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 during the pandemic.
The medicines used to treat ADHD include stimulants as well as non-stimulants. Methylphenidate, dexamfetamine and Lisdexamfetamine are amphetamine-based medicines that aid in managing ADHD symptoms.
Stimulants
The most commonly used kind of medication used to treat adult ADHD is a stimulant. These drugs work by increasing the activity in the brain regions that control attention and behavior. They are fast-acting and are frequently the first choice of GPs. Methylphenidate (also called Ritalin) is the most commonly prescribed stimulant in both children and adults.
This drug boosts the levels of neurotransmitters in the brain, improving attention span and decreasing hyperactivity and impulsivity. It can also reduce anxiety and depression, which may co-occur 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, nicotine, amphetamines, cocaine, modafinil, methylphenidate and others. These substances are used to control appetite and increase energy levels. However, they may also cause negative psychological and physical effects if taken in excess.
There are a number of different drugs used to treat adults with ADHD and psychiatrists will typically be careful to adjust the dosages for each patient they see. They will also consider any other medical conditions that the patient might be suffering from, as well as the effects of the medication on their sleep patterns. They will also look at the effects of the medication on the diet of a patient and lifestyle.
A large network meta-analysis conducted by the NIHR Oxford Health Biomedical Research Centre and Stichting Eunethydis, has found that the drug lisdexamfetamine (commonly called Adderall) is more effective than other stimulants in reducing symptoms of ADHD. It is recommended by NICE and is available in the UK by prescription.
Despite the evidence-based research however, there's a stigma attached to 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 make people hesitant to take a test or even consider taking medication for their condition.
As the number of patients referred to NHS psychiatry grew during the COVID-19 pandemic, so too did the number of adults receiving treatment 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 in the past two years.
Unlicensed Medication
A range of medicines are licensed for treating ADHD in adults and children including stimulant drugs like methylphenidate, and occasionally the more recent amphetamine-based medication lisdexamfetamine prescribed. These drugs are classified as controlled medications because they can be addictive and abuse. Your psychiatrist will only prescribe these medications if he or she believes they are the most effective solution for your treatment. You will be given an approved prescription in writing that you can pick up at your local pharmacy. The pharmacist will explain to you that this is for a monthly supply of drug.
In certain situations your doctor might determine that the medications they offer aren't appropriate for you and recommend a medication that is not licensed. It's a case-by-case decision and your doctor should only recommend unlicensed medication as a last resort. It is important to remember that, while medication is an integral part of treatment for ADHD however, talking therapy is equally important. Therapy can change your coping mechanisms and behavior patterns. Medication can manage your symptoms.
In the UK medications used to treat ADHD in adults must be accompanied by an authorisation to market (MA), which specifies the specific conditions for which it's approved. inattentive adhd medication includes the ages of the people who are treated and the method by which the medication should be administered. The MHRA will make an official evaluation of any IMP before it is released, and the manufacturer is able to promote it under its MA, unless it has a special licence for paediatric medicine.
Off label prescribing happens when a psychiatrist believes it is appropriate to prescribe a medication for an adult even if it was prescribed for a child. A "manipulated product" is a possibility, where pharmacists mix ingredients to make a formula for a patient who is unable to take tablets. There can be some stigmas associated with using non-licensed medications to treat ADHD in adults, with some psychiatrists expressing concern about the over-prescribing of psychoactive drugs for mental health issues.
Licensing
In the UK there is various medications that are licensed to treat ADHD in adults. This includes a variety of stimulant medicines such as methylphenidate (Ritalin) and the more recent amphetamine-based drug Lisdexamfetamine (Elvanse). They are typically offered to patients diagnosed with the condition after consulting with a psychiatrist. The treatment is prescribed as capsules, and patients should be closely monitored by their doctor in order to find the proper dosage.
In addition to these drugs in addition, there are a variety of other ways in which the illness can be treated and managed. For instance, behavioural therapy can aid patients in understanding the root causes of symptoms and develop strategies to overcome these. In addition, environmental modifications can also be useful in helping people to cope with the impact of their symptoms on daily activities. This can include arranging seating arrangements at work or at school and distributing cards that read "I Need a Break" and arranging frequent movement breaks as well as reducing noise and distractions.
The medicines that have been approved by the UK to treat ADHD among adults are not intended to be a cure, but they can enhance the quality of life for a lot of people. But, they're not an all-purpose cure and should only be used as a part of a comprehensive care package that includes psychiatric treatment and psychoeducation.
Patients who are able to bear children should take a pregnancy test prior to beginning any medication. They must also inform their GP if they fall pregnant or are planning to fall pregnant. It is also recommended that patients should see their GP when they experience serious side-effects or don't believe they are getting the benefits from the medication.
On the 27th of September, 2023, a national patient safety alert was issued about the shortage of extended-release Guanfacine tablets, lisdexamfetamine tablets, and methylphenidate tablets. On May 8, 2024 an Medicine Supply Notification was issued, which lifted the prescribing restrictions on Elvanse capsules.
It is a Schedule 2 controlled drug so it must be prescribed by an authorized practitioner and is subject to the Misuse of Drugs Regulations 2001. The guidelines recommend that an ADHD patient is evaluated annually by a healthcare professional who is knowledgeable and trained in managing the disorder. adhd medication and pregnancy can be done in primary or secondary care, depending on the local arrangement. This review should include monitoring of heart rate and blood-pressure as well as a discussion about the need to continue treatment, and continuous monitoring and evaluation 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 also helps improve the quality of work, relationships and learning.
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 beginning the medication. Some of the side effects include headaches, insomnia and a change in appetite. Certain medications can also increase the heart rate. This is usually mild and harmless, but it is worth noting to your doctor if you have any previous history of heart issues or cardiovascular disease.
adhd medication and pregnancy increase levels of norepinephrine and dopamine in the brain. This alters how the brain receives and transmits messages, which improves focus and attention. They are considered first-line treatments for adults suffering from ADHD. Nonstimulant medicines like buproprion and atomoxetine are available, but they have more complex effects on the brain and take longer to begin working. The latter is a drug that blocks dopamine reuptake into nerve cells and assists in enhancing concentration.
Research suggests that half of children diagnosed with ADHD get rid of their symptoms by adulthood. It may be due to how they manage their symptoms, or perhaps because they are less hyperactive. But a significant number continue to struggle in an environment that isn't specifically designed for them. That's why Nice recommends that doctors prescribe ADHD drugs only where they are necessary and continue to monitor patients regularly.
There are many other ways to help with ADHD symptoms, including psychoeducational and lifestyle modifications. These can be utilized in conjunction with medications to decrease the need for GPs to refer people suffering from ADHD to specialist services.
Many adults are hesitant inform their families, friends or employers that they use ADHD medication due to the stigma that surrounds it. There is increasing evidence that speaking out about the condition can help break down barriers to treatment.