The medicine is only approved for children – but is still prescribed for adults • Doctors go against the Medical Devices Agency
The ADHD medicine Attentin is a centrally stimulating preparation with the active substance dexamfetamine. The drug and its short-acting effect seem to be increasingly in demand by patients, but not everyone can get it prescribed.
In Sweden, the drug is approved for children and adolescents aged 6 to 17 years and only in cases where methylphenidate, which is primarily recommended for ADHD, has not worked sufficiently. For adults, however, Attentin is not recommended at all.
“In Sweden, Attentin is only approved for the treatment of children with ADHD. Prescribing to adults thus takes place outside the approved indication, so-called off-label prescribing,” writes Ylva Ginsberg, an expert in medicine at the National Board of Health and Welfare in an email to TV4 Nyheterna.
Not approved for adults
Mats Persson, investigator at the Swedish Medicines Agency, writes to TV4 Nyheterna that the drug is approved for children and adolescents, but that there is really no specific recommendation for adults, as there is a lack of sufficient scientific evidence.
“Therefore, Attentin is not approved for the treatment of adults with ADHD,” he announces.
Big differences between the regions
In each region, however, there are drug committees with a mandate to make their own decisions about local drug recommendations. In other words, they can choose to deviate from the Swedish Medical Products Agency’s guidelines. The prerequisite is that the recommendation is based on science and proven experience.
Mats Persson believes that product summaries and treatment recommendations should be followed, but that free prescription applies and that doctors can under certain conditions prescribe a medicine even if it is not approved for a certain patient group.
Increased risk of abuse
In the Västra Götaland region, doctors prescribe Attentin off-label – against the Medical Products Agency’s recommendation. However, in line with the local medical guidelines for dexamfetamine.
Region Stockholm, on the other hand, follows the Medical Products Agency’s line and has a more restrictive stance. The attention has a short-acting effect with a quick strike and turnover. It also increases the risk of abuse of the preparation.
“In Region Stockholm, Attentin is not recommended as a treatment for ADHD based on the fact that there are better and safer alternatives … The recommendation is a longer-acting preparation than Attentin based on the fact that you want an effect during most of your waking hours,” writes Mats Ek, chairman in Region Stockholm’s pharmaceutical committee, to TV4 Nyheterna.
“Game changer”
The difficult availability in some regions means that there is now a hunt for the drug, and various Facebook groups are looking for people to advise where Attentin can be prescribed.
“I have used what in Sweden is called Attentin and see that it can be difficult to get prescribed. Is there anyone who can recommend a clinic or doctor in Stockholm I can turn to?” writes a person.
“I was just told by my reception that they are no longer renewing prescriptions for Attentin as, according to the Swedish Medicines Agency, they should stop giving it to adults and should never have done so in the first place,” writes another.
A third believes that the medication has changed the game plan for ADHD treatment and writes how he added Attentin as a supplement to his regular medication: “It was a game changer.”