ADHD Medication For Adults in the UK
In the UK there are a variety of medicines licensed for treating ADHD. This includes the stimulant methylphenidate and the amphetamine based medication Lisdexamfetamine. The precise dose needs to be monitored carefully in the beginning stages of treatment (titration) and then, once stable, prescriptions can be managed by your GP as part of an agreed'shared care' arrangement.
What is a Licensed Medication?
A medicine that is licensed will have gone through all necessary clinical tests and trials and the MHRA (Medicines and Healthcare Products Regulatory Authority) has given it the go ahead to be used in Great Britain. The packaging of the medicine or the leaflet that comes with it will clearly state whether it's suitable for a particular condition. adhd medication uk licensed medicines are carefully controlled, even after they're on the market, meaning that any problems can be identified quickly and any risks reduced.
Unlicensed drugs are sometimes prescribed to those suffering from ADHD, but they are not often prescribed to adolescents or children. Unlicensed medications may be prescribed for other conditions that have been proven to be effective (known as "off-label prescribing") or they could be a form of treatment that is not yet available on the market like a liquid oral instead of a tablet. It could also be an experimental medication that is being tested in the UK.
The term "experimental drugs" is used to describe Medicines that have an Marketing Authorisation(MIA) (IMP) or Investigational Medicinal Products. These medicines haven't been granted a license yet and can therefore only be sold on a doctor's prescription. 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 often prescribed in the UK and Europe for ADHD. This is a selective noradrenaline reuptake inhibitor, and so works differently to other ADHD medications. It increases noradrenaline, which is a chemical that helps to transmit messages between brain cells. This improves concentration and helps to control impulses. It is taken in capsule form once or twice daily.
Only a psychiatrist can diagnose ADHD and prescribe medication for adults. It is important to keep in mind that ADHD isn't a condition that can be treated through medication by itself. Therapy is often included in treatment plans. This can include psychoeducation to help children, teens and adults comprehend their diagnosis and behavioural therapy which teaches techniques for managing symptoms.
What is an Unlicensed Medication?
The term "unlicensed medicines" refers to medications that are not licensed by the MHRA. It could be that the medication was not created by a UK-based company or it was prescribed outside of the licence terms (off-label). The GMC's guidance states that 'unlicensed medications are typically used when a suitable licensed product isn't available or a clinically effective treatment cannot be found using the product that makes the prescriber feel comfortable'.
A medical license will specify the health conditions it treats as well as the ages of patients it can be administered to. The licence will also specify the manner and method by which the medicine should be used. The MHRA only grants a license when it is considered safe and effective in that particular application, based on clinical trials and medical research. The drug manufacturers are not permitted to promote or promote any uses that are not covered under the licence.
It is not illegal in the UK for a healthcare professional to prescribe a medication that is not licensed, as long as they can explain the risks and benefits of doing so to the patient. They must keep a record of the use of non-licensed medications and give the patient sufficient information to help them make a decision.
Hospitals are more likely to give unlicensed drugs due to their more experience with them than GP surgeries. The hospital will follow procedures to ensure the safety and effectiveness of the medication. This includes keeping detailed patient records, and recording any adverse reactions. They must follow MHRA guidelines on the safe supply of unlicensed medications.
Specials are prescribed by doctors who must inform their patients, their parents or caregivers of the medication it is prescribed for, its purpose, and any potential side consequences. They should be able to address any questions and provide written details about any medication they prescribe, as well as the reasons behind it.
What is a Shared Care Agreement?
As the number of adults who are suspected of having ADHD has increased in recent years, so have requests to be referred for an NHS assessment and to receive medication for the condition. Unfortunately, the waiting lists for NHS assessments are long, and this means that a lot of patients are opting to pay for their own private ADHD assessments at private clinics. After a diagnosis has been confirmed, the GP could sign an agreement of shared-care (SCA) with the patient.
A SCA is an agreement between your psychiatrist and your GP in which the responsibility for prescribing, monitoring and the basic health checks for medicines is assigned to your GP. It is a well-known accepted method of transferring the responsibility of managing ADHD patients from a specialist clinic or hospital to a general practice.
These SCA guidelines should be discussed between the doctor and the GP before responsibility is passed over and this should be clearly stated on any referral form. It should also be clarified that the GP remains responsible for ongoing titration and monitoring requirements of the medication.
Unfortunately, many GPs are hesitant to accept SCAs. adhd medication is 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 motivation behind SCA and what the expectations of both parties, including the roles of the patient and their carers. It is important to be clear that the decision to go ahead with SCA must be made by the physician who initiated treatment. The GP should be informed that the patient isn't willing to take part in SCA.
If a GP does not desire to assume the responsibility of SCA they can refuse to do so, but this could result in patients being reverted back to the private ADHD assessment clinic and psychiatrist who carried out their initial diagnosis. This could mean that prescriptions for medication are given privately instead of through the NHS, which of course is more expensive.
What is Titration Period?
The tration phase 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 negative side effects. It takes time however, your healthcare professional should be in close contact with you to ensure that the titration process is as smooth as possible.
Some patients may experience worsening of their symptoms during the time of titration. People who are hyperactive, for instance, may become restless and irritable. For this reason, it is vital that family members are aware of any changes in behavior and provide assistance. To lessen the negative side effects from ADHD medications it is crucial to lead a healthy lifestyle and a regular sleep schedule.
It is important to keep in mind that medication is not the only option for ADHD treatment. However it is recommended as a first-line management method for adults. Talk therapy is a helpful tool to address anxiety and depression, which can be the cause of certain symptoms of ADHD. It is crucial to remember that medication can only treat the symptoms, not alter the coping mechanisms that have been in place for a long time. Some patients prefer not to take medication in the first place and instead concentrate on self-help methods such as exercise, nutrition, stress reduction and sleep strategies.
It is crucial to look over the adverse effects of any medication you are prescribed and know how the medication affects your body. Some medications can cause headaches or drowsiness, and can also cause a decrease in appetite. Always follow the directions for your medication and consult your doctor for any adverse effects that occur.
Presently, a lot of drugs used to treat adult ADHD are out of stock. This has caused delays in diagnosis and appointments with psychiatrists. NHS England has created a taskforce that will investigate the issue and provide recommendations regarding how to decrease waiting times for medications.
Ask your local GP what alternatives are available to you. You may be able to obtain the same medication privately or they could suggest alternatives with similar results.