The global shortage of medications used to treat attention deficit hyperactivity disorder is having “significant repercussions” in the UAE, doctors have told The National.
“In the UAE, the impact is seen in both educational and healthcare settings,” said Dr Suresh Wadhwani, a consultant psychiatrist at Lighthouse Arabia in Dubai.
“Children and adults with ADHD are experiencing difficulties managing their symptoms due to inconsistent medication availability. This can lead to challenges in academic performance, workplace productivity and daily functioning.”
The shortage is expected to persist throughout the rest of the year, added Dr Wadhwani.
“Long-term solutions, such as diversifying supply chains, creating medication reserves and developing new treatments, are being considered, though they may take years to fully stabilise the situation.
“Experts predict some relief by late 2024, but systemic changes will be necessary for a complete resolution.”
Supplies dwindle
There are several reasons why the supplies of ADHD medications – including brand names such as Concerta, Ritalin, Adderall, Stratox and Elvanse or Vyvanse – are dwindling across the world.
For a start, the number of people being diagnosed with ADHD has skyrocketed over the past few years.
ADHD is a neurodevelopmental condition categorised by three types: hyperactive and impulsive; inattentive; and a combination of the two.
Key symptoms of the hyperactive subset include being unable to sit still, poor concentration and excessive talking and movement.
Signs of the inattentive form of the condition include short attention spans, appearing forgetful and struggling to stick to time-consuming tasks and follow instructions.
The number of people aged 23 to 49 receiving a formal ADHD diagnosis from 2020 to 2022 has almost doubled, according to the 2023 report by Epic Research.
Experts largely agree the reasons for the increase include the Covid-19 pandemic, as people were less able to manage their symptoms, as well as the proliferation of telehealth services and rising awareness, prompted by social media.
As the number of diagnoses increase, so does the demand for medications, but these are predominantly subject to regulations in the US, where they are produced and where several controlled ingredients are allocated to drugmakers in limited quantities, making it difficult for manufacturers to keep up with demand.
“While demand for ADHD medications has surged, regulatory bodies have been slow to adjust these quotas due to concerns about misuse and diversion,” said Dr Wadhwani.
“This tight regulation, though important, has limited the availability of these drugs.”
Dr Valentina Faia, a specialist psychiatrist and medical director at the Free Spirit Collective, said up to a third of her patients at the City Walk clinic have been affected by the shortage.
“This is largely due to the scarcity of alternative generic producers and also due to the addictive potential of these drugs, which is an issue that is rightly closely monitored in the UAE,” she said.
In the UAE, Concerta and Ritalin, which are both made from the same active ingredient, methylphenidate, are in particularly short supply, she added.
The National reached out to the major pharmacy chains in the UAE for comment on the shortage. Some individual branches confirmed that they were out of stock of prescription medication for ADHD and could not say when the next delivery would be.
'Angry and frustrated'
Dubai resident, Jane O'Neill, 45, who works in the PR industry, has been taking the non-stimulant atomoxetine (Stratox) for about 18 months and said she has been unable to find any pharmacy with stock in recent weeks.
Each time she gets a new prescription, she has to ring around several different pharmacies across Dubai and Abu Dhabi to find anywhere with any left.
“The thing with ADHD is motivation and calling people and being organised are things we struggle with, so it can be really difficult.”
In the meantime, Ms O'Neill's doctor has prescribed an alternative medication called Wellbutrin, an antidepressant used off-label for ADHD, but which is also often in short supply.
“It’s not agreeing with me very much, though. I have insomnia, no appetite, dry mouth and it’s not doing what I need it to,” she said. “I really hope more becomes available soon.”
Gemma White, a mother of three and writer who contributes to The National, said her nine-year-old son has been affected. He has been taking the lowest dosage of Concerta for a year.
“He is able to focus so much better at school, sit still without constant fidgeting and it has vastly improved his ability to socialise with his peers,” she said.
Before the summer holidays, the family had had to travel to Abu Dhabi from their home in Dubai to fill prescriptions, but when they returned for the new school year, they contacted 10 pharmacies to find somewhere that had the medication and they were all out of stock.
