ADHD Medication For Adults in the UK
In the UK there are a variety of medications are approved for treating ADHD. The stimulant methylphenidate as well as the amphetamine-based medication lisdexamfetamine are two of the most commonly prescribed drugs. The exact dose will need to be monitored closely in the beginning stages of treatment (titration) and then stable prescriptions can be managed by your GP as part of an agreed'shared care arrangement.
What is what is Licensed Medication (L.M.)?
A licensed medicine will have gone through all necessary clinical studies and tests, and the MHRA (Medicines and Healthcare products Regulatory Authority) has given it the go ahead to be used in Great Britain. The medicine will also be identified as being suitable for specific conditions on its packaging or in a leaflet that comes with it. All licensed medicines undergo strict regulation, even after they are on the market. This allows for issues to be quickly identified and reduces the risk.
Unlicensed drugs are sometimes prescribed to people with ADHD however, they are rarely given to teenagers or children. Unlicensed medications can be prescribed for other ailments that have been shown to be effective (known as "off-label prescribing"), or they could be a formula not yet available on the market for example, an oral liquid instead of a tablet. It may be an experimental medication that is being studied in the UK.
The term "experimental drugs" is used to refer to medicines that have a Marketing Authorisation(MIA) (IMP) or Investigational Medicinal Products. These medicines have not been granted a licence yet and can therefore only be sold with the prescription of a doctor. The MHRA will conduct a formal assessment as part of the Early Access to Medicines Scheme.
Atomoxetine is an anti-stimulant medication that is often 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 medication. It increases noradrenaline, which is a chemical that helps to transmit messages between brain cells. This aids concentration and helps to control impulses. It is typically taken as a capsule once or twice daily.
A psychiatrist is the only mental health professional who can identify ADHD in adults, and then prescribe medications to treat it. It is crucial to remember that ADHD isn't just a disorder that can be treated with medication alone. Therapy is often incorporated in treatment plans. This can include psychoeducation to assist children, teens, and adults recognize their diagnosis as well as behavioural therapy which teaches techniques for managing symptoms.
What is an unlicensed medicine?
The term "unlicensed medicines" refers to medicines that have not been licensed by the MHRA. This could be due to the fact that the medicine has not been created by an UK company, or because it has been prescribed in violation of the terms of its licence (ie off-label). The GMC's guidelines state that 'unlicensed medicine is usually used when a suitable licensed product is not available, or when a treatment that is clinically effective cannot be found using the product the prescriber feels most comfortable using'.
The licence for a medicine will state the health conditions it treats and the age of patients it may be prescribed to. The licence will also specify what and how the medicine should be taken. The MHRA will only grant permission when the drug is believed to be safe and effective for that application, built on research in medical science and clinical trials. The manufacturers of the drugs are not permitted to promote or market any use that is not covered by the licence.
It is not illegal in the UK for healthcare professionals to prescribe a medication that is not licensed, as long as they explain the risks and benefits of this to the patient. They must keep records of the use of non-licensed medications and provide the patient with enough information to make an informed decision on whether or not to accept the.
Unlicensed medicines are usually administered in hospitals, where there is more experience using them than in GP surgeries. The hospital will have procedures to ensure the safety and effectiveness of the medication. This includes keeping thorough records of patients, and noting any adverse effects. They are required to adhere to MHRA guidelines for the safe supply of unlicensed medications.
Specials are prescribed by doctors who must be clear with their patients, parents or caregivers about the medicine as well as its purpose and possible side effects. They should be able to answer any questions they receive and always provide written details of the medicine they are prescribing, along with the reasons for it.
What is a Shared-Care Agreement?
The number of adults who are suspected to have ADHD has increased in recent years so have demanded to be referred for an NHS assessment and receive medication for the condition. The waiting lists for NHS assessments are long, and this means that many patients are opting to pay for their own private ADHD assessments at private clinics. Once a diagnosis is confirmed then the GP may enter into an agreement of shared-care (SCA) with the patient.
A SCA is a contract between your psychiatrist and your GP, whereby the responsibility for medication prescribing, monitoring, and basic health checks is transferred to your GP. This is a recognized and accepted method for the transfer of the responsibility for managing a patient suffering from ADHD from an institution or specialist service to general practice, provided it is in line with NHS England guidelines.
Before transferring responsibility the specialist and GP should agree on these SCA guidelines and this should be clearly stated on any referral form. It should also be clarified that the GP is responsible for the ongoing titration and monitoring requirements of the medication.
Unfortunately, a lot of GPs do not accept SCAs. It's not because they are not interested or desire, but because the work involved in SCAs isn't part of their regular funding.
The GP should be informed about the reasoning of SCA and the expectations of the parties involved, and the role of patients and their caregivers. It should be clear that the decision to proceed with SCA should be made by the prescriber initiating treatment. The GP should also be informed that the patient isn't willing to participate in SCA.
If a doctor does not desire to assume the responsibility of SCA they can choose not to do so, but this can lead to patients being sent back to the private ADHD assessment clinic and psychiatrist who made their initial diagnosis. This could result in medication prescriptions being issued privately, instead of through the NHS. This can be more expensive.
What is a titration duration?
The tration stage is a crucial stage to find the right medication for ADHD. It involves gradually increasing the dosage until you reach a dosage that maximizes your benefits while minimising your adverse effects. It takes time, but your healthcare specialist should work closely with you to ensure the titration process goes as smooth as it can be.
Some patients might experience an increase in their symptoms during the titration period. People who are hyperactive, like, may become restless and irritable. For this reason, it is vital that family members are aware of any changes in behavior and provide support. It is also essential to eat a balanced diet and to create a regular sleep routine in order to reduce the adverse effects of ADHD medications.
Medication is not the only treatment for ADHD, but it is usually recommended as the first line of management in adults. Talk therapy can be a helpful tool to address depression and anxiety that can cause some symptoms of ADHD. medication for adhd is important to keep in mind that medication only addresses symptoms and does not change the negative coping mechanisms. Some patients decide not to take any medication, instead focusing on self-help strategies such as fitness, nutrition and stress reduction.
It is essential to read over the adverse effects of any medication you are prescribed, and understand how the medication will affect your body. Certain medications can cause headaches or drowsiness, as well as decrease appetite. Be sure to use your medications as directed, and talk to your doctor if you notice any adverse reactions.
A lot of the drugs used to treat adult ADHD are currently out of stock due to shortages. This has led to delays in diagnosis and appointments with psychiatrists. NHS England has set up a taskforce to investigate the issue and recommend methods to speed up the process of waiting for prescriptions.
Ask your local GP what options are available for you. You might be able to get the same medications privately or they might suggest alternative medications that have similar results.