Adult ADHD Medication in the UK
In the UK in the United Kingdom, the NHS has guidelines for diagnosing ADHD in adults. During the pandemic, the number of referrals to the adult ADHD clinic quadrupled.
Both stimulants and non-stimulants are used to treat ADHD. Methylphenidate is the most common medication to treat the symptoms of ADHD as are two amphetamine-based medications called dexamfetamine and lisdexamfetamine.
Stimulants
Stimulants are the most commonly used medication used to treat ADHD in adults. These drugs work by increasing the activity in brain areas that control attention and behavior. They are quick-acting and are frequently the first choice of GPs. Methylphenidate, more commonly known as Ritalin is the most widely prescribed stimulant for adults and children.
The drug boosts neurotransmitter levels in the brain. It increases the quality of attention, and reduces the impulsivity and hyperactivity. It also helps reduce anxiety and depression that may be associated with ADHD.
Throughout history, stimulant drugs have been used both medicinally as well as recreationally to improve cognition, motivation, performance, and mood. These include caffeine and nicotine amphetamines modafinil, methylphenidate, and cocaine. These substances are used to suppress appetite and boost energy. However, they may also cause negative psychological and physical effects if taken in excess.
A psychiatrist will take care to adjust dosages for each patient. They'll also consider any other medical conditions a patient may have, as well as the effect of the medication on their sleep patterns. They will also consider the effects of medications on the patient's diet and lifestyle.
A large network meta analysis conducted by NIHR Oxford Health Biomedical Research Centre (NIHR Oxford Health Biomedical Research Centre) and Stichting Eunethydis has found that the drug lisdexamfetamine, also known as Adderall is more effective than any other stimulant at reducing the symptoms of ADHD. It is recommended by NICE and is available in the UK by prescription.
Despite the evidence-based findings however, there's a stigma that surrounds the use of medications to treat ADHD, with unhelpful framings that make it appear like child abuse and comparisons to controlled substances. This can make many people unwilling to seek an assessment, or to consider taking medication to treat their condition.
The number of adults being treated for ADHD increased as did the number referred to NHS psychiatry increased during the COVID-19 epidemic. Adult ADHD referrals are now more than those for children. Boys are still more likely to be referred for ADHD treatment, but the number women who receive it has quadrupled over the past two years.
Unlicensed Medication
There are a variety of medicines that can be prescribed to treat ADHD in both adults and children. These include stimulant drugs like methylphenidate, and sometimes the more recent amphetamine-based drug called lisdexamfetamine. These drugs are categorized as controlled drugs due to the fact that they can be addictive and abused. Your psychiatrist will only prescribe these drugs if he / believes that they are the most effective choice for your treatment. You will be given an approved prescription in writing that you can pick up at the local pharmacy. Your pharmacist will explain to you that this is for an ongoing supply of the medication.
In some cases your doctor might decide that the medicines that are available to them aren't suitable for you and suggest an unlicensed medicine. This will be an individual decision and your doctor should only prescribe unlicensed medications as an option last resort. It is crucial to remember that, while medication is an integral part of treatment for ADHD and ADD, therapy with a therapist is also essential. Medication can help to manage your symptoms, but therapy can help change long-standing negative coping mechanisms as well as behavioural patterns.
In the UK, medication used to treat ADHD in adults must be accompanied by an authorization for marketing (MA) that outlines the conditions under which it's approved. It will also include information about the age of people who can be prescribed the medication and the method by which it should be administered. The MHRA will assess any IMP prior to its release and the manufacturer is only allowed to promote it under their MA, except if they have a specific license to market paediatric medications.
Off label prescribing occurs when a psychiatrist feels it is appropriate to prescribe a drug for an adult even though it was prescribed for a child. A "manipulated product" is a possibility when a pharmacist mixes ingredients to create a formulation for a patient who can't take tablets. There's a stigma around using non-licensed medications to treat ADHD in adults, with psychiatrists complaining about the excessive prescribing of psychoactive drugs to treat mental health problems.
Licensing
In the UK There are many treatments are available to treat ADHD among adults. These include a number of stimulant medications, including methylphenidate (Ritalin) and the more recent amphetamine-based medication called lisdexamfetamine (Elvanse). These are typically prescribed to patients who have been diagnosed with the condition by a psychiatrist. The treatment is prescribed as capsules and the patient should be closely monitored by their physician to determine the proper dosage.
In addition to these medications however, there are a myriad of other ways that the condition can be treated and controlled. For example, behavioural therapy can help people to understand the root cause of their symptoms as well as come up with strategies to manage the symptoms. Changes in the environment can also aid in reducing the impact their symptoms have on their day-to-day lives. This could include arranging seating arrangements at work or school, arranging for frequent movement breaks and providing "I need a break" cards, and cutting down on the amount of distractions and noise.
The drugs that have been approved by the UK to treat ADHD in adults aren't intended to cure but can improve the quality of life for many. But, they're not a magic bullet and should only be used as a part of a comprehensive care package that includes psychoeducation and psychiatric care.
Patients with childbearing capacity should take an examination for pregnancy prior to starting any medication. They should also inform their GP when they become pregnant or wish to fall pregnant. It is also recommended that patients should see their GP if they experience any serious side-effects or don't think they are benefiting from the medication.
On the 27th of September, 2023, a nationwide patient safety alert was issued regarding the lack of extended-release guanfacine tablets, lisdexamfetamine tablets, and methylphenidate tablets. On May 8, 2024, an Medicine Supply Notification was issued that lifted the prescribing restrictions on Elvanse capsules.
It is classified as a Schedule 2 drug, so it is only prescribed by a registered doctor and is subject to the Misuse of Drugs Regulations of 2001. The guidelines recommend that an ADHD patient is evaluated annually by a healthcare provider with expertise and training in managing the disorder. This can be performed in primary care or secondary care, based on local arrangements. The review should include monitoring for heart rate and blood pressure as well as a discussion on the need for ongoing treatment, and continuous monitoring and evaluation of symptom improvement.
Side Effects
ADHD medication is safe and generally accepted by adults, but it does not cure the condition. It can help to reduce symptoms of behavioural disorder and improve quality of life. It can also aid in learning, work and relationships.
adult adhd medication uk for anyone considering treatment to be aware of the potential side effects and discuss these with their doctor before they start taking the medicine. Some side effects include sleeplessness, headaches and changes in appetite. Certain medications may increase heart rate. It is usually mild and harmless, but is worth mentioning to your doctor if you have a prior history of heart problems or cardiovascular disease.
Stimulants boost the levels of dopamine and norepinephrine in the brain. This alters the way that the brain sends and receives messages, and increases attention and focus. They are considered first-line treatments for adults suffering from ADHD. Nonstimulant medicines like buproprion and atomoxetine also available, but they have more complex effects on the brain and take longer to start working. The latter is a drug that blocks dopamine reuptake into nerve cells, and helps in enhancing concentration.
According to research, around half of the children diagnosed with ADHD will overcome their symptoms by the time they reach adulthood. This could be because they are able to manage their symptoms, or because they are less hyperactive. A large portion of them are still struggling with a world that was not designed for their needs. Nice suggests doctors prescribe ADHD medication only when they are needed and to continue to check on their patients frequently.
There are other ways to treat ADHD symptoms. These include lifestyle changes and psychoeducational therapy. These therapies can be used alongside medication to reduce the necessity of referring adults with ADHD to specialist services.
Many adults are hesitant to reveal to their family, friends or employers that they are taking ADHD medication due to the stigma associated with it. However, there is growing evidence that talking about the disorder and raising awareness of its symptoms can help overcome barriers to treatment.