And anything where they can regulate with getting that energy out has been just awesome.

For my younger kids, one of my kids I know that is not something that I loved, but when I realized he was doing that to regulate and to get himself back into an equilibrium inside of his body, I’m like, that’s his work. He’s jumping, wrestling like that because he needs that for his mental health. So, I think that that’s really fascinating.

I’m curious about your question about keeping it quiet because my son will tell me, “I need the radio. I need to be listening to music or playing a game or something as I’m listening because it makes me focus better.” Do you think that that’s true or do you think that he’s just trying to get away with something else?

ANN [28:32]

I think some people do do a little better with some quiet noise. But if you’re having noises that are distracting like the phone’s going off or people are in conversations or things like that, I think that makes it harder. I know some people do put headphones in. And if the music is drowning out stuff in the background, I think that’s okay. But if he tells you that he needs to go from his video game website to his website in order to do his homework, I might be a little suspicious.

CAMILLE [29:01]

Yeah. I agree with that, for sure. So, as far as medication that parents may have about if they get them started now, what do I do? And I actually had a really good conversation with a friend where we had met for dinner and we started talking about it.

And one thing that really made me feel good as a parent was hearing this idea and it was actually said to me by a doctor is that every child is different. If you were to start a medication now, it doesn’t mean that they’ll need it forever. And it’s not addictive. So, it’s not something where you have to start it and you have to do it forever. You could just try it in different doses and see what is most effective and what does work best for your child. So, talk us through that a little bit. How do we work through the fear of the unknown?

ANN [29:47]

One of the things I can tell you is that stimulants are controlled substances. They are in a category where they can be abused and they can be “addictive.” However, the biggest problem I have with my patients with ADHD is staying on their medication in adherence. I’ll have somebody I write a 3 months’ prescription for. And then, I don’t see them for 6 months. And yeah, I’ve been taking my medicine. You couldn’t have taken it every day.

And there are some good data that people that take medication are less likely to abuse stimulants in other ways. They’re less likely to abuse substances, but I just want to make sure your audience knows that yes, these are controlled substances and they can be addictive.

I think one thing that’s a problem is people don't know about the safety. And remember I told you that Ritalin, methylphenidate has been on the market in some formulations since 1955. So, that’s more than 60 years. So, that’s something to think about.

The other thing to think about is the guilt because I think that makes you feel really afraid. Am I a bad parent? Is that why I can’t control my child’s behavior? No. It’s because they have ADHD and they have a hard time regulating. That doesn’t mean that they’ve got an excuse to be bad and get into trouble on days when they’re not taking their medication because when they're out of medication, you're going to have to work really hard to control your behavior. Do your best. Just work really hard to do that.

So, those are some things I think about. And then, when Aunt Sally says, “Gee, you’re going to put them on that stuff. That stuff is going to stunt his growth,” there are some data that it will impact a little bit, but we’re not talking about a foot or six inches. We’re talking about maybe an inch or so over the long-term. The decrease in weight usually people catch up with and actually people with ADHD are more likely to be abused as adults than people without ADHD. And I tell parents when they come in, “This is a guilt-free zone. We all just want to help your child.”

CAMILLE [32:11]

Yeah. So, let’s talk about the addiction piece a little bit. So, let’s say for example, people that are taking it right now, they’re taking the dose that is prescribed to them. And then, there’s a shortage, is there an issue of coming off of that medication or to having to wean off it, is that an issue at all or where does that become a threat of becoming addictive?

ANN [32:36]

It’s just because some people take medication to feel good, but the longer-acting medications, so Adderall XR is less likely to be abused than Adderall. Concerta, methylphenidate just because of the way it’s put together is less likely to be abused. So, the abuse potential really happens to coincide with how fast it gets to your brain. If somebody's snorting cocaine, it gets to their brain really fast and they get high and they get that dopamine release, then it’s like, this is great. The extended-release stimulants are extended-release.

CAMILLE [33:14]

They’re not built that way, yeah.

ANN [33:14]

Yeah, they’re not put together that way.

