No, you won’t be seeing ADHD drugs anytime soon

It’s been 18 months since Adderall officially went into shortage, and since then other stimulants have joined the list. Bad news: “[C]linicians and advocates alike say there is no apparent end in sight.”

The good news is that there’s plenty of time for finger-pointing and plenty of places to point: manufacturers, PBMs, prescribers, the DEA, the FDA, telehealth, and of course politicians from The Other Side.

Interesting side note: The shortage primarily affects generic versions of the drugs — in several cases (Vyvance, Concerta) the branded version is available, just much costlier.

… which is too bad, because they might reduce the risk of death

Yep, people with ADHD who are on medication can have their risk of death cut by a quarter. And that’s not just from natural causes, but from unnatural causes as well, including accidents and overdoses.

To reach this conclusion, Swedish researchers (with help from US and UK colleagues) “followed nearly 150,000 Swedes aged 6-64 who were diagnosed with ADHD between 2007 and 2018.” They can’t say for certain exactly what the causal relationship is, but the connection is clear.

Considering that people with ADHD are among the brightest and most productive, it’s important to keep them alive lon—

Tryptophan might lead to arthritis

When everyone’s favorite Thanksgiving-sleepiness punching bag is broken down by gut bacteria, some of the byproducts — particularly indole — can lead to inflammation.

“We found that when indole is present, the mice start to develop autoreactive T-cells that are more inflammatory. They have less of those regulatory T-cells that help maintain balance in the immune system, and they start to develop antibodies that are more pathogenic. We found that the antibodies had flags for being more inflammatory when indole was present.”

So wrote University of Colorado researchers who made the discovery. There’s good news: Knowing that “indole generation” can lead to arthritis means it might be a therapeutic target. Even better, tryptophan is also broken down into some anti-inflammatory compounds, so blocking indole would mean two steps forward.

A coming “breakthrough” drug … based on acid

The FDA has given a breakthrough designation to Mind Medicine’s LSD-based drug, MM120. It still has to go through the whole approval process (and get its forever name), but at the moment it’s new and different enough to get the red carpet treatment.

Said one researcher, “I’ve conducted clinical research studies in psychiatry for over two decades and have seen studies of many drugs under development for the treatment of anxiety. That MM120 exhibited rapid and robust efficacy, solidly sustained for 12 weeks after a single dose, is truly remarkable.”

Quick Takes

• Aspirin used to be recommended for older people to help prevent heart disease, but those guidelines have changed. Lots of seniors are still taking it, though — people who maybe shouldn’t be — because they’re relying on outdated information.

• Leprosy is slowly making a comeback in the US, notably in the South (Florida in particular). Epidemiologists used to think it was due to interacting with armadillos, but newer cases don’t have that connection — in fact, they aren’t entirely sure why it’s becoming more common. (No, we’re not going to make a “give their right hand to find out” joke. Please. We have some dignity.)

Kids keep OD’ing on melatonin

Back in May 2023 we told you how kids were overdosing on melatonin thanks to parents being unaware of the dangers of giving them too much. (It doesn’t help that what’s on the label and what’s in the drug don’t always jibe.)

It’s bad enough when unwitting parents are overdosing their, but the OD trend is apparently being compounded by kids getting their grubby little hands on high doses of melatonin accidentally. The fact that the drug comes as gummies and without childproof packaging certainly makes that easier.

All this comes from the latest of the CDC’s Morbidity and Mortality Weekly Report, which found that a whopping 70% of kids’ visits to the ER for medication exposure was for “unsupervised melatonin ingestion.” That was about 11,000 kids from 2019 to 2022, and gummies were their preferred method of dosing.

Fun fact: Despite what 70% of primary care physicians think, melatonin is not recommended for insomnia.

RIP, Paul Alexander

Having contracted polio in 1952, he was the last person to be kept on an iron lung. He died this week at age 78.

Salt can carry folic acid (and why that’s important)

Adding minerals to table salt is an easy way to get people the nutrients they need. In 1924, the US started adding iodine to salt to help tackle iodine deficiency, which can lead to stunted intellectual development. IQs literally rose after iodized salt was introduced.

All that said, a new study (that included Emory University) found that adding folic acid to salt can reduce major birth defects, notably spina bifida and anencephaly.

In the US and a bunch of other countries we add folic acid to grain for just this reason, but other countries can’t afford to do that. This new study proved that using salt worked just as well, while being a lot cheaper.

“We proved that folic acid can get into the blood through salt. Hopefully countries that have not already implemented fortification programs can now look at their infrastructures and realize that salt fortification is cheap and it’s really easy to add in the amount of folic acid needed to save lives.”