Adult ADHD Medication in the UK
In the UK there are guidelines to diagnose ADHD in adults. During the pandemic, referrals to the adult ADHD clinic quadrupled.
The medicines used to treat ADHD comprise stimulants and non-stimulants. Methylphenidate, dexamfetamine, and Lisdexamfetamine are amphetamine-based medicines that help manage ADHD symptoms.
Stimulants
Stimulants are the most common treatment for ADHD in adults. They increase activity in the parts of the brain that regulate the behavior and attention. They are quick-acting and are frequently the first choice to be considered by GPs. Methylphenidate (also known as Ritalin) is the most commonly prescribed stimulant for adults and children.
adhd medication online increases neurotransmitter levels in the brain. It improves attention span, and decreases the impulsivity and hyperactivity. It can also reduce depression and anxiety, which may co-occur with ADHD.
Through time, stimulant drugs have been used both medicinally and recreationally, to enhance cognitive function, motivation, performance and mood. These include nicotine, caffeine, amphetamines, cocaine, modafinil and methylphenidate. They also serve to reduce appetite and as energy boosters. They can have serious physical and mental negative effects when taken in excessive amounts.
A psychiatrist will take care to adjust the doses for each patient. They will consider any other medical conditions patients may have, and the effect of the medication on their sleeping patterns. They will also look at the impact of the medication on a patient's diet as well as lifestyle.
A massive meta-analysis of the network conducted 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 any other stimulant at reducing the symptoms of ADHD. It is recommended by NICE and is available in the UK by prescription.
Despite positive evidence that supports the use of medications for ADHD is still viewed as a stigma. Ineffective framings refer to it as child exploitation and the use of controlled substances. This can cause people to be reluctant to get an assessment or even consider taking medication to treat 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. Adult ADHD referrals now outnumber 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 past two years.
Unlicensed Medication
A variety of drugs are approved to treat ADHD for children and adults including stimulant drugs such as methylphenidate, and occasionally the more recent amphetamine-based drug lisdexamfetamine being prescribed. These drugs are classified as controlled medications because they can be addicting and addictive. Your psychiatrist will only prescribe these drugs if he or believes that they are the most effective choice for your treatment. Then, you will be given a prescription which you can take to your local pharmacy and pick up. The pharmacist will explain to you that this is for an ongoing supply of the drug.
In some instances, your doctor may decide that the medications that are available to them aren't suitable for you and suggest an unlicensed drug. It's 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 significant role. The use of medication can help manage your symptoms but therapy can also help you change longstanding negative coping mechanisms and behaviour patterns.
In the UK medications used to treat ADHD among adults must have an authorisation to market (MA), which specifies the specific conditions under which it's approved. This will include the ages of people who can be treated and the method by which the medication should be taken. The MHRA will review any IMP prior to its launch and the manufacturer is only permitted to promote it under their MA, in the event that they do not have a special license to market paediatric medicines.
This is the situation where a drug has been approved for use by a child, but a psychiatrist feels it's appropriate to prescribe it to an adult. This is also known as off label prescribing. A'manipulated product' is possible, where a pharmacist mixes ingredients to make a formula for a patient who can't take tablets. Some psychiatrists have been critical of the over-prescription of psychoactive medications to treat mental health issues, including ADHD.
Licensing
In the UK, there are various medications that are licensed to treat ADHD in adults. These include a number of stimulant drugs, such as methylphenidate (Ritalin) and the newer amphetamine-based medication called lisdexamfetamine (Elvanse). These are typically offered to patients who have been diagnosed with the condition by psychiatrists. The treatment is prescribed as capsules, and patients should be closely monitored by their physician to determine the appropriate dosage.
There are other ways to treat and manage the condition, aside from medication. For example, behavioural therapies can assist patients in understanding the causes of their symptoms and devise strategies to combat 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 includes setting up seating arrangements at school or work or even distributing cards that say 'I Need a Break' and arranging frequent movement breaks and making sure that there is less noise and distraction.
The medicines that have been approved by the UK to treat ADHD in adults aren't meant to be a cure, but can improve the quality of life for a lot of people. However, they aren't an instant cure, and should only be used as part of a comprehensive care package that includes psychoeducation and psychiatric care.
It is crucial that anyone with pregnant potential undergoes a pregnancy test before starting medication, and should inform their GP immediately when they become pregnant or wish to become pregnant. It is also recommended that patients consult their GP when they experience significant side-effects or do not feel that they are benefiting from the medication.
A national alert for patient safety regarding the shortage of methylphenidate prolong-release tablets, guanfacine extended-release tablets, and lisdexamfetamine capsules was released on September 27, 2023. On 8 May 2024, a 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 be assessed annually by a healthcare professional who has the expertise and experience in managing the disorder. This can be performed in primary care or secondary care, based on local arrangements. The review should include a monitoring of blood pressure and heart rate, a discussion on the need to continue treatment, and ongoing evaluation and monitoring of symptom improvement.
Side Effects
ADHD medication is generally well-tolerated and is safe for adults. However, it can not cure this condition. It can reduce behavioural symptoms and improve the quality of life for people. It can also aid in learning, work and relationships.
Having said that, 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 of the side effects include changes in appetite, headaches or sleepiness. Certain medications may also increase the heart rate. It is usually not a problem and is mild however, it is important to inform your doctor if there is an history of heart disease or heart issues.
Stimulants boost the levels of dopamine and norepinephrine in the brain. This alters the way that the brain transmits and receives messages, which improves attention and focus. They are considered first-line treatments for adults suffering from 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 is a drug that blocks dopamine reuptake into nerve cells, and helps with concentration.
According to research, approximately half of the children diagnosed with ADHD will be free of symptoms by adulthood. It could be because they manage their symptoms, or simply because they become less hyperactive. But a significant number remain in an environment that isn't specifically designed to accommodate them. This is why Nice suggests that doctors prescribe ADHD medications only when they are necessary and continue to monitor patients regularly.
There are a number of alternatives to treat ADHD symptoms, including psychoeducational therapies and lifestyle changes. These therapies can be utilized together with medication to reduce the need to refer adults who suffer from ADHD to specialist services.
Many adults are hesitant tell their friends, families or employers that they take ADHD medication because of the stigma associated with it. There is increasing evidence that revealing the existence of the disorder can help break down barriers for treatment.