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 and the amphetamine-based drug lisdexamfetamine, are two of the most commonly prescribed medications. The exact dosage will need to be monitored carefully in the beginning stages of treatment (titration) and then the stable prescriptions will be administered by your GP as part of a shared care arrangement.
What is an Licensed Medication (L.M.)?
A medicine that is licensed has passed all of the necessary tests and clinical trials, and the MHRA the Medicines and Healthcare Products Regulatory Authority (MHRA) has granted the green light for its use in Great Britain. The packaging of the medicine or the leaflet included with it will clearly state whether it's suitable for a specific condition. All licensed medicines go through strict supervision and testing, even after they're available for sale. This allows for problems to be identified quickly and risks to be reduced.
Certain people with ADHD may be prescribed unlicensed drugs, but these are rarely utilized on teenagers and children. The unlicensed medication could be used for other conditions which have been proven to be effective (known as off-label prescribing) or it could be a specific formula that isn't available on the market, for instance an oral liquid in place of a tablet or something without certain additives. It could also be an experimental medication that is being tested in the UK.
The term "experimental drugs" is used to describe Medicines with an Marketing Authorisation(MIA) (IMP) or Investigational Medicinal Products. These medicines are not yet licensed and can only be purchased through the prescription of a physician. They will have undergone a formal assessment by the MHRA as part of the Early Access to Medicines Scheme (EAMS) and thus pharmaceutical quality is assured.
There is one non stimulant medication that is commonly prescribed for ADHD in the UK and Europe and this is Atomoxetine. It is a selective noradrenaline reuptake inhibitor, and so differs from other ADHD meds. It boosts the levels of noradrenaline within the brain, which is a sort of chemical that sends messages between nerve cells and this aids concentration and helps control impulses. It is typically taken as a capsule every day or twice per day.
A psychiatrist is the only mental health professional who can identify ADHD in adults, and prescribe medications to treat it. It's important to note that ADHD isn't a disorder which can be treated with medications alone. Therapy is often incorporated into treatment plans for those suffering from the disorder. This may include psychoeducation, which assists children, teenagers and adults make sense of their diagnosis, as well as behavioral therapy, which teaches strategies to manage symptoms.
What is an Unlicensed Medication?
The term "unlicensed medicines" refers to medicines that are not licensed by the MHRA. It could be because the medicine was not developed by a UK-based business or was prescribed outside of the licence terms (off-label). The GMC's guidelines state that 'unlicensed drugs are generally used when a suitable licensed product is not available or when a treatment that is clinically effective is not available with the product that the prescriber is most comfortable with'.
The medical license will list the conditions it treats, along with the age ranges it is able to treat. adhd sleep medication will also specify how it should be taken and by whom. The MHRA will only issue permission if the drug is considered to be safe and effective for the application, based on medical research and clinical trials. The manufacturers of the drugs are not permitted to promote or advertise any use that isn't covered by the licence.
In the UK it is not a crime to let a healthcare professional prescribe an unlicensed medication in the event that the patient is aware of the potential risks and benefits. They must also keep a record of the use of unlicensed medications and provide the patient sufficient information to make a decision.
Hospitals tend to provide unlicensed drugs because they have had more experience with them than doctors' surgeries. The hospital will have procedures in place to ensure the safety of the medication, including keeping accurate patient records and ensuring that any adverse effects are documented. 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 the nature of the medication and the reason it is being utilized and the possible adverse consequences. They should be able answer any questions and provide written information about any medicine they prescribe, including reasons for it.
What is a Shared-Care agreement?
In recent years as the number of adults who are suspected of being suffering from ADHD increased and so did the requests for an appointment with the NHS for an assessment and treatment to treat the condition. The waiting lists for NHS assessments can be lengthy and many patients decide to pay privately for ADHD assessments in specialist private clinics. It is hoped that once the diagnosis is confirmed through this process, the GP will enter into an agreement of shared care (SCA).
A SCA is a contract between your psychiatrist and your GP and GP, in which the responsibility for prescribing medications monitoring, as well as basic health checks is transferred to your GP. This is a recognized and accepted method of transferring responsibility for managing a patient with ADHD from an institution or specialist service to general practice, provided this is in accordance with NHS England guidelines.
Before the responsibility is transferred the specialist and GP should agree on these SCA guidelines and this should be clearly stated in any referral form. It must also be stated that the GP retains responsibility for regular monitoring and titration of the medication.
Unfortunately, a lot of GPs are reluctant to accept SCAs. It's not because they are not interested or desire, but because the work involved in SCAs is outside their core funding.
The doctor should be given adequate information regarding the rationale for SCA and what the expectations of both parties, including the role of the patient and their caregivers. It is also important to be clear that a decision regarding SCA should be made by the prescriber who initiated treatment. The doctor should be informed if they are not willing to participate in the SCA.
If a GP does not want to assume the responsibility of SCA they can refuse to do so, however this could result in patients being sent back to the private ADHD assessment clinic and psychiatrist who made their initial diagnosis. This can mean that prescriptions for medication are issued privately rather than through the NHS which, naturally, could be more expensive.
What is a Titration Period?
The tration period is a crucial element in determining the best medication to manage your ADHD. It is the process of increasing the dosage gradually until you get to the dosage that maximizes benefits and minimises side effects. It is a process that takes time. Your healthcare professional should be in close contact with you to ensure the titration procedure is as effortless as it can be.
Some patients may experience an increase in their symptoms during the titration time. Hyperactive people, for example, may become restless and angry. It is essential that loved ones are aware of any changes in behavior and provide assistance. It is also essential to eat a balanced diet and to create an established routine for sleeping in order to reduce the adverse effects of ADHD medications.
It is important to keep in mind that medication isn't the only option for ADHD treatment. However it is suggested as a first-line treatment method for adults. Talk therapy can be beneficial in addressing depression and anxiety, which can trigger certain symptoms of ADHD. It is important to keep in mind that medication only addresses symptoms and doesn't alter negative coping mechanisms. Some patients choose not to take any medication, instead focusing on self-help techniques such as exercise, nutrition and stress reduction.
It is important to understand the adverse effects and how they affect your body. Certain medications can cause a decrease in appetite and cause headaches, as well as cause you to feel sleepy. Make sure to always use your medications as directed, and talk to your doctor if you notice any adverse reactions.
Currently, many of the treatments for adults with ADHD are in short supply. This has led to delays in diagnosis and a backlog in appointments with psychiatrists. NHS England has set up an inquiry taskforce to look into the issue and suggest methods to speed up the process of waiting for medication.
Ask your local GP what alternatives are available to you. You may be able get the same medications privately or they could suggest alternatives that have similar results.