ADHD Medication For Adults in the UK
In the UK there are a range of medications that are approved for treating ADHD. The stimulant methylphenidate and the amphetamine-based drug lisdexamfetamine, are two of the most frequently prescribed medications. The dosage will be carefully checked in the initial stages of treatment.
What is an Licensed Medication?
A licensed medicine has gone through all the necessary clinical trials and tests and the MHRA, the Medicines and Healthcare Products Regulatory Authority (MHRA) has granted the green light for its use in Great Britain. The packaging of the medicine or the leaflet that comes along with it will clearly indicate the appropriateness of the medicine for a specific condition. All licensed medicines undergo rigorous regulation even after they have been placed available for sale. This allows problems to be identified quickly and reduces the risk.
Some people suffering from ADHD might be prescribed medications that are not licensed however, they are not often utilized on teenagers and children. Unlicensed medications can be prescribed for other conditions that have been proven to be effective (known as "off-label prescribing") or they could be a form of treatment that is not yet available in the market for example, liquid oral instead of tablets. It may be an experimental medication that is being evaluated in the UK.
Experimental drugs are referred to as Investigational Medicinal Products (IMPs) or Medicines with a Marketing Authorisation (MIA)(IMP). These medicines haven't been granted a license yet and so can only be sold on an order from a doctor. They'll have been through an assessment in a formal manner by the MHRA as part of the Early Access to Medicines Scheme (EAMS) and so the quality of the pharmaceutical is guaranteed.
There is one non stimulant medication that is commonly prescribed for ADHD in the UK and Europe, and this is atomoxetine. It is a selective inhibitor of noradrenaline uptake, so it works differently than other ADHD medications. It boosts the levels of noradrenaline within the brain which is a type of chemical that sends messages between nerve cells which improves concentration and aids in controlling impulses. It is typically taken as a capsule every day or twice daily.
A psychiatrist is the sole mental health professional who can diagnose ADHD in adults and prescribe medication to treat it. It's important to note that ADHD isn't just a condition that can be treated with medication alone, and therapy is frequently included in treatment plans for people suffering from the disorder. Psychoeducation is a way to assist children, teens, and adults understand their diagnosis and behavioural therapy which teaches techniques 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 that the medication was not created by a company based in the UK or was prescribed outside of the terms of licence (off-label). The GMC's guidelines state that 'unlicensed medicines are typically used when a suitable licensed product is not available, or a clinically effective treatment cannot be found with the product that the prescriber feels most comfortable using'.
The license of a medicine will list the conditions it treats, and the age ranges it is able to treat. The licence will also outline how and by whom the medicine is to be administered. The MHRA will only grant a licence when the drug is believed to be safe and effective for the usage, founded on medical research and clinical trials. The drug manufacturers are not allowed advertise or promote any use that are not covered by the license.
It is not illegal in the UK for a healthcare professional to prescribe an unlicensed medication in the event that they are able to explain the risks and benefits of doing so to the patient. They must also keep a record of the use of unlicensed medications and provide the patient enough information to make an informed decision.
Hospitals are more likely to give unlicensed drugs because they have had more experience with them than GP surgeries. The hospital will have procedures to ensure the safety and efficacy of the medication. This includes keeping thorough medical records of patients and noting any adverse effects. They are required to adhere to MHRA guidelines on the safe supply unlicensed medicine.
Doctors who prescribe specials must to be clear with patients and their parents or carers about what the medicine is and the reason it is being used and the potential adverse consequences. They should be able to address any questions and provide written information about any medication they prescribe, including the reasons for it.
What is what is a Shared Care Agreement?
The number of people who are suspected of having ADHD has increased in recent years, so have demanded to be referred for an NHS assessment and also to receive medication for the condition. Unfortunately, waiting lists for NHS assessments are lengthy and this means that many patients are turning to self-funding private ADHD assessments at private clinics. my response is that once a diagnosis has been confirmed through this process the GP will enter into an agreement of shared care (SCA).
A SCA is an agreement between your psychiatrist and your GP in which the responsibility for prescribing, monitoring and the basic health checks for medicines is assigned to your GP. This is a recognised and agreed method of transferring the responsibility of managing a patient suffering from ADHD from an institution or a specialist service setting to general practice, provided this is in line with NHS England guidelines.
Before transferring responsibility, the specialist and GP should agree on these SCA guidelines and this should be clearly stated in any referral form. It should be made clear to the GP that they are responsible for the ongoing adjustment of the medication as well as the monitoring requirements.
Unfortunately, many GPs are not able to accept SCAs. This isn't because of an inability to accept however, the work involved in SCAs can be outside of their primary funding, and usually an additional project in addition to their busy schedule.
The GP should be informed of the reasons behind SCA and the expectations of all parties involved, and the roles of patients and carers. It is also important to be clear that a decision on SCA should be made by the doctor who initiated treatment. In addition, the doctor should be informed that they do not want to participate in the SCA.
If a doctor refuses to take responsibility for SCA, they can refuse. However, this could result in patients being sent back to the private ADHD clinic and psychiatrist who made their initial diagnosis. This could result in prescriptions for medication being issued privately, instead of through the NHS. This can be more costly.
What is Titration Period?
The tration phase is a crucial stage to find the right medication for ADHD. It involves gradually increasing the dosage until you reach a dose that maximizes your benefits while minimising your side effects. It takes time but your healthcare specialist should work closely with you to ensure the titration process is as smooth as is possible.
Certain patients may experience an increase in their symptoms during the titration period. Hyperactive people, for example can become agitated and irritable. It is crucial to let loved ones know of any changes in behavior and provide support. It is also crucial to eat a balanced diet and to create a consistent sleep routine to lessen the adverse effects of ADHD medication.
Medication is not the only treatment for ADHD however it is usually suggested as the first line of treatment for adults. Talk my response is a helpful tool to treat depression and anxiety that could cause some of the symptoms of ADHD. It is crucial to remember that medication is only able to treat the symptoms, and not alter the coping mechanisms that have been in place for a long time. Some patients choose not to take meds in the first place and instead concentrate on self-help methods such as exercise, nutrition, stress reduction and sleep strategies.
It is essential to be aware of the side effects and how they will affect your body. Certain medications can reduce appetite and cause headaches, as well as make you drowsy. Make sure you follow the directions for taking your medication and speak to your doctor if you experience any adverse reactions.
Many of the medications used to treat adult ADHD are currently in short supply due to shortages. This has led to delays in diagnosis and appointments with psychiatrists. NHS England has set up an inquiry taskforce to look into the issue and recommend ways of reducing waiting times for prescriptions.
Despite the lack of certain popular drugs, it's still possible to get ADHD care in the NHS and it's worth speaking with your local GP about the options available to you. You may be able to obtain the same medications privately, or they may recommend alternatives that have similar results.