ADHD Medication For Adults in the UK
In the UK, a number of medications are approved to treat ADHD. The stimulant methylphenidate, and the amphetamine-based medication lisdexamfetamine are two of the most frequently prescribed drugs. The precise dose needs to be carefully monitored in the beginning stages of treatment (titration) and then, once stable, prescriptions can be managed by your GP as part of a'shared care' arrangement.
What is an Licensed Medication?
A licensed medicine has undergone all the required clinical trials and tests and the MHRA, the Medicines and Healthcare Products Regulatory Authority (MHRA), has granted the green light for its use in Great Britain. adhd without medication will also be listed as suitable for a particular condition on its packaging or in the leaflet that is provided with it. All licensed medicines undergo strict regulation, even after they are available for sale. This allows for problems to be quickly identified and the risk to be minimized.
Unlicensed medications are sometimes prescribed to people with ADHD, but they are seldom prescribed to teenagers or children. The unlicensed medication could be used to treat other conditions which have been found to work well with it (known as off-label prescribing), or it might be a specific formulation that isn't available on the market, such as an oral liquid instead of a tablet or something that is free of certain additives. It may be an experimental medication that is being tested in the UK.
The term "experimental drugs" is used to refer to Medicines that have an Marketing Authorisation(MIA) (IMP) or Investigational Medicinal Products. These medications are not yet licensed and can only be purchased through a prescription from a doctor. They'll have been through a formal assessment by the MHRA as part of the Early Access to Medicines Scheme (EAMS) and so the quality of pharmaceuticals is guaranteed.
There is one non stimulant medication that is commonly prescribed for ADHD in the UK and Europe, and this is atomoxetine. This drug is a selective inhibitor of noradrenaline's uptake which means it performs differently than other ADHD medications. It increases noradrenaline which is a chemical that helps to transmit messages between brain cells. This helps improve concentration and also helps control impulses. It is usually taken in capsules once or twice a day.
Only a psychiatrist can diagnose ADHD and prescribe medication for adults. It is important to remember that ADHD isn't a condition which can be treated by medication by itself. Therapy is often included in treatment plans. Psychoeducation is a form of therapy which helps adolescents, children, and adults make sense of their diagnosis, and the behavioural therapy, which helps teach methods to manage symptoms.
What is an Unlicensed Medication?
The term "unlicensed medication" is a reference to any drug that has not been granted a license by the MHRA. This may be because the medication was not developed by an UK company, or because it was prescribed outside the restrictions of its licence (ie off-label). The GMC's guidelines say that 'unlicensed drugs are generally employed when a licensed product is unavailable or when a treatment that is clinically effective is not available with the product that the prescriber feels most comfortable using'.
A medical license will specify which health conditions it treats and the age of the patients it can be administered to. It will also specify the dosage and by whom. The MHRA only grants a license when it is considered safe and effective in that specific use, based upon clinical trials and medical research. The drugs' manufacturers are not allowed to promote or market any use that isn't covered by the licence.
In the UK it is not a crime to let medical professionals to prescribe an unlicensed medicine provided that the patient is informed of the potential risks and benefits. They must keep an account of the use of unlicensed drugs and provide the patient with sufficient information to make an informed decision.
The majority of unlicensed medications are given in hospitals, where there is more experience using them than in GP practices. The hospital will follow procedures to ensure the safety and effectiveness of the medication. This includes keeping thorough medical records of patients as well as recording any adverse reactions. They are required to adhere to MHRA guidelines regarding the safe supply of unlicensed medications.
Specials are prescribed by doctors who must be clear with their patients, parents or caregivers about the medicine it is prescribed for, its purpose, and any potential side effects. They should be able answer any questions and provide written information about the medicine they prescribe, including the reasons for it.
What is a Shared-Care agreement?
The number of adults who are suspected to have ADHD has increased in recent years so have the demand to be referred to an NHS assessment and receive medication for the condition. Unfortunately, waiting lists for NHS assessments are long and this means that a lot of patients are reverting to self-funding private ADHD assessments at specialist private clinics. If a diagnosis is confirmed and the diagnosis is confirmed, the GP might sign a shared-care arrangement (SCA) with the patient.
A SCA is an agreement between your psychiatrist and GP and GP, in which the responsibility for prescribing medications monitoring, prescribing, and basic health checks is transferred to your GP. This is a recognized and accepted method for the transfer of the responsibility of managing a patient suffering from ADHD from a hospital or a specialist service setting to general practice, provided this is in line with NHS England guidelines.
These SCA guidelines should be discussed between the specialist and the GP before the responsibility is handed to the GP and should be clearly stated on any referral form. It must also be stated that the GP remains responsible for regular monitoring and titration of the medication.
Unfortunately, many GPs aren't keen on accepting SCAs. This isn't because of the lack of motivation but rather because the work involved with SCAs can be outside of their primary funding, and usually an additional project in addition to their busy schedule.
The doctor must be informed of the rationale of SCA, the expectations of the parties involved, as well as the role of patients and their caregivers. It should also be made clear that a decision on SCA must be made by the doctor who initiated treatment and the GP should be told that they do not want to participate in the SCA.
If a doctor does not wish to take on the responsibility of SCA they can refuse to do so, but this can lead to patients being reverted back to the private ADHD assessment clinic and psychiatrist who made 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 a crucial step to determine the best medication for ADHD. It involves gradually increasing your dose until you reach a dosage that maximizes the benefits while minimizing negative side effects. It is a process that takes time. Your healthcare professional should work with you closely to ensure the titration procedure is as smooth as it can be.
Certain patients may experience an increase in their symptoms during the titration period. People who are hyperactive, for instance can become agitated and irritable. It is important to let loved ones know of any changes in behavior and provide assistance. To minimize the adverse effects from ADHD medication it is crucial to maintain a healthy lifestyle and a regular sleep schedule.
Medication isn't the sole treatment for ADHD however it is usually recommended as the first line of treatment for adults. Talk therapy is a helpful tool to address depression and anxiety, which can be the cause of some symptoms of ADHD. It is crucial to remember that medication can only treat the symptoms, not alter longstanding negative coping mechanisms. Some patients decide not to take any medication and instead concentrate on self-help strategies such as exercise, nutrition and stress reduction.
It is important to go over the adverse effects of any medication you are prescribed and know how the medication affects your body. Certain medications can cause a decrease in appetite and cause headaches, as well as cause you to feel sleepy. Be sure to take your meds as directed and speak to your doctor if you notice any adverse reactions.
Many of the medications used to treat adult ADHD are currently in short supply due to supply issues. This has resulted in delays in diagnosis and a backlog in appointments with psychiatrists. NHS England has created a taskforce to study the issue and offer suggestions on how to reduce the time it takes to get medication.
Despite the lack of certain popular drugs, it's still possible to receive ADHD treatment in the NHS, and it's a good idea to ask your local GP about your options. You might be able to take the same medications privately, or they could recommend alternatives that will have similar results to what you are used to.