ADHD Medication For Adults in the UK
In the UK there is a variety of medicines licensed for treating ADHD. The stimulant methylphenidate as well as the amphetamine-based medicine lisdexamfetamine are two of the most commonly prescribed medications. The exact dose will need to be monitored carefully during the early stages of treatment (titration) and then, once stable, prescriptions will be administered by your GP as part of a shared care' arrangement.
What is an Licensed Medication?
A licensed medicine has undergone all the required clinical trials and tests and the MHRA the Medicines and Healthcare Products Regulatory Authority (MHRA) has given the go ahead for its use in Great Britain. The packaging of the medicine or the leaflet included with it will clearly state whether it is suitable for a particular condition. All licensed medications are controlled, even after they're on the market, so problems are quickly identified and any risks reduced.
Some people suffering from ADHD might be prescribed unlicensed drugs however they aren't often used on children and teenagers. The unlicensed medication could be prescribed for other conditions that have been found to work well with it (known as off-label prescribing) or it could be a specific formula that isn't yet on the market, such as an oral liquid in place of tablets or something without certain additives. It could also be an experimental medicine being trialled in the UK.
Experimental drugs are referred to as Investigational Medicinal Products (IMPs) or Medicines with a Marketing Authorisation (MIA)(IMP). These medicines are not yet licensed and can only be purchased through the prescription of a physician. They will have undergone an official assessment by the MHRA as part of the Early Access to Medicines Scheme (EAMS) and thus the quality of pharmaceuticals is guaranteed.
Atomoxetine is a non-stimulant medication that's often prescribed in the UK and Europe for ADHD. This is a selective noradrenaline reuptake inhibitor, and therefore is different from other ADHD medications. It increases noradrenaline, which is a chemical that helps to transmit messages between neurons in the brain. This aids concentration and helps to control impulses. It is typically taken as a capsule every day or twice per day.
A psychiatrist is the only mental health professional who can identify ADHD in adults, and then prescribe medication to treat it. It is important to keep in mind that ADHD isn't just a disease which can be treated by medication alone. Therapy is often included in treatment plans. Psychoeducation, which helps teens, children and adults comprehend their diagnosis, as well as behavioral therapy, which teaches techniques to manage symptoms.
What is an Unlicensed Medication?
The term "unlicensed medication" refers to any drug that has not been granted a license by the MHRA. It could be that the drug was not developed by a UK-based company or was prescribed outside of the licence conditions (off-label). The GMC's guidance states that 'unlicensed drugs are generally used when a suitably licensed product isn't readily available or a clinically effective treatment cannot be found using the product with which the prescriber feels comfortable'.
The label of a medicine will list the conditions it treats, as well as the age ranges it is able to treat. The licence will also state how and by whom the medicine is to be administered. The MHRA will only issue a licence if the drug is considered to be safe and effective for the usage, founded on medical research and clinical trials. The drug manufacturers are not permitted to advertise or promote any use that are not covered under the licence.
It is not illegal in the UK for healthcare professionals to prescribe a non-licensed medication provided they explain the advantages and risks of prescribing it to the patient. They must also keep an account of the use of non-licensed medications and give the patient sufficient information to help them make an informed decision.
Hospitals tend to provide unlicensed medicines because they have more experience with them than GP surgeries. The hospital will have procedures in place to ensure the safety of the medication which includes keeping detailed patient records and making sure that any adverse reactions are recorded. They will also be required to follow the MHRA's guidance on the safe supply of medicines that are not licensed.
Doctors who prescribe specials have to be open with patients and parents or caregivers about what the medicine is and the reason it is being used, and the possible adverse consequences. They should be able to answer any questions asked, and should always write down the details of the medicine they prescribe, along with the reasons for it.
What is a Shared Care Agreement?
In recent years as the number of people who are suspected of having ADHD increased and so did the requests for an appointment with the NHS for an assessment and medication to treat the condition. Unfortunately, waiting lists for NHS assessments are long and this means that a lot of patients are turning to self-funding private ADHD assessments at specialist private clinics. If a diagnosis is confirmed, the GP may enter into a shared-care agreement (SCA) with the patient.
A SCA is an agreement between your psychiatrist and your GP and GP, in which the responsibility for prescribing medication, monitoring, and basic health checks is transferred to your GP. It is a well-known and accepted method of shifting the responsibility of managing ADHD patients from a specialist service or hospital to a general practice.
These SCA guidelines should be discussed between the specialist and the GP before responsibility is handed over, and this should be clearly written on any referral form. It should be clear to the GP that he or she is responsible for the continual adjustment of the medication as well as the monitoring requirements.
Unfortunately, a lot of GPs are reluctant to accept SCAs. It is not because they lack desire however, it is because the work involved in SCAs is outside their core funding.
The GP should be informed about the reasoning behind SCA, the expectations of all parties involved, as well as the roles of patients and carers. It should be made clear that the decision to proceed with SCA should be taken by the prescriber initiating treatment. The GP should be informed of the patient's refusal to be willing to participate in SCA.
If a GP does not desire to assume the responsibility of SCA they may 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 can lead to medication prescriptions being issued privately, instead of through the NHS. This can be more costly.
What is a titration duration?
The tration phase is a crucial step to find the appropriate medication for ADHD. It involves gradually increasing your dose until you reach a dosage that maximises your benefits while minimising your negative side effects. It is a process that takes time. Your healthcare professional should work with you closely to ensure that the titration procedure is as easy as it can be.
adhd medication uk for adults might notice an increase in their symptoms during the titration phase. For example, hyperactive people may be more agitated and angry than they normally are. This is why it is crucial that family members are aware of any changes and offer support. To lessen the negative side effects from ADHD medication it is crucial to live a healthy life and a consistent sleep schedule.
The use of medication isn't the only treatment for ADHD, but it is usually suggested as the first line of treatment for adults. Talk therapy is a helpful method to deal with depression and anxiety that could cause some of the symptoms of ADHD. It is important to remember that medication only addresses symptoms and doesn't alter the negative coping mechanisms. Some patients opt to not take any medication and instead focus on self-help techniques such as fitness, nutrition and stress reduction.
It is essential to be aware of the adverse effects and how they affect your body. Certain medications can reduce appetite and cause headaches, as well as make you drowsy. Always take your medication as directed and consult your doctor if any adverse effects occur.
Today, many of the medications used for treating adult ADHD are in short supply. This has caused delays in diagnosis and a backlog in appointments with psychiatrists. NHS England has set up an inquiry taskforce to look into the issue and suggest ways of reducing waiting times for medication.
Despite the lack of certain popular drugs, it's still possible to get ADHD treatment through the NHS, and it's worth speaking with your local GP about the options available to you. You may be able get the same medication privately or they might suggest alternative medications with similar results.
