Adult ADHD Medication in the UK
In the UK there are guidelines to diagnose ADHD among adults. The number of referrals to the adult ADHD specialist clinic quadrupled during the time of the pandemic.
The medications used to treat ADHD comprise stimulants and non-stimulants. Methylphenidate is the most common medicine to help manage symptoms of ADHD and is accompanied by two amphetamine-based drugs called dexamfetamine and lisdexamfetamine.
Stimulants
Stimulants are the most commonly used medication used to treat ADHD in adults. They increase the activity of parts of the brain that regulate attention and behaviour. They are fast-acting and are often the first choice of GPs. Methylphenidate (also known as Ritalin) is the most frequently prescribed stimulant in both children and adults.
This drug increases the levels of neurotransmitters in the brain, improving attention span and decreasing impulsivity and hyperactivity. It also helps to reduce anxiety and depression that may occur with ADHD.
Through time, stimulant drugs have been used medicinally and for recreational purposes, to enhance cognitive function, motivation, performance, and mood. These include caffeine, nicotine amphetamines and cocaine, modafinil and methylphenidate. These substances are used to suppress appetite and increase energy. However, they may also have serious physical and psychological effects if taken in excess.
A psychiatrist will be careful to adjust the dosages for each patient. They will also take into consideration any other medical conditions that a patient may have, and the effect of the medication on their sleep patterns. They will also consider the impact of the medication on the diet of a patient and lifestyle.
A large network meta analysis conducted by NIHR Oxford Health Biomedical Research Centre (NIHR Oxford Health Biomedical Research Centre) and Stichting Eunethydis has found that the drug lisdexamfetamine, also known as Adderall, is more effective than any other stimulant in reducing symptoms of ADHD. It is recommended by NICE and is available in the UK on prescription.
Despite the evidence-based evidence that support the use of drugs for ADHD is still viewed as a stigma. Unhelpful framings refer to it as child exploitation and controlled substances. This makes many unwilling to seek an assessment or to think about taking medication for their condition.
As the number of patients referred to NHS mental health services increased during the COVID-19 epidemic, as did the number of adults receiving treatment for ADHD. In fact, adult ADHD referrals have now surpassed those for children. Boys are still more likely to be referred for ADHD treatment however the number of women who receive it has quadrupled in the last two years.
Unlicensed Medication
A range of medicines are licensed for treating ADHD for children and adults with stimulant drugs such as methylphenidate, and occasionally the more recent amphetamine-based medication lisdexamfetamine prescribed. These drugs are classified as controlled drugs due to the fact that they can be addicting and addictive. Your psychiatrist will only prescribe them if they believe they are the best option for you as part of your treatment. You will then be given a prescription which you can visit your local pharmacy and pick up. It is for a month's supply the medication and your pharmacist will be able to explain the procedure to you.
In some cases, your doctor may decide that the drugs they offer aren't appropriate for you and recommend a medication that is not licensed. It's a case by case decision and your psychiatrist should only use unlicensed medication as a last resort. It is crucial to remember that even though medication is a key part of treatment for ADHD and ADD, therapy with a therapist is equally important. Medicine can aid in managing your symptoms, but therapy can help change longstanding negative coping mechanisms and behavior patterns.
In how to get adhd medication uk , medication used to treat ADHD among adults must have an authorization for marketing (MA) that specifies the specific conditions for which it's approved. It will also include information about the age of people who are eligible to receive the medication and how it should be taken. The MHRA will conduct an official assessment of any IMP before it is released, and the manufacturer can only promote it under its MA or if it has a specific licence for paediatric medicine.
This is the situation where a drug is approved for children but a psychiatrist believes it's appropriate to prescribe it to an adult. This is also known as off label prescribing. It is also possible to have"manipulated" products - in which the pharmacist makes up the formulation for a specific patient by mixing ingredients, for example in the event that they are unable to take tablets. There is a stigma around the use of unlicensed drugs to treat ADHD in adults, with psychiatrists expressing concern about the over-prescribing of psychoactive drugs to treat mental health issues.
