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ADHD Medication For Adults in the UK In the UK there are a variety of medicines licensed for treating ADHD. The stimulant methylphenidate, and the amphetamine-based drug lisdexamfetamine, are two of the most commonly prescribed drugs. The exact dose will need to be monitored closely in the beginning stages of treatment (titration) and then stable prescriptions will be administered by your GP as part of an agreed'shared care' arrangement. What is an Licensed Medication? A medicine that is licensed will have been through all the necessary clinical studies and tests and the MHRA (Medicines and Healthcare products Regulatory Authority) has granted it approval to use it in Great Britain. The medication will also be clearly listed as suitable for specific conditions on its packaging or in the leaflet that is included with it. All licensed medicines are regulated and monitored, even after they've entered the market, so problems can be identified quickly and risks minimized. Some people suffering from ADHD might be prescribed unlicensed drugs, but these are rarely utilized on teenagers and children. The medication that is not licensed may be used for other conditions which have been found to work well with it (known as off-label prescribing) or it could be a particular formulation that isn't yet available on the market, for instance an oral liquid instead of a tablet or something that is free of certain additives. It could also be an experimental medication that is being tested in the UK. The term “experimental drugs” is used to refer to Medicines that have a Marketing Authorisation(MIA) (IMP) or Investigational Medicinal Products. These medicines are not yet approved and can only be purchased through a prescription from a doctor. They will have undergone a formal assessment by the MHRA as part of the Early Access to Medicines Scheme (EAMS) and so pharmaceutical quality is assured. There is a non-stimulant medication that is commonly prescribed for ADHD in the UK and Europe and that is Atomoxetine. This is a selective noradrenaline-reuptake inhibitor, which works differently to other ADHD medications. It increases the amount of 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 in capsule form once or twice daily. A psychiatrist is the sole mental health professional who can diagnose ADHD in adults and prescribe medications to treat it. It's important to note that ADHD is not just a condition which can be treated with medication alone. Therapy is frequently included in treatment plans for people with the condition. Psychoeducation, which helps adolescents, children, and adults understand their diagnosis, and behavioural therapy, which teaches techniques to manage symptoms. What is an unlicensed drug? The term 'unlicensed medicine' refers to any medicine that has not been granted a license by the MHRA. It could be that the medicine has not been developed by an UK company, or because it has been prescribed in violation of the conditions of its licence (ie off-label). The GMC's guidelines say that 'unlicensed drugs are generally used when a suitable licensed product is not available or when a clinically-effective treatment cannot be found with the medication that the doctor is most comfortable with'. The license of a medicine will include 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 used. types of adhd medication will only grant an approval if the drug is thought to be safe and effective for that use, which is based on medical research and clinical trials. The manufacturers of the drugs are not permitted to promote or market any use that isn't covered by the licence. In the UK it is not a crime to let healthcare professionals to prescribe unlicensed drug provided that the patient is informed of the risks and benefits. They must also keep records of the use of unlicensed drugs and provide the patient with sufficient information to make the decision. Hospitals are more likely to offer unlicensed medicines because they have had more experience with them than GP surgeries. The hospital will have procedures to ensure the safety and effectiveness of the medication. This includes keeping detailed medical records of patients and also noting any adverse effects. They will also have to follow the MHRA's guidance on the safe supply of medicines that are not licensed. Doctors who prescribe specials have to be clear with patients and their parents or carers about what the medicine is and the reason it is being used, and the possible adverse effects. They should be able to answer any questions and provide written information about the medicine they prescribe, including reasons behind it. What is what is a Shared Care Agreement? In recent years as the number of people who are suspected of being suffering from ADHD increased and so did the requests for referrals to the NHS for an assessment and medication to treat the condition. Unfortunately, waiting lists for NHS assessments are long, and this means that many patients are reverting to self-funding private ADHD assessments at specialist private clinics. Once a diagnosis is confirmed then the GP may enter into a shared-care agreement (SCA) with the patient. A SCA is an agreement between your psychiatrist and your GP and GP, in which the responsibility for medication prescribing monitoring, as well as basic health checks is transferred to your GP. This is a recognized accepted method of transferring the responsibility for managing ADHD patients from a specialist or hospital to general practice. These SCA guidelines should be discussed between the doctor and the GP before responsibility is passed over and this should be clearly written on any referral form. It must also be stated that the GP remains responsible for continuous monitoring and titration of the medication. Unfortunately, a lot of GPs aren't keen on accepting SCAs. types of adhd medication isn't because of an inability to accept however, the work involved in SCAs can be out of their normal funding and it is usually an additional project on top of a busy schedule. The doctor must be informed about the reasoning for SCA as well as the expectations of all parties involved, and the role of the patients and their caregivers. It is also important to be clear that a decision on SCA should be taken by the doctor who initiated treatment. In addition, the doctor should be informed that they do not want to take part in the SCA. If a GP refuses to accept the responsibility for SCA and/or SCA, they are able to refuse. However, this can result in patients being referred back to the private ADHD clinic and psychiatrist that made their initial diagnosis. treating adhd without medication could result in prescriptions for medications being given privately, rather than through NHS. This could be more costly. What is a Titration Period? The tration phase is a crucial step to determine the best medication for ADHD. It is a process of increasing the dosage gradually until you reach the level that maximizes the benefits and minimizes the risk of side effects. It takes time but your healthcare professional should work closely with you to ensure that the titration process goes as smooth as possible. Some patients may experience a worsening of their symptoms during the titration phase. For example, those who are hyperactive may be more agitated and anxious than normal. For this reason, it is essential that family members are aware of any changes and provide assistance. To reduce the side effects of ADHD medications, it is important to maintain a healthy lifestyle and a regular sleep schedule. Medication isn't the sole treatment for ADHD, but it is generally suggested as the first line of treatment for adults. Talk therapy is a useful tool to address underlying depression and anxiety that could cause certain symptoms of ADHD. It is important to keep in mind that medication is only able to treat the symptoms, and not alter the coping mechanisms that have been in place for a long time. Some patients decide not to take any medication and instead concentrate on self-help strategies like fitness, nutrition and stress reduction. It is important to understand the adverse effects and how they affect your body. Certain medications can cause headaches or drowsiness, as well as decrease appetite. Be sure to use your medications as directed and consult your doctor if you notice any adverse reactions. A lot of the drugs used to treat adult ADHD are currently out of stock due to shortages. This has caused delays in the diagnosis process and a backlog in appointments with psychiatrists. NHS England has set up a taskforce to investigate the issue and recommend ways of reducing waiting times for medication. Ask your local GP what options are available for you. You may be able to get the same medications privately, or they may suggest alternative treatments that will produce similar results to those you're used to.