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 drug lisdexamfetamine, are two of the most frequently prescribed medications. The dosage will be carefully monitored in the beginning stages of treatment.
What is a Licensed Medication?
A licensed medicine has undergone all the necessary tests and clinical trials and the MHRA, the Medicines and Healthcare Products Regulatory Authority (MHRA) has given the go ahead for its use in Great Britain. The medication will also be clearly identified as being suitable for specific conditions on its packaging or in a leaflet that is included with it. All licensed medicines undergo rigorous regulation even after they have been placed being sold. This allows problems to be identified quickly and reduces the risk.
adhd medication list suffering from ADHD might be prescribed unlicensed drugs however they aren't often used on children and teenagers. Unlicensed medications may be prescribed for other ailments that have been shown to be effective (known as "off-label prescribing") or they could be a formula that is not yet available on the market, such as a liquid oral instead of a tablet. It could be an experimental medicine 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 have not been granted a licence as of yet and can therefore only be sold with an order from a doctor. The MHRA will have conducted a formal evaluation as part of the Early Access to Medicines Scheme.
Atomoxetine is an anti-stimulant medication that's often prescribed in the UK and Europe for ADHD. It is a selective noradrenaline inhibitor, and therefore works differently to other ADHD meds. It increases noradrenaline, which is a chemical that aids in transmitting messages between neurons in the brain. This aids concentration and helps to control impulses. It is typically taken in capsules once or twice a day.
A psychiatrist is the sole mental health professional who can identify ADHD in adults, and prescribe medications to treat it. It is crucial to understand that ADHD is not just a condition that can be treated by medications alone. Therapy is very often included in treatment plans for people suffering from the condition. Psychoeducation is a way to help children, teens and adults understand their diagnosis as well as behavioral therapy that teaches strategies for managing symptoms.
What is an Unlicensed Medication?
The term "unlicensed medicine" refers to drugs that are not licensed by the MHRA. It could be because the drug was not developed by a UK-based business 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 drug that the prescriber is comfortable'.
A medical license will specify the health conditions it treats as well as the age of the patients it can be prescribed to. It will also specify how it should be taken and by whom. The MHRA only issues a licence when it is considered safe and effective in that specific use, based upon clinical studies and medical research. The manufacturers of drugs are not permitted to advertise or promote any use that are not covered by the licence.
It is not illegal in the UK for a healthcare professional to prescribe a non-licensed medication in the event that they are able to explain the risks and benefits of prescribing it to the patient. They must keep records of the use of medications that are not licensed and provide the patient with enough information to make an informed choice on whether or not to take it.
Unlicensed medications are often offered in hospitals, where there is more experience of using these medications than in GP clinics. The hospital will have procedures in place to ensure the safety of the medication including keeping accurate patient records and making sure that any adverse reactions are documented. They will also be required to follow the MHRA's guidance on the safe supply of non-licensed medicines.
Specials are prescribed by doctors who must communicate with their patients, their parents or caregivers about the medication, its purpose and any potential side effects. They must be able answer any questions asked, and should always provide written information about any medication they prescribe, as well as the reasons for it.
What is a Shared Care Agreement?
The number of people who are suspected to have ADHD has increased in recent years so are the demand to be referred to an NHS assessment and to receive medication for the condition. Unfortunately, the waiting lists for NHS assessments are lengthy and this means that a lot of patients are opting to pay for their own private ADHD assessments at specialist private clinics. It is hoped that once the diagnosis is confirmed through this process the GP will sign an agreement of shared care (SCA).
A SCA is an agreement between your psychiatrist and your GP where the responsibility for prescribing, monitoring and basic health checks for medications is transferred to your GP. It is a well-known and accepted method of shifting the responsibility of managing ADHD patients from a specialist clinic or hospital to general practice.
These SCA guidelines should be discussed between the specialist and the GP before responsibility is handed over and this should be clearly in any referral form. It must also be stated that the GP retains responsibility for continuous monitoring and titration of the medication.
Unfortunately, a lot of GPs aren't keen on accepting SCAs. This isn't due to a lack of desire but rather because the work involved with SCAs could be out of their normal funding and it is usually an additional project on top of a busy schedule.
The GP must be informed of the rationale of SCA, the expectations of all participants, and the roles of patients and carers. It should be made clear that the decision to go ahead with SCA should be taken by the physician who initiated treatment. The GP should also be informed of the patient's refusal to be willing to participate in SCA.
If a doctor doesn't wish to take on the responsibility of SCA they can refuse to do so, but this can lead to patients being sent back to the private ADHD assessment clinic and psychiatrist who carried out their initial diagnosis. This can mean that prescriptions for medication are issued privately rather than through the NHS, which of course is more expensive.
What is Titration Period?
The tration time is a crucial element to determine the appropriate medication to manage your ADHD. It is a process of increasing the dosage gradually until you reach a level that maximises benefits and minimizes adverse effects. It is an ongoing process that can take time. Your healthcare professional should work with you closely to ensure that the titration procedure is as effortless as it can be.
Some patients might experience an increase in their symptoms during the titration time. For example, those who are hyperactive may be more agitated and irritable than usual. Because of this, it is essential that family members are aware of any changes and offer support. It is also crucial to maintain a healthy diet and to create an established routine for sleeping to minimize the side effects of ADHD medications.
Medication isn't the sole treatment for ADHD, but it is generally suggested as the first line of management in adults. Talk therapy is an effective method to deal with depression and anxiety that may cause certain symptoms of ADHD. It is important to keep in mind that medication only treats the symptoms and does not change negative coping mechanisms. Some patients prefer not to take meds at all and instead concentrate on self-help methods such as nutrition, exercise as well as stress reduction and sleep strategies.
It is essential to be aware of the adverse effects and how they affect your body. Some medications can cause headaches or drowsiness, and also reduce appetite. Always follow the directions for your medication and speak to your doctor if any adverse effects occur.
Currently, many of the drugs used to treat adult ADHD are out of stock. This has caused delays in diagnosis and a backlog in appointments with psychiatrists. NHS England has created a taskforce to study the issue and make recommendations regarding how to decrease waiting times for medication.
Ask your local GP what options are available for you. You may be able get the same medication privately or they might suggest alternative medications with similar results.