Adult ADHD Medication in the UK
In the UK in the United Kingdom, the NHS has guidelines for diagnosing ADHD in adults. Referrals to the adult ADHD specialist clinic quadrupled in the course of the pandemic.
Both stimulants and non-stimulants are used to treat ADHD. Methylphenidate, dexamfetamine, and Lisdexamfetamine are amphetamine-based medicines which help to manage ADHD symptoms.
Stimulants
Stimulants are the most commonly used medication used to treat ADHD in adults. They work by enhancing activity in the parts of the brain that control the behavior and attention. They are quick-acting and are often the first choice for GPs. Methylphenidate (also called Ritalin) is the most frequently prescribed stimulant in both children and adults.
This medication increases the amount of neurotransmitters in the brain, which improves attention span and decreasing impulsivity and hyperactivity. It also helps reduce anxiety and depression, which may be a co-morbidity with ADHD.
In the past, stimulant substances are used for both medicinal purposes and recreationally, 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 cause negative psychological and physical effects if taken in excess.
There are a number of different medications that are used to treat adults with ADHD and psychiatrists will typically carefully adjust the doses of each patient they see. They will take into account any other medical issues a patient may have, as well as the impact of the medication on their sleep patterns. They will also consider the impact of the medication on a patient's diet as well as 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 lisdexamfetamine, commonly 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 with a prescription.
Despite adhd without medication , there's a stigma attached to the use of medication to treat ADHD that is based on unhelpful framings that compare it to child abuse, and even comparisons to controlled substances. This can make people hesitant to seek an assessment or to even think about taking medication for their condition.
The number of adults treated for ADHD increased with the increase in the number referred to NHS psychiatry during the COVID-19 epidemic. Adult ADHD referrals now outnumber those for children. Boys remain more likely to receive referrals, but the number of women who receive treatment for ADHD has quadrupled over the last two years.
Unlicensed Medication
A variety of medications are approved for treating ADHD for children and adults with stimulant drugs like methylphenidate and, sometimes, the newer amphetamine based medication lisdexamfetamine being prescribed. These are considered controlled drugs because they can be open to abuse and become addictive. Your consultant psychiatrist will only prescribe these drugs if he or believes that they are the most effective solution for your treatment. Then, you will be given a prescription which you can visit your local pharmacy and pick up. see it here will explain to you that this is for a monthly supply of the medication.
In some instances, your doctor may feel that the drugs they have available are not suitable for you and suggest an unlicensed medication. It's an individual decision and your doctor should only prescribe unlicensed medications as a last resort. Be aware that although medication is a crucial component of treating ADHD, talking therapy also plays a significant role. Therapy can alter your coping mechanisms as well as behavior patterns. Treatment with medication can alleviate your symptoms.
Medication used to treat ADHD in adults has to be licensed in the UK, with a licence known as marketing authorisation (MA) that will define the specific health conditions it's approved for. This will include the ages of the people who are treated and how the medication is to be used. The MHRA will provide an official assessment of any IMP before it is released, and the manufacturer can only promote it under its MA unless it holds an exclusive license for paediatric medicine.
Off label prescribing is when a psychiatrist believes it is appropriate to prescribe a medicine for an adult even though it was originally approved for a child. It is also possible to have"manipulated products" - where the pharmacist creates a formulation for an individual patient by mixing ingredients, for instance in the event that they are unable to take tablets. Some psychiatrists have voiced their displeasure at the over-prescription of psychoactive drugs to treat mental health issues, such as ADHD.
Licensing
In the UK There are many treatments are available to treat ADHD in adults. This includes a range of stimulant medications, including methylphenidate (Ritalin) and the newer amphetamine-based medicine lisdexamfetamine (Elvanse). These are typically offered to patients who have been diagnosed with the condition by a psychiatrist. The treatment is usually prescribed in the form of capsules and patients should be closely monitored by their doctor to ensure that the right dose is found.
In addition to these medicines however, there are a myriad of other ways in which the illness can be treated and controlled. For instance, behavioural therapies can help people understand the root causes of symptoms and develop strategies to overcome these. Changes in the environment can also aid in reducing the impact their symptoms have on their day-to-day lives. This includes arranging seating arrangements at work or school or at home, scheduling frequent movement breaks and providing 'I need a break' cards, and cutting down on distractions and noise.
The medicines that have been approved by the UK to treat ADHD in adults aren't meant to be a cure, but can improve the quality-of-life for many people. However, they are not a magic bullet and should only be used as a part of a holistic care plan that includes psychiatric and psychoeducational care.
Patients who are able to bear children should have a pregnancy test prior starting any medication. They must also inform their GP in the event that they fall pregnant or are planning to fall pregnant. It is also recommended that patients visit their GP if they experience any serious side-effects or don't feel that they are benefiting from the medication.
On the 27th of September, 2023, a nationwide patient safety alert was issued about the shortage of extended-release Guanfacine tablets, tablets of lisdexamfetamine and methylphenidate tablets. On May 8, 2024, a Medicine Supply Notification was issued that lifted the prescribing restrictions on Elvanse capsules.
It is an Schedule 2 drug, so it is only prescribed by a registered doctor and is subject to the Misuse of Drugs Regulations of 2001. The guidelines recommend that an ADHD patient be assessed annually by a healthcare provider who has the expertise and experience in managing the disorder. This can be done in primary care or secondary care, depending on local arrangements. The review should include a monitoring of heart rate and blood-pressure, a discussion on the need for continued treatment, and ongoing evaluation and monitoring of symptom improvement.
Side Effects
ADHD medication is generally well tolerated and safe for adults. However, it will not cure the condition. It can reduce behavioural symptoms and improve the quality of life for those suffering from the condition. It can also assist with working, learning and relationships.
It's crucial for anyone considering treatment to be aware of the potential side effects and discuss these with their doctor before they begin taking the medication. The side effects can include an increase in appetite, headaches and sleeplessness. Certain medications can raise your heart rate. This is usually minor and harmless, but it is worth noting to your doctor if there is a previous history of heart issues or cardiovascular disease.
Stimulants boost levels of norepinephrine and dopamine in the brain. This alters the way that the brain processes and transmits messages, improving attention and focus. These medications are first-line treatments of adult ADHD. Buproprion and Atomoxetine, which are non-stimulant drugs, have a more complex action on the brain. They also take longer to start working. The latter blocks the reuptake of dopamine into nerve cells and aids in concentration.
According to research, approximately half of the children diagnosed with ADHD will overcome their symptoms in adulthood. It may be due to how they manage their symptoms or because they become less active. A significant number of them are still struggling with a society that is not designed for their needs. That's why Nice recommends that doctors prescribe ADHD drugs only where they are necessary and keep monitoring patients on a regular basis.
There are other methods to treat ADHD symptoms. These include lifestyle changes and psychoeducational therapy. These can be used alongside medication to reduce the need for doctors to refer patients suffering from ADHD to specialist services.
The stigma that surrounds ADHD can make it difficult to open about medication and many adults are reluctant to disclose that they take it to their friends, family or employers. There is increasing evidence that revealing the existence of the condition can help break down barriers for treatment.