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ADHD Medication For Adults in the UK In the UK There are many medicines are licensed to treat ADHD. This includes the stimulant methylphenidate, as well as the amphetamine based medication Lisdexamfetamine. The exact dose will need to be carefully monitored during the initial stages of treatment (titration) and then, once stable, prescriptions can be managed by your GP as part of a shared care' arrangement. What is a Licensed Medication? A medicine that is licensed will have undergone all the appropriate clinical trials and tests and the MHRA (Medicines and Healthcare Products Regulatory Authority) has granted it approval for use in Great Britain. Read Home Page packaging of the medicine or the leaflet included with it will clearly state whether it's suitable for a specific condition. All licensed medicines are carefully controlled and monitored, even after they've entered the market, meaning that any problems can be spotted quickly and any risks reduced. Unlicensed medications are sometimes prescribed to people with ADHD, but they are seldom prescribed to teenagers or children. Unlicensed medications may be prescribed for other conditions that have been proven to work well (known as “off-label prescribing”) or they could be a formulation not yet available on the market for example, an oral liquid instead of a tablet. It could also be an experimental medicine currently being evaluated in the UK. The term “experimental drugs” is used to describe Medicines that have an IMP or Marketing Authorisation(MIA) (IMP) or Investigational Medicinal Products. These medications are not yet approved and can only be purchased with an order from a doctor. The MHRA will have conducted a formal review as part of the Early Access to Medicines Scheme. There is one non stimulant medication that is frequently prescribed for ADHD in the UK and Europe, and this is atomoxetine. It is a selective blocker of noradrenaline's absorption and therefore works in a different way than other ADHD medication. It increases noradrenaline which is a chemical that helps transmit messages between brain cells. This improves concentration and also helps control impulses. It is taken in capsule form once or twice daily. A psychiatrist is the only mental health professional who can diagnose ADHD in adults, and then prescribe medications to treat it. It is important to remember that ADHD is not just an illness that can be treated with medication alone. Therapy is often incorporated into treatment plans for people with the condition. Psychoeducation is a way to assist children, teens, and adults understand their diagnosis, as well as behavioural therapy which teaches techniques to manage symptoms. What is an Unlicensed Medication? The term “unlicensed medication” is a reference to any drug that has not been granted a licence by MHRA. It could be because the medication was not created by a company based in the UK or was prescribed outside of the licence conditions (off-label). The GMC's guidelines say that 'unlicensed medicines are typically employed when a licensed product is not available or when a clinically-effective treatment cannot be found with the product the prescriber is most comfortable with'. The label of a medicine will list the conditions it treats and the age ranges it can be administered to. The licence will also state how and by whom the medicine is to be administered. The MHRA only grants a license when it is considered safe and effective for that specific use, based upon clinical studies and medical research. The drugs' manufacturers are not allowed to promote or promote any use that is not covered by the licence. It is not illegal in the UK for medical professionals to prescribe an unlicensed medication, as long as they explain the risks and benefits of prescribing it to the patient. They must also keep records of the use of unlicensed medication and give the patient enough information to make an informed decision regarding whether or not they wish to take it. Hospitals are more likely to offer unlicensed medications because they have had more experience with them than doctors' surgeries. The hospital will have procedures in place to ensure the safety of the medication including keeping accurate patient records and ensuring that any adverse effects are documented. They must also adhere to the MHRA's guidelines for the safe supply of medicines that are not licensed. Doctors who prescribe specials have to be clear with patients and their parents or caregivers about the nature of the medication and the reason it is being used and the potential negative side consequences. They must be able answer any questions asked and must always provide written information about the medicine they prescribe along with the reasons for it. What is a Shared Care Agreement? In recent years as the number of adults who are suspected of having ADHD increased, 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 long and a lot of patients choose to pay privately for ADHD assessments in specialist private clinics. It is hoped that once a diagnosis has been confirmed by this process, the GP will sign an agreement of shared care (SCA). A SCA is an agreement between your psychiatrist and your GP where the responsibility for prescribing, monitoring and the basic health checks for medications is handed over to your GP. This is a recognized, agreed method of transferring responsibility for managing ADHD patients from a specialist service or hospital to general practice. These SCA guidelines should be discussed between the specialist and the GP before responsibility is handed to the GP and should be clearly in any referral form. It should be clear to the GP that they are responsible for the continual titration of the medication as well as the monitoring requirements. Unfortunately, many GPs aren't keen on accepting SCAs. This isn't because of a lack of desire however, the work involved with SCAs is often outside of their primary funding and it is often an additional task on top of a busy schedule. The GP should be informed about the reasoning of SCA, the expectations of the parties involved, as well as the role of the patients and their carers. It should be clear that the decision to pursue SCA should be taken by the doctor who is initiating treatment. The GP must also be informed that the patient isn't willing to participate in SCA. If a doctor does not want to accept responsibility for SCA and/or SCA, they are able to refuse. However, this could result in patients being sent back to the private ADHD clinic and the psychiatrist who provided their initial diagnosis. This can result in prescriptions for medication being issued privately rather than through the NHS which, of course, can be more costly. What is a Titration Period? The tration phase is a crucial step to find the right medication for ADHD. It is a process of increasing your dosage gradually until you get to the dosage that maximizes benefits and minimizes adverse effects. It takes time, but your healthcare specialist should work closely with you to ensure the titration process is as smooth as is possible. Certain patients may experience an increase in their symptoms during the titration phase. People who are hyperactive, like might become restless and irritable. This is why it is essential that family members are aware of any changes and offer support. It is also essential to have a healthy diet and to create a consistent sleep routine to lessen the side effects of ADHD medication. It is important to note that medication is not the only option for ADHD treatment. However it is suggested as a first-line treatment method for adults. Talk therapy is a helpful method to deal with depression and anxiety that could cause some of the symptoms of ADHD. It is important to remember that medication can only treat the symptoms, not alter long-standing negative coping mechanisms. Some patients decide not to take any medication, instead focusing on self-help techniques such as exercise, nutrition and stress reduction. It is important to go about the possible side effects of any medicine you are prescribed, and to understand how the medication affects your body. Certain medications can reduce appetite, cause headaches, or cause you to feel sleepy. Be sure to take your meds as directed and consult your doctor if you notice any adverse reactions. Currently, many of the drugs used to treat adult ADHD are out of stock. This has resulted in delays in the diagnosis process and a backlog in appointments with psychiatrists. NHS England has created a taskforce that will investigate the issue and provide recommendations on how to reduce waiting times for medication. Despite the shortage of some popular medications, it is still possible to get ADHD treatment through the NHS, and it's worth asking your local GP about options for you. You may be able get the same medications privately, or they may recommend alternatives with similar results.