ADHD medication shortages: A progressive care model for pediatric clinics in Thailand

Abstract

Intermittent shortages of attention-deficit/hyperactivity disorder (ADHD) medications, particularly stimulant agents, have become an important challenge affecting continuity of care, academic functioning, and the emotional stability of children and their families. This article describes the overall landscape of ADHD medication shortages and related system-level challenges in the Thai context. It also summarizes the ADHD medications currently available in Thailand, including short-acting and long-acting methylphenidate formulations (Ritalin^®, Rubifen^®, methylphenidate GPO, Ritalin^® LA, Concerta^®, and methylphenidate Sandoz^®). In addition, the non-stimulant agent atomoxetine, which had previously been imported, has been discontinued for approximately the past year, resulting in the current absence of any non-stimulant ADHD medication approved by the Thai Food and Drug Administration. The article also discusses preparation for the potential future availability of lisdexamfetamine. Finally, it presents a practical, proactive planning model for developmental-behavioral clinics with a case coordinator or case manager, using a color-coded patient stratification system to guide the intensity of follow-up, communication, and medication preparation in a structured manner. Accompanying tables are provided to support clinical decision-making in routine practice.