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ADHD Medication For Adults in the UK In the UK there are a variety of drugs that are licensed to treat ADHD. This includes the stimulant methylphenidate, as well as the amphetamine based medication lisdexamfetamine. The dose will be closely checked in the initial stages of treatment. What is an Licensed Medication? A licensed medicine has undergone all of the necessary tests and clinical trials and the MHRA the Medicines and Healthcare Products Regulatory Authority (MHRA) has granted the green light for its use in Great Britain. The medication will also be clearly identified as being suitable for a particular condition on its packaging or in the leaflet that is included with it. All licensed medicines are monitored even after they've been placed on the market, meaning that any problems can be spotted quickly and risks minimized. Unlicensed medicines are often prescribed to patients with ADHD however they are not often prescribed to children or teenagers. Unlicensed medicines can be prescribed for other conditions that have been proven to work well (known as “off-label prescribing”), or they could be a formulation that isn't yet on the marketplace, such as liquid oral instead of tablets. It could also be an experimental medication that is being tested in the UK. The term “experimental drugs” is used to refer to Medicines that have an IMP or Marketing Authorisation(MIA) (IMP) or Investigational Medicinal Products. These medicines are not yet licensed and can only be purchased with an order from a doctor. The MHRA will have conducted a formal review as part of the Early Access to Medicines Scheme. There is one non stimulant medication that is frequently prescribed for ADHD in the UK and Europe and that is atomoxetine. This is a selective noradrenaline-reuptake inhibitor, which works differently to other ADHD meds. It increases noradrenaline in the brain which is a type of chemical that transmits messages between nerve cells, which aids concentration and aids in controlling impulses. It is usually taken as a capsule every day or twice daily. Only psychiatrists are able to diagnose ADHD and prescribe medication for adults. It is crucial to remember that ADHD isn't a condition that can be treated through medication by itself. Therapy is often included in treatment plans. Psychoeducation can help children, teens and adults understand their diagnosis and behavioural therapy which teaches techniques for managing symptoms. What is an unlicensed drug? The term “unlicensed medicine” refers to any drug that has not been granted a license by the MHRA. This could be due to the fact that the medicine has not been developed by an UK company, or because it was prescribed outside the terms of its licence (ie off-label). The GMC's guidance states that 'unlicensed drugs are generally employed when a licensed product isn't readily available or when an effective treatment that is clinically proven cannot be found using the product with which the prescriber feels at ease'. The medical license will list the conditions it treats and the ages it can be administered to. The licence will also specify the manner and method by which the medicine should be used. The MHRA only issues a licence when it is considered to be safe and effective in the specific use, based upon clinical studies and medical research. The manufacturers of drugs are not permitted to promote or advertise any uses that are not covered by the license. In the UK It is not illegal for medical professionals to prescribe an unlicensed medication provided that the patient is aware about the risks and benefits. 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 regarding whether or not they wish to accept the. Hospitals tend to provide unlicensed medicines due to their more experiences with them than GP surgeries. add adhd medications will have procedures in place to ensure the safety of the medication including keeping detailed patient records and ensuring that any adverse reactions are documented. They must follow MHRA guidelines for the safe supply of unlicensed medicines. Doctors who prescribe specials have to be transparent with patients and their parents or caregivers about what the medicine is and the reason it is being used, and the possible adverse effects. They should be able to answer any questions and provide written details about any medication they prescribe, including reasons for prescribing it. What is a Shared-Care Agreement? In recent years, as the number of people suspected of having ADHD increased and so did the requests for a referral to the NHS for an assessment and treatment to treat the condition. The waiting lists for NHS assessments can be lengthy, and many patients opt to pay for their ADHD assessments at private clinics. Once a diagnosis is confirmed, the GP may enter into a shared-care arrangement (SCA) with the patient. A SCA is an agreement between your psychiatrist and your GP where the responsibility of monitoring, prescribing and basic health checks for medications is transferred to your GP. It is a well-known and accepted method of shifting responsibility for managing ADHD patients from a specialist or hospital to general practice. Before responsibility is transferred, the specialist and GP must agree on the SCA guidelines and this must be clearly stated on any referral form. It should also be made clear that the GP remains responsible for continuous monitoring and titration of the medication. Unfortunately, a lot of GPs are hesitant to accept SCAs. This is not due to the lack of motivation but rather because the work involved with SCAs can be outside of their core funding, and usually an additional project in addition to their busy schedule. The doctor must be informed about the reasoning for SCA and the expectations of all parties involved, as well as the role of the patients and their caregivers. It should be made clear that the decision to pursue SCA should be made 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 does not wish to take on the responsibility of SCA they may choose not to do so, however this could result in patients being sent back to the private ADHD assessment clinic and psychiatrist who performed their initial diagnosis. This can lead to prescriptions for medication being issued privately, instead of through the NHS. This could be more costly. What is a titration time? The tration stage is a crucial stage to find the right medication for ADHD. It involves gradually increasing your dose until you reach a level that maximizes your benefits while minimising your side effects. It takes time however, your healthcare professional should be in close contact with you to ensure that the titration process is as smooth as possible. Some patients might notice an increase in their symptoms during the titration phase. For example, those who are hyperactive may be more agitated and irritable than usual. For this reason, it is crucial that loved ones are aware of any changes and offer assistance. It is also essential to have a healthy diet and to create a regular sleep routine in order to reduce the adverse effects of ADHD medications. It is important to keep in mind that medication isn't the only option for ADHD treatment. However it is recommended as a first-line management method in adults. Talk therapy is a useful tool to treat depression and anxiety that could cause some of the symptoms of ADHD. It is crucial to keep in mind that medication only addresses symptoms and does not alter the negative coping mechanisms. Some patients choose not to take medication at all and prefer to focus on self-help treatments such as exercise, nutrition and stress reduction strategies. It is crucial to look about the potential adverse effects of any medication you are prescribed and know how the medication will affect your body. Some medications can cause headaches or drowsiness, and can also cause a decrease in appetite. Be sure to take your meds as directed, and talk to your doctor if you experience any adverse reactions. Today, many of the treatments for adults with ADHD are out of stock. This has led to delays in diagnosis and a backlog in appointments with psychiatrists. NHS England has set up a taskforce to investigate the issue and recommend methods to speed up the process of waiting for medications. Ask your local GP what options are available for you. You may be able get the same medications privately, or they could suggest alternatives that can provide similar results to those you're used to.