ADHD Medication For Adults in the UK
In the UK there is a variety of medications that are approved for treating ADHD. These include the stimulant methylphenidate, as well as the amphetamine-based drug called lisdexamfetamine. The exact dose will need to be carefully monitored during the early stages of treatment (titration) and then stable prescriptions can be managed by your GP as part of an agreed'shared care' arrangement.
What is a Licensed Medication (L.M.)?
A medicine that is licensed will have gone through all necessary clinical trials and tests, and the MHRA (Medicines and Healthcare products Regulatory Authority) has granted it approval to be used in Great Britain. The packaging of the medicine or the leaflet included with it will clearly state the appropriateness of the medicine for a particular condition. All licensed medicines are subject to strict regulation, even after they are available for sale. This allows for issues to be detected quickly and reduces the risk.
Some people suffering from ADHD may be prescribed unlicensed drugs however they aren't often used on children and teenagers. The medication that is not licensed may be prescribed for other conditions that have been found to be effective (known as off-label prescribing) or it could be a specific formulation that isn't yet on the market, for instance an oral liquid in place of tablets or a product free from certain additives. It could also be an experimental medicine currently being evaluated in the UK.
Experimental drugs are referred to as Investigational Medicinal Products (IMPs) or Medicines with a Marketing Authorisation (MIA)(IMP). These medications are not yet approved and can only be purchased with the prescription of a physician. The MHRA 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 drug is a selective inhibitor of noradrenaline uptake which means it performs differently than other ADHD drugs. It increases noradrenaline, a chemical that aids in transmitting messages between nerve cells in the brain. This aids concentration and also helps control impulses. It is usually taken in capsules once or twice daily.
A psychiatrist is the only mental health professional who can diagnose ADHD in adults, and then prescribe medication to treat it. It is important to remember that ADHD isn't a condition that can be treated with medication alone. Therapy is often included in treatment plans. This may include psychoeducation, which assists children, teenagers and adults understand 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 have not been approved by the MHRA. It could be that the drug was not developed by a company based in the UK or it was prescribed in violation of the terms of licence (off-label). The GMC's guidelines state that 'unlicensed medicines are usually employed when a licensed product isn't available or when a clinically effective treatment cannot be found using the product that the prescriber is at ease'.
The medical license will list the conditions it treats along with the age ranges that it can be administered to. It will also state how it should be taken and by whom. The MHRA only issues a licence only if it is safe and effective for that particular application, based on clinical studies and medical research. The drug manufacturers are not permitted to promote or promote any uses that are not covered by the license.
It is not illegal in the UK for medical professionals to prescribe a non-licensed medication, as long as they are able to explain the advantages and risks of this to the patient. They must also keep records of the use of unlicensed drugs and provide the patient with sufficient information to help them make a decision.
Unlicensed medications are often given in hospitals, as there is more experience using these medications than in GP clinics. The hospital will have procedures to ensure the safety and efficacy of the medication. This includes keeping detailed patient records, and noting any adverse effects. They will be required to follow MHRA guidelines for the safe supply unlicensed medicine.
Specials are prescribed by doctors who must communicate with their patients, parents or caregivers about the medicine it is prescribed for, its purpose, and any potential side consequences. They should be able to answer any questions asked and always provide written information about any medication they are prescribing, along with the reasons for it.
What is what is a Shared Care Agreement?
In recent years, as the number of adults suspected of having 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 turning to self-funding private ADHD assessments at specialist private clinics. It is hoped that once the diagnosis is confirmed through this process, the GP will sign an agreement of shared care (SCA).
A SCA is an agreement between your psychiatrist and GP, whereby the responsibility for prescribing medications, monitoring, and basic health checks are transferred to your GP. This is a well-known and accepted method of transferring the responsibility for managing a patient suffering from ADHD from a hospital or a specialist service setting to general practice, provided that it is in accordance with NHS England guidelines.
Before the responsibility is transferred, the specialist and GP must agree on the SCA guidelines and this should be clearly stated on any referral form. It should be made clear to the GP that he or she is responsible for the ongoing monitoring of the medication as well as the monitoring requirements.
Unfortunately, many GPs are hesitant to accept SCAs. This is not due to the lack of motivation however, the work involved in SCAs could be outside of their primary budget and is typically an additional task in addition to their busy schedule.
The doctor should be given good quality information on the motivation behind SCA and what the expectations of both parties are including the roles of the patient and their carer. It is important to be clear that the decision to proceed with SCA should be made by the prescriber initiating treatment. The GP should also be informed of the patient's refusal to be willing to participate in SCA.
If a doctor doesn't desire to assume the responsibility of SCA they can choose not to do so, but this could result in patients being sent back to the private ADHD assessment clinic and psychiatrist who carried out their initial diagnosis. This could mean that medication prescriptions are given privately instead of through the NHS which, naturally, is more expensive.
What is a titration duration?
The tration time is a crucial step to determine the appropriate medication to help manage your ADHD. It involves gradually increasing the dosage until you reach a dosage that maximizes your benefits while minimising your side effects. It is an ongoing process that can take time. Your healthcare professional must work with you closely to ensure that the titration process is as smooth as it can be.
Certain patients may experience worsening of their symptoms during the titration phase. For example, hyperactive people might become more restless and angry than they normally are. It is essential that loved ones are aware of any changes in behavior and provide support. To reduce the side effects from ADHD medications, it is important to live a healthy life and a regular sleep schedule.
It is important to remember that medication is not the only option for ADHD treatment. However it is recommended as a first-line treatment method in adults. Talk adhd medication uk is an effective tool to address underlying depression and anxiety that could 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 take any medication, instead focusing on self-help strategies such as fitness, nutrition and stress reduction.
It is important to go about the potential adverse effects of any medication you are prescribed, and understand how the medication affects your body. Certain medications can cause a decrease in appetite, cause headaches, or cause you to become drowsy. Always use your medication according to the instructions and consult your doctor if any adverse effects occur.
A lot of the drugs used to treat adult ADHD are currently out of stock due to shortages. This has resulted in delays in diagnosis and appointments with psychiatrists. NHS England has set up a taskforce to investigate the issue and recommend ways of reducing waiting times for medications.
Ask your local GP what options are available to you. You may be able to receive the same medication privately, or they could suggest alternatives that can provide similar results to those you are used to.