“We finally located one bottle, which we only got because it had been turned down by someone else who needed a different dose level.”
As a result, they have begun to ration the medication, giving it to her son only from Monday to Thursday. “It has already been noted by his teachers and teaching assistants how different his behaviour and ability to focus on a Friday is compared to the rest of the week, which is negatively impacting his education.
“It has changed his life and now it is being taken away from him which we are very angry and frustrated about.”
Dr Teizeem Dhanji, a consultant child and adolescent psychiatrist at Sage Clinics in Dubai, said it is important that pupils receive help from schools, particularly as those starting the new term struggle to settle in.
“It’s important to meet with the school to think about accommodations that can be made to support children,” she said.
“Such as movement breaks, extra time in exams, one-to-one support or practical changes within the classroom environment."
Job loss and examination struggles
Earlier this year, ADHD UK found that 6 per cent of the 2,000 ADHD sufferers who responded to a recent survey reported they had lost their jobs because of a medication shortage.
Dr Faia said adult patients, when unmedicated, often struggle with procrastination and low productivity in the workplace.
“This is due to a fundamental divergence from the norm in the way dopamine is transported and absorbed in ADHD brains, providing significantly less motivation to do work that the patient does not find enthralling,” she said.
In schools, where in some cases as much as five to 10 per cent of the population suffers from ADHD, the shortage of medication has done more “substantial damage”, she added.
“ADHD children who have been prescribed medication oftentimes are simply unable to follow classes and learn properly without these drugs," Dr Faia said.
“The critical period in brain plasticity found within school-age children is being wasted as a result of these shortages, in a way that risks doing permanent harm to the quality of education that ADHD children receive.”
What to do if you can’t find medication
When a patient is unable to access their ADHD medication, the first step is to consult with their prescribing doctor to assess the situation and explore alternative options, said Dr Wadhwani.
They may prescribe a different, more accessible medication or discuss a temporary discontinuation plan. Non-pharmacological interventions such as behavioural therapy, executive coaching or lifestyle changes, including structured routines, exercise and mindfulness, may also be recommended, he added.
“Continuous communication between the patient and healthcare provider is crucial to managing ADHD symptoms effectively during the shortage,” said Dr Wadhwani.
2.0
Director: S Shankar
Producer: Lyca Productions; presented by Dharma Films
Cast: Rajnikanth, Akshay Kumar, Amy Jackson, Sudhanshu Pandey
Rating: 3.5/5 stars
Specs – Taycan 4S
Engine: Electric
Transmission: 2-speed auto
Power: 571bhp
Torque: 650Nm
Price: Dh431,800
Specs – Panamera
Engine: 3-litre V6 with 100kW electric motor
Transmission: 2-speed auto
Power: 455bhp
Torque: 700Nm
Price: from Dh431,800
AL%20BOOM
%3Cp%20style%3D%22text-align%3Ajustify%3B%22%3E%26nbsp%3B%26nbsp%3B%26nbsp%3BDirector%3AAssad%20Al%20Waslati%26nbsp%3B%3C%2Fp%3E%0A%3Cp%20style%3D%22text-align%3Ajustify%3B%22%3E%0DStarring%3A%20Omar%20Al%20Mulla%2C%20Badr%20Hakami%20and%20Rehab%20Al%20Attar%0D%3Cbr%3E%0D%3Cbr%3EStreaming%20on%3A%20ADtv%0D%3Cbr%3E%0D%3Cbr%3ERating%3A%203.5%2F5%0D%3Cbr%3E%0D%3Cbr%3E%3C%2Fp%3E%0A
COMPANY%20PROFILE
%3Cp%3E%3Cstrong%3ECompany%20name%3A%3C%2Fstrong%3E%20Revibe%20%0D%3Cbr%3E%3Cstrong%3EStarted%3A%3C%2Fstrong%3E%202022%0D%3Cbr%3E%3Cstrong%3EFounders%3A%3C%2Fstrong%3E%20Hamza%20Iraqui%20and%20Abdessamad%20Ben%20Zakour%20%0D%3Cbr%3E%3Cstrong%3EBased%3A%3C%2Fstrong%3E%20UAE%20%0D%3Cbr%3E%3Cstrong%3EIndustry%3A%3C%2Fstrong%3E%20Refurbished%20electronics%20%0D%3Cbr%3E%3Cstrong%3EFunds%20raised%20so%20far%3A%3C%2Fstrong%3E%20%2410m%20%0D%3Cbr%3E%3Cstrong%3EInvestors%3A%20%3C%2Fstrong%3EFlat6Labs%2C%20Resonance%20and%20various%20others%0D%3C%2Fp%3E%0A
Labour dispute
The insured employee may still file an ILOE claim even if a labour dispute is ongoing post termination, but the insurer may suspend or reject payment, until the courts resolve the dispute, especially if the reason for termination is contested. The outcome of the labour court proceedings can directly affect eligibility.