Licensing
In the UK, there are a range of medications that are authorised to treat ADHD in adults. There are several stimulant drugs, such as methylphenidate, (Ritalin) and the more recent amphetamine-based medication lisdexamfetamine, (Elvanse). Typically, they are given to patients suffering from the condition after consulting a psychiatrist. The treatment is typically prescribed in the form of capsules and patients are closely monitored by their physician to ensure that the right dose is found.
In addition to these drugs in addition, there are a variety of other ways that the disease can be treated and controlled. For instance, behavioural therapy can help people understand the root causes of symptoms and develop strategies to overcome these. In addition, environmental modifications can also be useful in helping people to cope with the effects of their symptoms in daily activities. This includes making seating arrangements at work or school and distributing cards that read 'I Need a Break' and scheduling frequent breaks for movement, as well as reducing noise and distractions.
The drugs that have been approved by the UK to treat ADHD among adults aren't intended to cure, but can improve the quality of life for a lot of people. They are not a cure-all and should be used as a component of a comprehensive care package that includes psychoeducation, psychiatric treatment and medication.
Patients with childbearing capacity should have a pregnancy test prior to taking any medication. They should also inform their GP in the event that they fall pregnant or want to become pregnant. It is also recommended that patients should see their GP if they experience any significant side effects or do not feel that they are benefiting from the medication.
A national patient safety alert regarding the shortage of methylphenidate prolonged-release tablets, guanfacine extended-release tablets and lisdexamfetamine capsules was released on September 27, 2023. It was replaced by an Medicine Supply Notification (MSN) on May 8, 2024. The MSN lifted the restrictions on prescribing for Elvanse capsules and advised ADHD services to resume the initiation of treatment.
It is a Schedule 2 controlled drug so it is prescribed by a registered physician and is subject to the Misuse of Drugs Regulations 2001. The guidelines suggest that people suffering from ADHD should be evaluated annually by a healthcare expert with experience and training in managing the disorder, whether in primary or secondary care depending on the local arrangements. This review should include monitoring for blood pressure and heart rate, a discussion about the need for ongoing treatment, and continuous evaluation of symptoms and monitoring improvement.
Side Effects
ADHD medication is generally well-tolerated and is safe for adults. However, it does not cure the condition. It can help reduce symptoms of behavioural, and improve the quality of life of people. It can also help with learning, work and relationships.
However, it's essential for anyone who is starting treatment to be aware of the potential adverse effects and to discuss them with their doctor before they begin taking the medication. Some side effects include sleeplessness, headaches and changes in appetite. Some medications can increase heart rate. This is usually minor and harmless but is worth noting to your doctor if there is a previous history of heart issues or cardiovascular disease.
Stimulants increase the levels of dopamine and norepinephrine within the brain. This alters the way the brain receives and transmits messages, improving concentration and attention. These medications are first-line treatments of adult ADHD. Buproprion and Atomoxetine which are non-stimulant drugs have a more intricate effect on the brain. They also take longer to start working. The latter block dopamine reuptake by nerve cells, and aids with concentration.
Research suggests that half of children who are diagnosed with ADHD are able to overcome their symptoms in adulthood. It could be due to the fact that they manage their symptoms, or perhaps because they are less active. But a significant number remain in the society that was not designed specifically for them. That's why Nice recommends doctors prescribe ADHD drugs only where they are needed and keep monitoring patients on a regular basis.
There are many other ways to help with ADHD symptoms, such as lifestyle changes and psychoeducational therapies. These can be combined with medications to decrease the need for GPs to refer adults with ADHD to specialist services.
Many adults are hesitant to inform their families, friends or employers that they are taking ADHD medication due to the stigma associated with it. But, there is growing evidence that discussing the condition and raising awareness of its symptoms can help to reduce barriers to treatment.