Adult ADHD Medication in the UK
In the UK, the NHS has guidelines for diagnosing ADHD in adults. The number of referrals to the adult ADHD specialist clinic quadrupled in the course of the pandemic.
Non-stimulants and stimulants are both used to treat ADHD. Methylphenidate is the most common medication to treat the symptoms of ADHD, along with two amphetamine-based medications known as dexamfetamine and Lisdexamfetamine.
Stimulants
The most popular kind of medication used to treat adult ADHD is stimulants. They increase activity in the parts of the brain that control attention and behaviour. They are fast-acting and are frequently the first choice to be considered by GPs. Methylphenidate, more commonly known as Ritalin, is the most widely prescribed stimulant for adults as well as children.
This drug boosts the levels of neurotransmitters in the brain, improving the quality of attention and reducing hyperactivity and impulsivity. It can also reduce anxiety and depression, which can co-occur with ADHD.
Throughout history, stimulant drugs have been used both medicinally and recreationally, to enhance performance, motivation, cognition and mood. These include nicotine and caffeine amphetamines, modafinil, methylphenidate, and cocaine. These substances are used to suppress appetite and boost energy levels. However, they may cause severe psychological and physical effects when taken excessively.
There are a variety of different drugs used to treat adults suffering from ADHD, and a psychiatrist will typically carefully adjust the doses of each patient they visit. adhd without medication 'll also consider any other medical conditions that a patient might have, and the impact of the medication on sleep patterns. They will also consider the impact of the medication on the diet of a patient and lifestyle.
A massive network meta analysis carried out by NIHR Oxford Health Biomedical Research Centre (NIHR Oxford Health Biomedical Research Centre) and Stichting Eunethydis has found that Lisdexamfetamine, more commonly referred to as Adderall is more effective than other stimulant at reducing the symptoms of ADHD. It is recommended by NICE, and it is available for prescription in the UK.
Despite positive evidence that support the use of drugs for ADHD is still viewed as a stigma. Falsely framed arguments make it appear like child exploitation and controlled substances. This can make many people unwilling to seek an assessment, or even to consider taking medication for their condition.
As the number of referrals to NHS psychiatry increased during the COVID-19 pandemic as did the number of adults being treated for ADHD. In fact the number of adult ADHD referrals have now overtaken those for children. Boys are still more likely to be referred for ADHD treatment however the number of women receiving it has quadrupled over the last two years.
Unlicensed Medication
A variety of medications are approved to treat ADHD for children and adults, with stimulant drugs like methylphenidate, and occasionally the more recent amphetamine based medication lisdexamfetamine being prescribed. These are classified as 'controlled medications' because they are addictive and abused. Your psychiatrist will only prescribe these medications if he or she believes they are the most effective option for your treatment. You will be provided with an approved prescription in writing that you can pick up at your local pharmacy. It is for a month's supply the drug. Your pharmacist should be able to explain it to you.
In certain situations your doctor might decide that the drugs they offer aren't suitable for you and recommend a medication that is not licensed. This will be a case-by-case decision and your doctor should only prescribe unlicensed medications as an option last resort. Be aware that although medication is an essential component of treating ADHD, talking therapy also plays a vital role. Therapy can change your coping mechanisms and behavior patterns. Treatment with medication can alleviate your symptoms.
In the UK, medication used to treat ADHD for adults requires a marketing authorisation (MA) that outlines the specific conditions under which it's approved. This includes the ages of the people who are treated and the method by which the medication should be administered. The MHRA will provide an official assessment of any IMP before it is released and the manufacturer is able to advertise it under its MA unless it holds a specific licence for paediatric medicine.
Off label prescribing happens when a psychiatrist believes that it is appropriate to prescribe a drug for an adult even though it was prescribed for children. It is possible to manipulate a product, where pharmacists mix ingredients to create a formulation for a patient that is unable to take tablets. There is an unpopularity around the use of unlicensed drugs to treat ADHD in adults, with psychiatrists criticising the over-prescribing of psychoactive drugs for mental health problems.
