ADHD Medication For Adults in the UK
In the UK there are a range of drugs that are licensed to treat ADHD. This includes the stimulant methylphenidate and the amphetamine based medication called lisdexamfetamine. The exact dose will need to be monitored carefully during the initial stages of treatment (titration) and then stable prescriptions can be handled by your GP as part of a'shared care' arrangement.
What is an Licensed Medication?
A medicine that is licensed will have undergone all the appropriate clinical tests and trials, and the MHRA (Medicines and Healthcare Products Regulatory Authority) has granted it the approval to be used in Great Britain. The medicine will also be declared suitable for use in a particular condition on its packaging or in a leaflet which is provided with it. All licensed medicines are subject to strict regulation even after they have been placed on the market. This allows for problems to be identified quickly and risks to be reduced.
Some people with ADHD may be prescribed unlicensed drugs however, they are not often used for teenagers and children. The unlicensed medication could be prescribed for other conditions which have been found to work well with it (known as off-label prescribing), or it might be a specific formula that isn't yet available on the market, such as an oral liquid in place of tablets or a product without certain additives. It may be an experimental medication that is being studied in the UK.
Experimental drugs are referred to as Investigational Medicinal Products (IMPs) or Medicines with a Marketing Authorisation (MIA)(IMP). These drugs aren't yet licensed and can only be purchased with a prescription from a doctor. The MHRA will have conducted a formal evaluation as part of the Early Access to Medicines Scheme.
Atomoxetine is an anti-stimulant medication that is commonly prescribed in the UK and Europe for ADHD. This is a selective noradrenaline-reuptake inhibitor, which is different from other ADHD medications. It increases noradrenaline, which is a chemical that aids in transmitting messages between brain cells. This aids concentration and helps to control impulses. It is taken as a capsule once or twice daily.
A psychiatrist is the sole mental health professional who can diagnose ADHD in adults and prescribe medications to treat it. It is crucial to understand that ADHD isn't an illness that can be treated by medication alone. Therapy is frequently included in treatment plans for people suffering from the condition. This may include psychoeducation, which aids teens, children and adults understand their diagnosis, as well as behavioral therapy, which teaches strategies to manage symptoms.
What is an Unlicensed Medication?
The term "unlicensed medicine" refers to medications that are not licensed by the MHRA. It could be that the drug was not developed by an UK company, or it was prescribed outside the restrictions of its licence (ie off-label). The GMC's guidelines state that 'unlicensed medicine is usually employed when a licensed product is not available or when a treatment that is clinically effective is not available with the product that the prescriber is most comfortable with'.
A medical license will specify which health conditions it treats and the age of the patients it can be administered to. The licence will also state how and by whom the medicine is to be administered. The MHRA will only issue permission if the drug is thought to be safe and effective for the application, built on research in medical science and clinical studies. The drugs' manufacturers are not allowed to promote or promote any use that isn't covered by the licence.
It is not illegal in the UK for healthcare professionals to prescribe a non-licensed medication, as long as they can explain the dangers and benefits of doing so to the patient. They must also keep an account of the use of unlicensed drugs and provide the patient with sufficient information to make the decision.
Unlicensed medicines are usually administered in hospitals, as there is more experience using them than in GP practices. The hospital will implement procedures to ensure the safety and efficacy of the medication. This includes keeping thorough records of patients, as well as recording any adverse reactions. They will also have to adhere to the MHRA's guidelines for the safe supply of unlicensed medicines.
medication for inattentive adhd are prescribed by doctors who must be clear with their patients, their parents or caregivers of the medication, its purpose and any potential side consequences. They should be able to address any questions and provide written details about the medicine they prescribe, as well as the reasons behind it.
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In recent years, as the number of people suspecting of having ADHD increased and so did the requests for a referral to the NHS for an assessment and treatment to treat the condition. The waiting lists for NHS assessments can be lengthy, and many patients opt to pay for their ADHD assessments at private clinics. The hope is that once the diagnosis is confirmed by this process, the GP will enter into an agreement for shared care (SCA).
A SCA is an agreement between your psychiatrist and your GP where the responsibility of monitoring, prescribing and basic health checks for medicines is assigned to your GP. This is a well-known and accepted method of transferring the responsibility for managing a patient suffering from ADHD from the hospital or specialist service to general practice, provided this is in line with NHS England guidelines.
Before the responsibility is transferred, the specialist and GP should be in agreement on these SCA guidelines. This should be clearly stated on any referral form. It should also be clarified that the GP is responsible for the continuous monitoring and titration of the medication.
Unfortunately, many GPs are not able to accept SCAs. This is not due to the lack of motivation however, the work involved with SCAs is often outside of their core budget and is usually an additional project on top of a busy schedule.
The doctor should be provided with good quality information on the rationale for SCA and what the expectations of both parties are, including the roles of the patient and their carer. It should also be clear that a decision regarding SCA should be made by the doctor who initiated treatment. The doctor should be informed if they are not willing to participate in the SCA.
If a doctor does not want to accept responsibility for SCA or SCA, they may refuse. However, this can result in patients being referred back to the private ADHD clinic and psychiatrist who provided their initial diagnosis. This could mean that prescriptions for medication are issued privately, rather than through the NHS, which of course can be more costly.
What is a titration time?
The tration phase is an important step to determine the appropriate medication to treat your ADHD. It involves increasing the dosage gradually until you reach a dosage that maximizes benefits and minimizes the risk of side effects. It takes time but your healthcare professional should work closely with you to ensure that the titration process goes as smooth as possible.
Some patients may experience a worsening of their symptoms during the titration phase. For example, hyperactive people may be more agitated and irritable than usual. It is crucial to let loved ones know of any changes in behavior and provide assistance. It is also essential to eat a balanced diet and to create a consistent sleep routine to lessen the negative effects of ADHD medications.
Medication isn't the sole treatment for ADHD, but it is usually recommended as the first line of management in adults. Talk therapy is a useful tool to treat depression and anxiety that could cause some of the symptoms of ADHD. It is important to keep in mind that medication can only treat the symptoms, and not alter long-standing negative coping mechanisms. Some patients opt to not take any medication, instead focusing on self-help strategies like nutrition, exercise and stress reduction.
It is essential to read about the possible side effects of any medicine you are prescribed, and understand how the medication will affect your body. Certain medications can cause headaches or drowsiness, and also reduce appetite. Make sure to always follow the directions for taking your medication and consult your doctor if you experience any adverse reactions.
A lot of the drugs used to treat adult ADHD are currently in short supply due to supply issues. This has caused delays in the diagnosis process as well as appointments with psychiatrists. NHS England has created a taskforce to study the issue and offer suggestions on how to cut down waiting times for medications.
Ask your local GP what alternatives are available to you. You may be able get the same medications privately or they may recommend alternatives that have similar results.