Adult ADHD Medication in the UK
In the UK, the NHS has guidelines for diagnosing ADHD in adults. The number of referrals to the adult ADHD specialist clinic quadrupled in the course of the pandemic.
The medicines used to treat ADHD comprise stimulants and non-stimulants. Methylphenidate is the most commonly used medication used to treat symptoms of ADHD as are two amphetamine-based medicines known as lisdexamfetamine and dexamfetamine.
Stimulants
The most commonly used kind of medication used to treat adult ADHD is a stimulant. These work by increasing activity in parts of the brain that control attention and behaviour. These are fast-acting, and are often the first choice for GPs. Methylphenidate is also known as Ritalin, is the most frequently prescribed stimulant for adults as well as children.
adhd medication uk for adults increases the amount of neurotransmitters in the brain, thereby improving attention span and decreasing impulsivity and hyperactivity. It also helps reduce anxiety and depression that may be associated with ADHD.
In the past, stimulant drugs were used to boost cognition, motivation and performance. They include caffeine, nicotine amphetamines, cocaine methylphenidate, and modafinil. These substances are used to reduce appetite and boost energy levels. However, they can cause severe psychological and physical consequences if they are taken in large quantities.
A psychiatrist will carefully adjust the dosages for each patient. They will also consider any other medical conditions patients may have, and the effect of the medication on their sleeping patterns. They will also consider 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 other stimulant at reducing the symptoms of ADHD. It is recommended by NICE and is available on prescription in the UK.
Despite the evidence-based research that supports it, there is a certain stigma that surrounds the use of medications to treat ADHD and other disorders, with unhelpful frames that make it appear like child abuse and compare it to controlled substances. This can cause people to be reluctant to seek an assessment or to even consider taking medication to treat their condition.
As the number of people referred to NHS psychiatry grew during the COVID-19 pandemic as did the number of adults receiving treatment for ADHD. In fact, adult ADHD referrals are now surpassing those for children. Boys are still more likely to receive ADHD treatment however, the number of women receiving treatment has quadrupled over the last two years.
Unlicensed Medication
A range of medicines are approved for treating ADHD for children and adults including stimulant drugs such as methylphenidate and, sometimes, the newer amphetamine-based drug lisdexamfetamine being prescribed. These are considered 'controlled' medications because they are prone to abuse and addictive. Your psychiatrist will only prescribe these medications if he or believes that they are the most effective choice for your treatment. Then, you will be given a prescription which you can go to a local pharmacy and take home. It will be for a month's supply of the drug and your pharmacist will be able to explain the procedure to you.
In certain instances, your doctor may feel that the medications they have available are not suitable for you and recommend an unlicensed drug. This is a choice that will be made on a case-by-case basis. Your doctor should only recommend non-licensed medications as a last resort. Remember that while medication is an important part of treating ADHD, talking therapy also plays a significant role. Therapy can change your coping mechanisms and behaviour patterns. Treatment with medication can alleviate your symptoms.
In adult adhd medication uk used to treat ADHD in adults must be accompanied by a marketing authorisation (MA), which specifies the specific conditions under which it's approved. This will include information about the age of those who can be prescribed the medication and how it should be taken. The MHRA will assess any IMP before its release and the manufacturer is permitted to market it under their MA, except if they have a specific license to market paediatric medications.
This is where a medicine is approved for use by a child, but a psychiatrist feels it is appropriate to prescribe it for an adult, this is also called off label prescribing. A "manipulated product" is a possibility, where a pharmacist mixes ingredients to make a formula for a patient who is unable to swallow tablets. Some psychiatrists have been critical of the over-prescription of psychoactive drugs to treat mental health issues, including ADHD.
Licensing
In the UK there are a range of medications that are licensed to treat ADHD in adults. This includes a variety of stimulant drugs, such as methylphenidate (Ritalin) and the more recent amphetamine-based drug called lisdexamfetamine (Elvanse). These are typically prescribed to patients who have been diagnosed with the condition by a psychiatrist. The treatment is prescribed in capsules, and the patient should be closely monitored by their doctor to determine the right dosage.
In addition to these medications, there are a number of other ways that the condition can be treated and managed. For instance the use of behavioural therapy can help people to understand the root cause of their symptoms and to come up with strategies to manage these. Environment-related changes can aid people in coping with the impact that their symptoms can affect their daily lives. This can include organising seating arrangements at school or at work, arranging for frequent breaks in movement, and distributing 'I need a break' cards, as well as making it easier to avoid distractions and noise.
The medications that are licensed to treat ADHD in adults in the UK are not designed to be a cure, but they can greatly improve the quality of life of many people with the condition. However, they aren't a magic bullet and should only be used as part of a comprehensive care package that includes psychiatric treatment and psychoeducation.
It is crucial that any patient of the potential of becoming pregnant undergoes an examination for pregnancy prior to starting medication, and that they inform their GP immediately if they become pregnant or wish to become pregnant. It is also recommended that patients should see their GP in the event of significant side-effects or do not feel that they are benefiting from the medication.
A national patient safety alert regarding the shortage of methylphenidate prolong-release tablets, guanfacine extended-release tablets, and lisdexamfetamine capsules was released on September 27, 2023. On May 8, 2024, a Medicine Supply Notification was issued that lifted the restrictions on prescribing Elvanse capsules.
It is an Schedule 2 drug, so it is only prescribed by a licensed physician and is subject to the Misuse of Drugs Regulations of 2001. The guidelines recommend that an ADHD patient be evaluated annually by a healthcare provider with expertise and training in managing the disorder. This can be done in primary or secondary care, depending on the local arrangement. 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 safe for adults. However, it does not cure this condition. It can help to reduce symptoms of behavioural disorders and improve quality of life. It can also improve learning, work and relationships.
It is essential that anyone who is beginning treatment be aware of any possible adverse effects. They should discuss them with their physician prior to starting the medication. The side effects can include a change in appetite, headaches or sleepiness. Some medications can also raise the heart rate. This is generally harmless and not harmful but it's important to tell your doctor if you have an history of heart disease or issues.
Stimulants increase levels of dopamine and norepinephrine in the brain. This alters the way the brain sends and receives messages, and increases concentration and attention. These drugs are the first line treatment of adult ADHD. Nonstimulant medications such as buproprion and atomoxetine also available, however they have more complex actions on the brain and take longer to start working. The latter works by blocking the reuptake and release of dopamine into nerve cells and helps with concentration.
Research suggests that half of children who are diagnosed with ADHD grow out of their symptoms in adulthood. This could be due to the fact that they are able to manage their symptoms, or because they become less hyperactive. However, a large portion struggle to cope with the society that was not designed to accommodate them. Nice recommends that doctors prescribe ADHD medications only when they are necessary and continue to keep track of their patients frequently.
There are other methods to treat ADHD symptoms. These include lifestyle changes and psychoeducational therapy. These can be combined with medication to reduce the need for GPs to refer patients suffering from ADHD to specialist services.
The stigma associated with ADHD can make it difficult to open about the medication. Many adults are hesitant to reveal that they are taking it to family members, friends or employers. There is increasing evidence that talking openly about the condition can help to break down barriers for treatment.