 Hello friends and subscribers, welcome back to my YouTube channel. This is Daniel Rosehill. I thought I'd put together a video today about treatment for ADHD in Israel for adults, especially what medicines are available here. A lot of people are thinking about making Aliyah at the moment and some of them struggle with ADHD, so I figured that I'd share some information that might be useful to those people. Before I go any further with this video, let me make the mandatory disclosure. I'm not a doctor, I'm simply somebody who was diagnosed with ADHD as an adult in Israel, and I'm currently taking a medicine called Vivance, which makes it a lot easier for me to focus, get things done, and generally enjoy a happier, more productive existence. In this video, I want to talk about the diagnostic process that I went through, how much my medication costs, and what other medications are available on the market. Naturally, this isn't anything like an exhaustive explanation of what ADHD treatment is like in Israel. Firstly, let's talk about diagnosis. I was diagnosed in my 30s, so I have absolutely no idea what treatment for children with ADHD is like. But lots of people do, and there's a useful Facebook group if you're an English speaker with ADHD called Navigating ADHD in Israel. I'll leave a link to that Facebook group in the description. A lot of people in that group are talking about treatment options for their children. A huge chunk of my adult life was spent aggressively self-medicating ADHD with coffee, tea, caffeine pills, or just about any stimulant that sort of worked. So getting on actual medication has been a huge relief for me. I was diagnosed with ADHD by a private ADHD specialist, although it's my understanding that general psychiatrists can also make the diagnosis. I didn't need to do any specific testing, but I did have an hour-long interview and could remember having to fill out a lot of questionnaires. Friends have told me that I'm the last person they think of as having ADHD. My response is usually that you've probably never seen me when I'm not taking some kind of stimulant. And ADHD is not solely typified by hyperactivity. The subtype that I have in attentive ADHD doesn't have hyperactivity at all. I can also look a lot like depression. You can also have both. But I also don't like having to justify my diagnosis, so I usually just ignore these arguments. I mentioned in previous videos that Israeli citizens need to belong to one of four Kupot Holim called Health Maintenance Organizations in English. I was able to take my diagnosis from the private system and receive medications through the public system by having my family doctor transcribe that prescription. This is a very common place. Not only is it best practice to have your medical records in the public system, but it also means that you can get your prescriptions filled via your Kupa, which usually makes them quite a bit cheaper. During the course of my ADHD career, I've taken quite a few medications. I've been on Ritalin, Consurza, Wellbutrin, Stratera and Vivance. Vivance is the medication that I've personally had the best success with. The cost of medications in Israel varies according to what percentage your health fund covers and what percentage is left up to you to pay. These cost for medications are in addition to your monthly subscription to the Kupot Holim. For instance, I have Maccabi insurance and have to cover 65% of the cost of my Vivance. But with Ritalin and Consurza, the co-pay is less and the medication is therefore considerably cheaper. There's a really cool website that you can look up to see what drugs are available in Israel. It's called the Israeli Drug Registry and is an official resource maintained by the Ministry of Health. You can put in a chemical name to see if the drug is available in Israel at all. If so, what its local trade names are, photographs of the product and even what formulations are available here. For instance, at the time I'm making this video, Vivance is available in Israel but only in the 30mg, 50mg and 70mg formulations. Vivance went off-patent last year in 2023 but the generic form of Vivance, Lizdexamphetamine, is not yet available here in Israel. Ritalin is available in both Instant Release and Modified Release formulations. Ritalin Long Acting or LA is available at 10, 20, 30 and 40mg. Teva also makes the generic form of Methylphenidate. It's available in the same dosages as Concerta. Concerta is a longer acting form of Methylphenidate and is available in 18mg, 27mg, 36mg and 54mg formulations. Dex-Methylphenidate is available at a variety of strengths in its XR or Extended Release formulations at dosages ranging from 5mg to 40mg. Mixed Amphetamine salts are sold in most of the world as Adderall. In Israel the trade name is Attent. Attent is available in 10, 20, 30mg in its Instant Release formulations and Attent XR is available in 10mg through 30mg. This is a long release formulations. So within the psychostimulant class we have both Instant and Long Acting release formulations in both the Amphetamine salts and Methylphenidate families. It's important to underscore that not all ADHD medications are available in Israel and not all formulations of drugs that do exist here are licensed. For instance there are 20mg, 40mg and 60mg formulations of Vivants manufactured but none of them are available here in Israel. Myadis is a relatively new long acting formulation of mixed amphetamine salts and it's also not licensed here in Israel at least at the time I'm making this video. Probably because it's not considered sufficiently distinct from the long acting Attent formulations. Now let's look at non-stimulants. Atomoxidine is a norepinephrine reuptake inhibitor that's best known by its trade name of Strateria. In Israel its trade name is Atomic, which I always think is kind of funny. Atomic is available in a variety of formulations and is manufactured locally in Israel by Uniform. At the time I'm recording this, Veloxazine, trade name Quelbi, isn't yet available here. In terms of third line agents, Clonidine is available in Israel but Guanfacine as far as I know isn't. I had to take a break from ADHD medications because of blood pressure issues and these drugs might have been great options. However, local doctors didn't seem very familiar with prescribing them, so instead I got put on a blood pressure med and I'm back taking vibrance. There are other drugs that are used more occasionally for ADHD, such as Medafinal and Nortriptyline. Nortriptyline is available in Israel as is Medafinal, but I haven't heard of so many people getting prescribed either. While Butrin or Bupropion is also sometimes used off-label for ADHD, it's widely available here in both the 150mg and 300mg extended release formulations. So how much do the drugs cost? And generally it's a little bit cheaper to get them from your Kupa pharmacy rather than in Superfarm. Yesterday I bought a month worth of vibrance in Superfarm for 238 shackles, that's 63 bucks at the exchange rate on the day I'm making this video. I paid 216 shackles the previous month or $57 at my Kupa pharmacy called Maccabi Farm, so I found that the difference between the Kupa pharmacy price and Superfarm does exist, but it's also not that huge. Ritalin is substantially cheaper than vibrance in Israel, 30 tablets of 10mg Ritalin cost me only 18 shackles which is less than $5, you can usually look up the cost of medications online via your Kupa's website. There's going to be a bit of variation between the different Kupa, but it's usually not too dramatic. Finally, let's talk about pharmacies. As most people know, ADHD medicines are usually controlled substances. This is also true in Israel. Whenever I pick up my prescription, I need to present my National ID card or Teodazahut. The pharmacy is very strict about dispensing vibrance, and I also need to complete a declaration that I think says that I'm not selling the drugs illegally or something like that. If you're picking up your ADHD meds, make sure that you have your ID packed as well as your health card. Be prepared to fill out a form and answer some questions from the pharmacist, but other than that you should be pretty much good to go. This has been very far from a comprehensive guide to ADHD treatment in Israel, but I hope I've given some useful information about what's available here in terms of drug therapy. Just remember that drug development is dynamic, new drugs are always being developed, existing drugs are in the process of getting approved here in Israel, so this information will become outdated at some point in time. I may do an update of this video in the future as the variety of drugs licensed and available to treat ADHD in Israel hopefully updates and widens. Thank you so much for watching this video. To get more updates from me about life in Israel and Jerusalem, do please consider subscribing.