- Abdullah Ishnaneh, Partner, BSA Law
The struggle is on for active managers
David Einhorn closed out 2018 with his biggest annual loss ever for the 22-year-old Greenlight Capital.
The firm’s main hedge fund fell 9 per cent in December, extending this year’s decline to 34 percent, according to an investor update viewed by Bloomberg.
Greenlight posted some of the industry’s best returns in its early years, but has stumbled since losing more than 20 per cent in 2015.
Other value-investing managers have also struggled, as a decade of historically low interest rates and the rise of passive investing and quant trading pushed growth stocks past their inexpensive brethren. Three Bays Capital and SPO Partners & Co., which sought to make wagers on undervalued stocks, closed in 2018. Mr Einhorn has repeatedly expressed his frustration with the poor performance this year, while remaining steadfast in his commitment to value investing.
Greenlight, which posted gains only in May and October, underperformed both the broader market and its peers in 2018. The S&P 500 Index dropped 4.4 per cent, including dividends, while the HFRX Global Hedge Fund Index, an early indicator of industry performance, fell 7 per cent through December. 28.
At the start of the year, Greenlight managed $6.3 billion in assets, according to a regulatory filing. By May, the firm was down to $5.5bn.
GOLF’S RAHMBO
- 5 wins in 22 months as pro
- Three wins in past 10 starts
- 45 pro starts worldwide: 5 wins, 17 top 5s
- Ranked 551th in world on debut, now No 4 (was No 2 earlier this year)
- 5th player in last 30 years to win 3 European Tour and 2 PGA Tour titles before age 24 (Woods, Garcia, McIlroy, Spieth)
How does ToTok work?
The calling app is available to download on Google Play and Apple App Store
To successfully install ToTok, users are asked to enter their phone number and then create a nickname.
The app then gives users the option add their existing phone contacts, allowing them to immediately contact people also using the application by video or voice call or via message.
Users can also invite other contacts to download ToTok to allow them to make contact through the app.
THE%20FLASH
%3Cp%3E%3Cstrong%3EDirector%3A%3C%2Fstrong%3E%20Andy%20Muschietti%3Cbr%3E%3Cstrong%3EStars%3A%3C%2Fstrong%3E%20Sasha%20Calle%2C%20Ben%20Affleck%2C%20Ezra%20Miller%3Cbr%3E%3Cstrong%3ERating%3A%20%3C%2Fstrong%3E3%2F5%3C%2Fp%3E%0A
Normcore explained
Something of a fashion anomaly, normcore is essentially a celebration of the unremarkable. The term was first popularised by an article in New York magazine in 2014 and has been dubbed “ugly”, “bland’ and "anti-style" by fashion writers. It’s hallmarks are comfort, a lack of pretentiousness and neutrality – it is a trend for those who would rather not stand out from the crowd. For the most part, the style is unisex, favouring loose silhouettes, thrift-shop threads, baseball caps and boyish trainers. It is important to note that normcore is not synonymous with cheapness or low quality; there are high-fashion brands, including Parisian label Vetements, that specialise in this style. Embraced by fashion-forward street-style stars around the globe, it’s uptake in the UAE has been relatively slow.
