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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. The stimulant methylphenidate as well as the amphetamine-based drug lisdexamfetamine, are two of the most commonly prescribed drugs. The dosage will be closely monitored in the beginning stages of treatment. What is a Licensed Medication? A medicine that is licensed will have gone through all necessary clinical tests and trials, and the MHRA (Medicines and Healthcare Products Regulatory Authority) has granted it approval to be used in Great Britain. The medication will also be clearly identified as being suitable for specific conditions on its packaging or in a leaflet that is provided with it. All licensed medications are monitored, even after they're on the market, so problems are quickly identified and risks minimized. Unlicensed medicines are often prescribed to those suffering from ADHD however they are not often prescribed to children or teenagers. The unlicensed medication may be used to treat other conditions which have been found to be effective (known as off-label prescribing), or it might be a specific formula that isn't yet on the market, for instance an oral liquid in place of tablets or a product that is free of certain additives. It could be an experimental medicine that is being studied in the UK. The term “experimental drugs” is used to refer to Medicines with an Marketing Authorisation(MIA) (IMP) or Investigational Medicinal Products. These drugs aren't yet licensed and can only be purchased through the prescription of a physician. The MHRA will conduct a formal assessment as part of the Early Access to Medicines Scheme. There is a non-stimulant medication that is commonly prescribed for ADHD in the UK and Europe and that is the atomoxetine. This drug is a selective inhibitor of noradrenaline uptake, so it works differently than other ADHD drugs. It boosts the levels of noradrenaline within the brain which is a kind of chemical that sends messages between nerve cells, which improves concentration and helps control impulses. It is usually taken as a capsule every day or twice daily. A psychiatrist is the sole mental health professional who can identify ADHD in adults, and then prescribe medications to treat it. It is crucial to understand that ADHD is not just an illness which can be treated with medication alone, and therapy is very often included in treatment plans for those suffering from the condition. Psychoeducation can assist children, teens, and adults comprehend their diagnosis and the use of behavioural therapy to teach techniques for managing symptoms. What is an unlicensed medication? The term “unlicensed medicines” refers to drugs that have not been licensed by the MHRA. It could be that the drug was not developed by a UK-based business or it was prescribed outside of the terms of licence (off-label). The GMC's guidelines state that 'unlicensed medicine is usually utilized when a suitable licensed product is unavailable or when a clinically-effective treatment is not available with the medication that the doctor feels most comfortable using'. Iampsychiatry will list the health conditions it treats as well as the age of patients it may be prescribed to. It will also indicate how it should be used and by whom. The MHRA only grants a licence only if it is safe and effective in that specific use, based upon clinical studies and medical research. The drug manufacturers are not permitted to promote or advertise any uses that are not covered under the licence. It is not illegal in the UK for healthcare professionals to prescribe an unlicensed medication, as long as they explain the dangers and benefits of doing so to the patient. They must also keep records of the use of non-licensed medications and provide the patient with sufficient information to make an informed decision on whether or not to accept the. Hospitals tend to provide unlicensed medications because they have had more experience with them than doctors' surgeries. The hospital will have 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 be required to adhere to the MHRA's guidelines for the safe supply of non-licensed medicines. Doctors who prescribe specials need to be open with patients and parents or carers about the purpose of the medicine and why it is used and the potential side consequences. They must be able to answer any questions asked and always write down the details of the medicine they are prescribing, and the reason for prescribing it. What is a Shared Care Agreement? In recent years, as the number of adults suspecting of being suffering from ADHD increased, so did the requests for referrals to the NHS for an assessment and medication to treat the condition. The waiting lists for NHS assessments can be lengthy and many patients decide to pay for their ADHD assessments in specialist private clinics. The hope is that after a diagnosis has been confirmed through this process, the GP will sign an agreement of shared care (SCA). A SCA is an agreement between your psychiatrist and GP, whereby the responsibility for medication prescribing monitoring, prescribing, and basic health checks is transferred to your GP. This is a recognised and accepted method of transferring responsibility for managing a patient suffering from ADHD from an institution or a specialist service setting to general practice, provided that it is in accordance with NHS England guidelines. Before the responsibility is transferred the specialist and GP must agree on the SCA guidelines. This should be clearly stated on any referral form. It should also be clarified that the GP remains responsible for continuous monitoring and titration of the medication. Unfortunately, a lot of GPs are reluctant to accept SCAs. This isn't due to the lack of motivation, but because the work involved with SCAs is often outside of their core funding and it is often an additional task in addition to their busy schedule. The GP must be informed of the rationale of SCA and the expectations of the parties involved, and the role of patients and their carers. It should be made clear that the decision to proceed with SCA must be made by the prescriber initiating treatment. The GP should be informed of the patient's refusal to be willing to take part in SCA. If a doctor refuses to take responsibility for SCA or SCA, they may refuse. However, this could result in patients being sent back to the private ADHD clinic and psychiatrist that gave their initial diagnosis. This can lead to prescriptions for medication being issued privately, rather than via the NHS. This can be more expensive. What is Titration Period? The tration phase is a crucial step to find the appropriate medication for ADHD. It is the process of gradually increasing your dosage until you reach a dose that maximises the benefits while minimizing side effects. It is a process that takes time. Your healthcare professional should collaborate closely with you to ensure that the titration process is as easy as it can be. Some patients may experience worsening of their symptoms during the time of titration. For example, hyperactive people may be more agitated and anxious than normal. Because of this, it is crucial that family members are aware of any changes and provide assistance. To reduce the side effects from ADHD medications, it is important to maintain a healthy lifestyle and a consistent sleep schedule. The use of medication isn't the only treatment for ADHD however it is typically recommended as the first option for treatment for adults. Talk therapy can be beneficial in addressing depression and anxiety that can cause certain symptoms of ADHD. It is essential to keep in mind that medication only treats the symptoms and doesn't alter negative coping mechanisms. Some patients prefer not to take medication at all and instead concentrate on self-help methods such as nutrition, exercise, stress reduction and sleep strategies. It is essential to be aware of the effects of side effects and how they affect your body. Some medications can decrease appetite and cause headaches, as well as make you drowsy. Make sure to always take your meds as directed, and talk to your doctor if you experience any adverse reactions. Many of the medications used to treat adult ADHD are currently out of stock because of supply issues. This has led to delays in the diagnosis process and appointments with psychiatrists. NHS England has created a taskforce to investigate the issue and offer suggestions regarding how to decrease the time it takes to get medication. Despite the dearth of certain 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 take the same medications privately, or they might suggest alternatives that can provide similar results to those you're accustomed to.