ADHD Medication For Adults in the UK
In the UK there are a range of medicines licensed for treating ADHD. This includes the stimulant methylphenidate and the amphetamine-based medication Lisdexamfetamine. The exact dosage will need to be monitored carefully in the beginning stages of treatment (titration) and then the stable prescriptions can be managed by your GP as part of a'shared care arrangement.
What is a Licensed Medication (L.M.)?
A licensed medicine has undergone 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 included with it will clearly state whether it is suitable for a particular condition. All licensed medicines go through rigorous regulation and testing, even after they're available for sale. This allows for problems to be quickly identified and risks to be reduced.
Some people with ADHD may be prescribed medications that are not licensed however, they are not often used for teenagers and children. The unlicensed medication 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 specific formula that isn't yet on the market, like an oral liquid instead of a tablet or something free from 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 with an Marketing Authorisation(MIA) (IMP) or Investigational Medicinal Products. These medicines haven't been granted a licence as of yet and therefore can only be sold on an order from a doctor. adhd medication adults uk will conduct a formal assessment as part of the Early Access to Medicines Scheme.
Atomoxetine is a medication that's not stimulant that is commonly prescribed in the UK and Europe for ADHD. This medication is a specific inhibitor of noradrenaline's uptake and therefore works in a different way than other ADHD drugs. It increases noradrenaline in the brain which is a type of chemical that sends messages between nerve cells which aids concentration and helps control impulses. It is taken in capsule form once or twice daily.
A psychiatrist is the sole mental health professional who can identify ADHD in adults, and prescribe medications to treat it. It is important to keep in mind that ADHD isn't just a disease which can be treated by medication by itself. Therapy is often included in treatment plans. Psychoeducation is a form of therapy which helps children, teenagers and adults make sense of their diagnosis, as well as behavioural therapy, which teaches strategies to manage 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 in violation of the licence conditions (off-label). The GMC's guidelines state that 'unlicensed medicines are typically used when a suitable licensed product is unavailable or a clinically effective treatment cannot be found with the product the prescriber feels most comfortable using'.
A medicine's licence will list the conditions it treats and the ages of patients it can be given to. It will also specify how it should be taken and by whom. The MHRA only grants a licence only if it is safe and effective in that particular application, based on clinical studies and medical research. The manufacturers of drugs are not permitted to advertise or promote any use that are not covered by the licence.
It is not illegal in the UK for medical professionals to prescribe an unlicensed medication, as long as they can explain the dangers and benefits of prescribing it to the patient. They must keep records of the use of medications that are not licensed and give the patient enough information to make an informed decision on whether or not to take it.
Hospitals are more likely to give unlicensed drugs because they have more experiences with them than GP surgeries. The hospital will have procedures in place to ensure the safety of the medication which includes keeping detailed patient records and ensuring that any adverse reactions are documented. They will also be required to adhere to the MHRA's guidelines on the safe supply of non-licensed medicines.
Doctors who prescribe specials have to be open with patients and parents or caregivers about what the medicine is, why it is being used and the potential negative side effects. They should be able to answer any questions and provide written information about any medication they prescribe, including reasons for prescribing it.
What is a Shared Care Agreement?
In recent years, as the number of people who are 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 can be lengthy and many patients decide to pay privately for ADHD assessments at private clinics. If a diagnosis is confirmed and the diagnosis is confirmed, the GP might sign an agreement of shared-care (SCA) with the patient.
A SCA is an agreement between your psychiatrist and your GP where the responsibility for prescribing, monitoring and basic health checks for medications is handed over to your GP. It is a well-known and accepted method of shifting the responsibility of managing ADHD patients from a specialist clinic or hospital to a general practice.
These SCA guidelines should be agreed between the specialist and the GP before the responsibility is handed over and this should be clearly stated on any referral form. It should also be made clear that the GP retains responsibility for continuous monitoring and titration of the medication.
Unfortunately, a lot of GPs aren't keen on accepting SCAs. It's not because they are not interested or desire, but because the work involved in SCAs is not part of their primary funding.
The doctor must be informed of the reasons for SCA, the expectations of the participants, and the roles of patients and their caregivers. It is also important to be clear that the decision to participate in SCA should be taken by the prescriber who initiated treatment and the doctor should be informed whether they wish to participate in the SCA.
If a GP refuses to accept the responsibility for SCA, they can refuse. However, this may result in patients being referred back to the private ADHD clinic and the psychiatrist who gave their initial diagnosis. This can result in prescriptions for medication being given privately instead of through the NHS which, of course, can be more costly.
What is a titration duration?
The tration phase is a crucial stage to find the appropriate medication for ADHD. It involves gradually increasing your dosage until you reach a level that maximizes the benefits of your medication while minimizing negative side effects. It takes time however, your healthcare specialist should work closely with you to ensure that the titration process goes as smooth as it can be.
Certain patients may experience an increase in their symptoms during the titration period. For example, hyperactive people may be more agitated and irritable than usual. It is essential to let loved ones know of any changes in behavior and offer support. It is also crucial to eat a balanced diet and an established routine for sleeping to lessen the adverse effects of ADHD medications.
Medication is not the only treatment for ADHD, but it is usually recommended as the first option for management in adults. Talk therapy is an effective tool to deal with depression and anxiety that can be the cause of some symptoms of ADHD. It is crucial to remember that medication can only treat the symptoms, not change the coping mechanisms that have been in place for a long time. Some patients opt to not take any medication and instead concentrate on self-help techniques such as fitness, nutrition and stress reduction.
It is crucial to look about the possible side effects of any medicine you are prescribed, and understand how the medication will affect your body. Some medications can decrease appetite and cause headaches, as well as make you drowsy. Be sure to take your meds as directed and speak to your doctor if there are any adverse reactions.
Presently, a lot of treatments for adults with ADHD are in short supply. This has caused delays in the diagnosis process and appointments with psychiatrists. NHS England has created a taskforce that will investigate the issue and offer suggestions on how to reduce waiting times for medications.
Ask your local GP what options are available for you. You may be able get the same medications privately or they could suggest alternatives with similar results.