'O'
%3Cp%3E%3Cstrong%3EAuthor%3A%3C%2Fstrong%3E%20Zeina%20Hashem%20Beck%3Cbr%3E%3Cstrong%3EPages%3A%3C%2Fstrong%3E%20112%3Cbr%3E%3Cstrong%3EPublisher%3A%3C%2Fstrong%3E%20Penguin%20Books%3Cbr%3E%3Cstrong%3EAvailable%3A%3C%2Fstrong%3E%20Now%3C%2Fp%3E%0A
Paatal Lok season two
Directors: Avinash Arun, Prosit Roy
Stars: Jaideep Ahlawat, Ishwak Singh, Lc Sekhose, Merenla Imsong
Rating: 4.5/5
UAE currency: the story behind the money in your pockets
The%20specs
%3Cp%3E%3Cstrong%3EEngine%3A%20%3C%2Fstrong%3E2.0-litre%204-cyl%20turbo%3Cbr%3E%3Cstrong%3EPower%3A%20%3C%2Fstrong%3E190hp%20at%205%2C600rpm%3Cbr%3E%3Cstrong%3ETorque%3A%20%3C%2Fstrong%3E320Nm%20at%201%2C500-4%2C000rpm%3Cbr%3E%3Cstrong%3ETransmission%3A%20%3C%2Fstrong%3E7-speed%20dual-clutch%20auto%3Cbr%3E%3Cstrong%3EFuel%20consumption%3A%20%3C%2Fstrong%3E10.9L%2F100km%3Cbr%3E%3Cstrong%3EPrice%3A%20%3C%2Fstrong%3EFrom%20Dh119%2C900%3Cbr%3E%3Cstrong%3EOn%20sale%3A%20%3C%2Fstrong%3ENow%3C%2Fp%3E%0A
Sour%20Grapes
%3Cp%3E%3Cstrong%3EAuthor%3A%20%3C%2Fstrong%3EZakaria%20Tamer%3Cbr%3E%3Cstrong%3EPublisher%3A%20%3C%2Fstrong%3ESyracuse%20University%20Press%3Cbr%3E%3Cstrong%3EPages%3A%20%3C%2Fstrong%3E176%3C%2Fp%3E%0A
TO A LAND UNKNOWN
Director: Mahdi Fleifel
Starring: Mahmoud Bakri, Aram Sabbah, Mohammad Alsurafa
Rating: 4.5/5
What is Folia?
Prince Khaled bin Alwaleed bin Talal's new plant-based menu will launch at Four Seasons hotels in Dubai this November. A desire to cater to people looking for clean, healthy meals beyond green salad is what inspired Prince Khaled and American celebrity chef Matthew Kenney to create Folia. The word means "from the leaves" in Latin, and the exclusive menu offers fine plant-based cuisine across Four Seasons properties in Los Angeles, Bahrain and, soon, Dubai.
Kenney specialises in vegan cuisine and is the founder of Plant Food Wine and 20 other restaurants worldwide. "I’ve always appreciated Matthew’s work," says the Saudi royal. "He has a singular culinary talent and his approach to plant-based dining is prescient and unrivalled. I was a fan of his long before we established our professional relationship."
Folia first launched at The Four Seasons Hotel Los Angeles at Beverly Hills in July 2018. It is available at the poolside Cabana Restaurant and for in-room dining across the property, as well as in its private event space. The food is vibrant and colourful, full of fresh dishes such as the hearts of palm ceviche with California fruit, vegetables and edible flowers; green hearb tacos filled with roasted squash and king oyster barbacoa; and a savoury coconut cream pie with macadamia crust.
In March 2019, the Folia menu reached Gulf shores, as it was introduced at the Four Seasons Hotel Bahrain Bay, where it is served at the Bay View Lounge. Next, on Tuesday, November 1 – also known as World Vegan Day – it will come to the UAE, to the Four Seasons Resort Dubai at Jumeirah Beach and the Four Seasons DIFC, both properties Prince Khaled has spent "considerable time at and love".