Licensing
In the UK there is various medicines that are approved to treat ADHD in adults. These include a number of stimulant medicines such as methylphenidate (Ritalin) and the newest amphetamine-based medicine lisdexamfetamine (Elvanse). Typically, these are offered to patients who have been diagnosed with the condition following consultation with a psychiatrist. The treatment is usually prescribed in capsules, and patients are closely monitored by their physician to ensure that the correct dose is found.
In addition to these drugs in addition, there are a variety of other ways that the condition can be managed and treated. For example, behavioural therapies can assist patients in understanding the causes of symptoms and develop strategies to deal with these. Changes in the environment can also help people cope with the impact that their symptoms can have on their day-to-day lives. This can include organising seating arrangements at school or at work or at home, scheduling frequent movement breaks and providing 'I need a break' cards, and making it easier to avoid distractions and noise.
The medications that are licensed to treat ADHD in adults in the UK are not intended as a cure, but they can greatly improve the quality of life for many people who suffer from the condition. They aren't a cure-all and should be used as a component of a complete care plan that includes psychoeducation, psychiatric treatment, and medication.
It is important that any patient with childbearing potential takes a pregnancy test prior to beginning medication and inform their GP immediately when they become pregnant or want to become pregnant. Patients should also consult their GP in the event of any side effects or if they don't think they are gaining.
A national alert for patient safety regarding the shortage of methylphenidate prolong-release tablets, extended-release guanfacine tablets, and lisdexamfetamine capsules was released on September 27, 2023. On 8 May 2024, an Medicine Supply Notification was issued, which lifted the prescribing restrictions on Elvanse capsules.
It is a Schedule 2 controlled drug so it must be prescribed by a registered physician and is subject to the Misuse of Drugs Regulations 2001. The guidelines recommend that an ADHD patient be evaluated annually by a healthcare professional who is knowledgeable and trained in managing the disorder. This can be performed in primary care or secondary care, depending on local arrangements. This review should include a check for heart rate and blood pressure and a discussion of the need for ongoing treatment, and continuous monitoring and evaluation of symptom improvement.
Side Effects
ADHD medication is safe and generally well tolerated by adults, but it doesn't cure the condition. It can help reduce symptoms of behavioural disorder and improve quality of life. It can also aid in learning, work and relationships.
It's crucial for anyone considering treatment to be aware of potential adverse effects and to discuss them with their physician prior to when they start taking the medicine. Some side effects include headaches, insomnia and an increase in appetite. Certain medications can also raise the heart rate. This is usually minor and harmless, but is something to mention to your doctor if you have any prior history of heart problems or cardiovascular disease.
The effects of stimulants increase the levels of dopamine and norepinephrine in the brain. This changes the way the brain processes and transmits messages, increasing attention and focus. They are regarded as the first line treatment for adult ADHD. Atomoxetine and Buproprion, which are medications that do not stimulate, have a more complex effect on the brain. They also take longer to begin working. The latter block the reuptake and release of dopamine into nerve cells and helps with concentration.
Research suggests that about half of children who are diagnosed with ADHD grow out of their symptoms by adulthood. This could be due to the fact that they are able to manage their symptoms or because they become less hyperactive. But a significant number continue to struggle in a society which is not designed to accommodate them. Nice suggests doctors prescribe ADHD medication only when they are needed and keep track of their patients on a regular basis.
There are many other options to treat ADHD symptoms. These include psychoeducational therapy and lifestyle changes. These therapies can be utilized together with medications to decrease the necessity of referring adults who suffer from ADHD to specialist services.
The stigma associated with ADHD can make it difficult to be open about medication and many adults are hesitant to reveal the fact that they have ADHD to their family, friends or employers. There is increasing evidence that talking about the disorder and raising awareness of its symptoms can help to break down barriers to treatment.