CAMILLE [33:18]

Okay. So, when we’re going through these shortages, it’s not like our child is in an extended-release medication that they’re going to all of a sudden have withdrawals or anything like that.

ANN [33:28]

Right, they shouldn't. I say every day is a new day. Somebody might be a little bit tired if they're not used to taking their medication. But if you stop taking your medication, you’re pretty much back at square one and we see that with the laboratory classroom studies. If they don't take their medicine that next morning, they’re back to square one.

CAMILLE [33:48]

Okay. That makes a lot of sense with the way that it’s formulated where the slow release, which I know that my son has really loved that. So, let’s say there's someone who is on a slow-release medication and for example, I think my son’s wears off at 3 o’clock, but that’s when kids get home. And they’re doing homework and night time routines and maybe they have chores and with the things that we talked about before. Would you say that structure is the best way to handle that? Are there any other things that we can do as parents or families to support them?

ANN [34:22]

Structure is good. Sometimes, if the medication is wearing off before homework, I will give them an immediate-release booster. And you just told me, wait a minute, people abuse immediate release more. And I’m careful with what I do. And I don’t care if you’re 17. I want your parents in charge of your medicine because these are controlled substances. It’s a felony. If you let your friend borrow your pill for a test, it’s a felony. So, you can get in big trouble.

So, I always have parents in charge. That’s one thing. In addition to the structure, they could switch to a medication that might last a little bit longer. And we’re even now looking at a methylphenidate that we’re hoping will last up to 16 hours. I haven't seen it in a lab classroom yet. We’re going to see that in a couple months. But that would be nice for folks too because it’s really interesting.

We talk about sleep issues, but sometimes, people when their medicine wears off, they have a hard time turning down their mind, turning off their thoughts. So, sleep for some people actually gets better on those longer-acting medications.

CAMILLE [35:28]

That’s so fascinating. I know that I’ve learned a lot and I know that you have a lot of resources for parents and you’re helping so many people. I just think that this line of work is so impressive. So, thank you so much for lending your expertise and sharing with us today. And I think you said just before as we’re wrapping up, you’re hoping or we’re hoping that this shortage should start to resolve in the spring. Did you say May or could it be a lot longer than that?

ANN [35:57]

I don’t know. They say that the Ryan Haight Act that they’re going to I guess start enforcing it again at the end of April. So, hopefully, we’ll be catching up with things a little bit later in the year. But in the meantime, folks can look, the branded medications are out there. They may not be on their insurance. So, that’s something to look at. They need to talk to their doctors about it.

Most of the companies have coupons. I know the folks that make Dyanavel have coupons and the folks that make Vyvanse have coupons and also the folks that make Adzenys. So, that may help them be able to afford their medication with less out of pocket.

CAMILLE [36:43]

And where do you get those coupons, just from those individual websites?

ANN [36:47]

You can go online, yeah. And you can look up the different companies and you can usually print out a coupon. Sometimes, in my office, if I’m worried that a patient’s not going to do that, I’ll actually get on the computer and say, “Can I type in your information?” And I type it in and print out a coupon for them if I haven’t seen one of the drug reps to drop me off a stack.

CAMILLE [37:11]

That’s helpful. Good luck to everyone out there. Thank you so much for your time today and talking to us through ADHD. I feel like this topic, we’re going to be learning more and more about as time goes on. So, thank you for doing those clinical trials and for helping us learn a little bit more today.

ANN [37:25]

You’re welcome. Thanks so much.

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CAMILLE [37:30]

Thank you so much for listening to this episode. If you found it helpful, I would love it so much if you could leave a 5-star rating and review. Any time that you leave a review, a rating or share this with a friend, it helps the podcast to grow and also helps many entrepreneurs find the help that they need both in motherhood and in their business. So, thank you so much for being here today. I can’t wait to see you next week.

Hey, CEOs. Thank you so much for spending your time with me. If you found this episode inspiring or helpful, please let me know in a comment and a 5-star review. You could have the chance of being a featured review on an upcoming episode. Continue the conversation on INstagram @callmeceopodcast. And remember, you are the boss!

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