There are also plans to take Folia to several more locations throughout the Middle East and Europe.
While health-conscious diners will be attracted to the concept, Prince Khaled is careful to stress Folia is "not meant for a specific subset of customers. It is meant for everyone who wants a culinary experience without the negative impact that eating out so often comes with."
Jetour T1 specs
Engine: 2-litre turbocharged
Power: 254hp
Torque: 390Nm
Price: From Dh126,000
Available: Now
The five pillars of Islam
1. Fasting
2. Prayer
3. Hajj
4. Shahada
5. Zakat
Know before you go
- Jebel Akhdar is a two-hour drive from Muscat airport or a six-hour drive from Dubai. It’s impossible to visit by car unless you have a 4x4. Phone ahead to the hotel to arrange a transfer.
- If you’re driving, make sure your insurance covers Oman.
- By air: Budget airlines Air Arabia, Flydubai and SalamAir offer direct routes to Muscat from the UAE.
- Tourists from the Emirates (UAE nationals not included) must apply for an Omani visa online before arrival at evisa.rop.gov.om. The process typically takes several days.
- Flash floods are probable due to the terrain and a lack of drainage. Always check the weather before venturing into any canyons or other remote areas and identify a plan of escape that includes high ground, shelter and parking where your car won’t be overtaken by sudden downpours.
In numbers: China in Dubai
The number of Chinese people living in Dubai: An estimated 200,000
Number of Chinese people in International City: Almost 50,000
Daily visitors to Dragon Mart in 2018/19: 120,000
Daily visitors to Dragon Mart in 2010: 20,000
Percentage increase in visitors in eight years: 500 per cent
Tips to stay safe during hot weather
- Stay hydrated: Drink plenty of fluids, especially water. Avoid alcohol and caffeine, which can increase dehydration.
- Seek cool environments: Use air conditioning, fans, or visit community spaces with climate control.
- Limit outdoor activities: Avoid strenuous activity during peak heat. If outside, seek shade and wear a wide-brimmed hat.
- Dress appropriately: Wear lightweight, loose and light-coloured clothing to facilitate heat loss.
- Check on vulnerable people: Regularly check in on elderly neighbours, young children and those with health conditions.
- Home adaptations: Use blinds or curtains to block sunlight, avoid using ovens or stoves, and ventilate living spaces during cooler hours.
- Recognise heat illness: Learn the signs of heat exhaustion and heat stroke (dizziness, confusion, rapid pulse, nausea), and seek medical attention if symptoms occur.
What the law says
Micro-retirement is not a recognised concept or employment status under Federal Decree Law No. 33 of 2021 on the Regulation of Labour Relations (as amended) (UAE Labour Law). As such, it reflects a voluntary work-life balance practice, rather than a recognised legal employment category, according to Dilini Loku, senior associate for law firm Gateley Middle East.
“Some companies may offer formal sabbatical policies or career break programmes; however, beyond such arrangements, there is no automatic right or statutory entitlement to extended breaks,” she explains.
“Any leave taken beyond statutory entitlements, such as annual leave, is typically regarded as unpaid leave in accordance with Article 33 of the UAE Labour Law. While employees may legally take unpaid leave, such requests are subject to the employer’s discretion and require approval.”
If an employee resigns to pursue micro-retirement, the employment contract is terminated, and the employer is under no legal obligation to rehire the employee in the future unless specific contractual agreements are in place (such as return-to-work arrangements), which are generally uncommon, Ms Loku adds.
WITHIN%20SAND
%3Cp%3EDirector%3A%20Moe%20Alatawi%3C%2Fp%3E%0A%3Cp%3EStarring%3A%20Ra%E2%80%99ed%20Alshammari%2C%20Adwa%20Fahd%2C%20Muhand%20Alsaleh%3C%2Fp%3E%0A%3Cp%3ERating%3A%203%2F5%3C%2Fp%3E%0A
