ADHD Medication For Adults in the UK
In the UK there is a variety of drugs that are licensed to treat ADHD. relevant internet page includes the stimulant methylphenidate as well as the amphetamine-based medication Lisdexamfetamine. The dosage will be closely monitored in the beginning stages of treatment.
What is a Licensed Medication?
A licensed medicine has gone through all of the necessary clinical trials and tests and the MHRA Medicines and Healthcare Products Regulatory Authority (MHRA) has given the go ahead for its use in Great Britain. The packaging of the medicine or the leaflet that comes with it will clearly indicate the appropriateness of the medicine for a particular condition. All licensed medicines are monitored, even after they're on the market, meaning that any problems are quickly identified and any risks reduced.
Unlicensed medications are sometimes prescribed to those suffering from ADHD however they are not often prescribed to adolescents or children. Unlicensed medications may be prescribed for other conditions that have been proven to be effective (known as "off-label prescribing") or they could be a form of treatment that is not yet available in the market, such as a liquid oral instead of tablets. It could also be an experimental drug being trialled 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 haven't been granted a license yet and can therefore only be sold with the prescription of a doctor. The MHRA will have conducted a formal evaluation as part of the Early Access to Medicines Scheme.
Atomoxetine is a medication that's not stimulant that's often prescribed in the UK and Europe for ADHD. It is a selective inhibitor of noradrenaline's uptake and therefore works in a different way than other ADHD medication. It boosts the levels of noradrenaline within the brain which is a kind of chemical that passes messages between nerve cells which improves concentration and helps control impulses. It is typically taken in capsules once or twice a day.
A psychiatrist is the sole mental health professional who can identify ADHD in adults, and then prescribe medication to treat it. It is crucial to understand that ADHD isn't a disorder that can be treated by medication alone. Therapy is frequently included in treatment plans for people suffering from the disorder. This can include psychoeducation to help children, teens and adults understand their diagnosis as well as behavioral therapy that teaches strategies for managing symptoms.
What is an unlicensed medication?
The term "unlicensed medicines" refers to drugs that have not been approved by the MHRA. It could be because the medication was not created by a company based in the UK or it was prescribed in violation of the terms of licence (off-label). The GMC's guidelines say that 'unlicensed medicines are typically utilized when a suitable licensed product is not available, or when a clinically-effective treatment cannot be found with the product the prescriber feels most comfortable using'.
The medical license will specify the conditions it treats as well as the age ranges that it can be administered to. It will also state how it should be used and by whom. The MHRA only grants a license only if it is safe and effective for that specific use, based upon clinical studies and medical research. The drug's manufacturers are not permitted to promote or advertise any use that isn't covered by the licence.
It is not illegal in the UK for healthcare professionals to prescribe a non-licensed medication in the event that they explain the advantages and risks of this to the patient. They must also keep an account of the use of unlicensed drugs and provide the patient with sufficient information to make the decision.
Unlicensed medicines are usually offered in hospitals, as there is more experience of using them than in GP surgeries. The hospital will implement procedures to ensure the safety and effectiveness of the medication. This includes keeping detailed patient records, and noting any adverse effects. They are required to adhere to MHRA guidelines on the safe supply unlicensed medicine.
Specials are prescribed by doctors who must inform their patients, their parents or caregivers of the medication as well as its purpose and possible side effects. They should be able to answer any questions and provide written information about any medication they prescribe, including reasons behind it.
What is what is a Shared Care Agreement?
In recent years, as the number of adults suspected of having ADHD increased as did the demand for a referral to the NHS for an assessment and medication to treat the condition. The waiting lists for NHS assessments are long and this means that a large number of patients are opting to pay for their own private ADHD assessments at specialist private clinics. The hope is that after the diagnosis is confirmed through this process the GP will enter into an agreement of shared care (SCA).
A SCA is an agreement between your psychiatrist and GP, whereby the responsibility for medication prescribing, monitoring, and basic health checks are transferred to your GP. This is a recognised, agreed method of transferring the responsibility of managing ADHD patients from a specialist service or hospital to a general practice.
Before transferring responsibility the specialist and GP should agree on these SCA guidelines and this must 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, many GPs aren't keen on accepting SCAs. This isn't due to a lack of desire but rather because the work involved in SCAs could be out of their normal funding, and usually an additional project on top of a busy schedule.
The doctor should be provided with high-quality information about the reasons behind SCA and what the expectations of both parties are including the role of the patient and their caregivers. It should also be made clear that a decision on SCA should be taken by the doctor who initiated treatment. The GP should be told that they do not want to take part in the SCA.
If a GP does not want to assume the responsibility of SCA they can refuse to do so, but this could result in patients being sent back to the private ADHD assessment clinic and psychiatrist who performed their initial diagnosis. This could result in prescriptions for medication being issued privately rather than through the NHS, which of course is more expensive.
What is a Titration Period?
The tration phase is a crucial step to find the right medication for ADHD. It is the process of gradually increasing your dosage until you reach a dose that maximizes the benefits of your medication while minimizing negative side effects. It is an process that takes time. Your healthcare professional must work with you closely to ensure that the titration procedure is as easy as it can be.
Certain patients might notice an increase in their symptoms during the titration time. Hyperactive people, for example can become agitated and irritable. It is essential that loved ones are aware of any changes in behavior and offer support. To lessen the negative side effects from ADHD medication it is crucial to maintain a healthy lifestyle and a consistent sleep schedule.
The use of medication isn't the only treatment for ADHD however it is usually recommended as the first line of treatment for adults. Talk therapy is an effective tool to address underlying depression and anxiety that may 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 choose not to use meds in the first place and instead focus on self-help treatments such as exercise, nutrition, stress reduction and sleep strategies.
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 cause a decrease in appetite, cause headaches, or cause you to become drowsy. Always take your medication as directed and consult your physician in the event of any adverse reactions.
Presently, a lot of medications used for treating adult ADHD are out of stock. This has led to delays in diagnosis and a backlog in appointments with psychiatrists. NHS England has created a taskforce to study the issue and provide recommendations on how to cut down waiting times for medications.
Ask your local GP what options are available for you. You may be able to take the same medications privately, or they may recommend alternatives that will have similar results to what you are used to.