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ADHD Medication For Adults in the UK In the UK there are a variety of drugs that are licensed to treat ADHD. This includes the stimulant methylphenidate, as well as the amphetamine-based drug called lisdexamfetamine. The exact dosage will need to be monitored carefully in the beginning stages of treatment (titration) and then the stable prescriptions can be handled by your GP as part of a'shared care arrangement. What is an Licensed Medication (L.M.)? A licensed medicine has gone through all the required tests and clinical trials, and the MHRA Medicines and Healthcare Products Regulatory Authority (MHRA), has given the green light for its use in Great Britain. The packaging of the medicine or the leaflet that comes with it will clearly state whether it is suitable for a particular condition. All licensed medicines are controlled even after they've been placed on the market, so problems can be spotted quickly and any risks reduced. Some people with ADHD might be prescribed unlicensed drugs, but these are rarely used for teenagers and children. Unlicensed medications may be prescribed for other conditions that have been proved to work well (known as “off-label prescribing”), or they could be a formula that isn't yet on the marketplace for example, an oral liquid instead of a tablet. It could also be an experimental medication being trialled in the UK. The term “experimental drugs” is used to describe Medicines with an Marketing Authorisation(MIA) (IMP) or Investigational Medicinal Products. These medicines have not been granted a licence as of yet and therefore can only be sold on a doctor's prescription. They will have been subject to a formal assessment by the MHRA as part of the Early Access to Medicines Scheme (EAMS) and therefore the quality of pharmaceuticals is guaranteed. There is one non stimulant medication that is frequently prescribed for ADHD in the UK and Europe and this is atomoxetine. This medication is a specific inhibitor of noradrenaline uptake and therefore works in a different way than other ADHD medications. It increases noradrenaline in the brain which is a type of chemical that passes messages between nerve cells, which improves concentration and aids in controlling impulses. It is taken as a capsule once or twice daily. Only psychiatrists are able to diagnose ADHD and prescribe medication for adults. It is crucial to remember that ADHD isn't just a disease that can be treated with medication by itself. Therapy is often included in treatment plans. Psychoeducation can help children, teens and adults comprehend their diagnosis, as well as behavioral therapy that teaches strategies to manage symptoms. What is an Unlicensed Medication? The term “unlicensed medicine” is a reference to any drug that has not been granted a licence by the MHRA. It could be that the medication was not developed by a UK company, or it was prescribed outside the terms of its licence (ie off-label). The GMC's guidelines state that 'unlicensed drugs are generally employed when a licensed product is not available or when a treatment that is clinically effective is not available with the medication that the doctor feels most comfortable using'. The label of a medicine will list the conditions it treats, as well as the age ranges that it is able to treat. The licence will also state what and how the medicine should be taken. The MHRA only grants a licence if it is deemed safe and effective in that specific use, based upon clinical trials and medical research. The manufacturers of the drugs are not allowed to promote or advertise any use that isn't covered by the licence. It is not illegal in the UK for medical professionals to prescribe a medication that is not licensed in the event that they are able to explain the advantages and risks of doing so to the patient. They must also keep records of the use of medications that are not licensed and provide the patient with sufficient information to make an informed choice on whether or not to take it. Unlicensed medications are often given in hospitals, as there is more experience using these medications than in GP clinics. The hospital will follow procedures to ensure the safety and efficacy of the medication. This includes keeping thorough medical records of patients as well as recording any adverse effects. They will also be required to adhere to the MHRA's guidelines on the safe supply of unlicensed medicines. Doctors who prescribe specials must to be open with patients and parents or carers about what the medicine is and why it is utilized and the possible negative side consequences. They must be able to answer any questions asked and must always provide written information about any medication they are prescribing, along with the reasons for prescribing it. What is a Shared Care Agreement? The number of people who are suspected to have ADHD has increased in recent years, so are the demand to be referred to an NHS assessment and also to receive treatment for the condition. The waiting lists for NHS assessments can be very long and a lot of patients choose to pay privately for ADHD assessments at private clinics. It is hoped that once a diagnosis has been confirmed through this process the GP will enter into an agreement of shared care (SCA). A SCA is an agreement between your psychiatrist and GP which means that the responsibility for medication prescribing monitoring, as well as basic health checks are transferred to your GP. This is a recognised and accepted method for the transfer of the responsibility of managing a patient with ADHD from an institution or specialist service setting to general practice, provided that it is in accordance with NHS England guidelines. These SCA guidelines should be discussed between the doctor and the GP before responsibility is handed to the GP and should be clearly written on any referral form. It must also be stated that the GP is responsible for the continuous monitoring and titration of the medication. Unfortunately, many GPs are not able to accept SCAs. It's not because they are not interested, but rather that the work involved in SCAs isn't part of their regular funding. The GP should be provided with high-quality information about the rationale for SCA and what the expectations of both parties, including the roles of the patient and their carers. It should also be clear that a decision regarding SCA must be made by the doctor who initiated treatment and the doctor should be informed if they are not willing to take part in the SCA. If a GP refuses to accept the 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 gave their initial diagnosis. This could lead to prescriptions for medications being given privately, rather than via the NHS. This can be more costly. What is a titration duration? The tration phase is a crucial step in determining the best medication to help manage your ADHD. It is the process of gradually increasing your dosage until you reach a level that maximises the benefits while minimizing side effects. It is an ongoing process that can take time. Your healthcare professional should be in close contact with you to ensure that the titration process is as effortless as it can be. Some patients might notice an increase in their symptoms during the titration time. People who are hyperactive, for instance, may become restless and angry. It is important to let loved ones know of any changes in behavior and provide support. It is also essential to maintain a healthy diet and to establish a consistent sleep routine to lessen the side effects of ADHD medication. Our Site of medication isn't the only treatment for ADHD however it is usually suggested as the first line of management in adults. Talk therapy can be an effective tool to deal with depression and anxiety, which can cause some symptoms of ADHD. It is important to keep in mind that medication can only treat the symptoms, not change the coping mechanisms that have been in place for a long time. Some patients choose not to take any medication and instead concentrate on self-help techniques such as nutrition, exercise and stress reduction. It is crucial to look over the side effects of any medicine you are prescribed, and understand how the medication affects your body. Certain medications can cause a decrease in appetite and cause headaches. Others can cause you to become drowsy. Make sure to always take your meds as directed and speak to your doctor if there are any adverse reactions. A lot of the drugs used to treat adult ADHD are currently out of stock because of shortages. This has caused delays in the diagnosis process and a backlog in appointments with psychiatrists. NHS England has set up an inquiry taskforce to look into the issue and recommend methods to speed up the process of waiting for medication. Ask your local GP what options are available for you. You may be able get the same medications privately, or they may recommend alternatives with similar results.