ADHD Medication For Adults in the UK
In the UK there are a variety of medications are approved for treating ADHD. This includes the stimulant methylphenidate, as well as the amphetamine based medication lisdexamfetamine. The dosage will be closely monitored in the early stages of treatment.
What is a Licensed Medication?
A medicine that is licensed will have undergone all the appropriate clinical studies and tests, and the MHRA (Medicines and Healthcare Products Regulatory Authority) has granted it the approval to be used in Great Britain. The medicine will also be clearly listed as suitable for a particular condition on its packaging or in a leaflet which is provided with it. All licensed medicines go through strict regulation and testing, even after they're on the market. This allows for problems to be detected quickly and reduces the risk.
Some people suffering from ADHD may be prescribed unlicensed medications however they aren't often used for teenagers and children. The unlicensed medication may be used to treat other conditions which have been proven to be effective (known as off-label prescribing), or it might be a specific formulation that isn't available on the market, like an oral liquid instead of tablets or something without certain additives. It could also be an experimental medicine that is being tested in the UK.
Experimental drugs are known as Investigational Medicinal Products (IMPs) or Medicines with a Marketing Authorisation (MIA)(IMP). These medicines are not yet approved and can only be purchased with the prescription of a physician. They will have undergone an assessment in a formal manner by the MHRA as part of the Early Access to Medicines Scheme (EAMS) and so the quality of pharmaceuticals is guaranteed.
Atomoxetine is a non-stimulant medication that is often prescribed in the UK and Europe for ADHD. It is a selective noradrenaline reuptake inhibitor, and therefore differs from other ADHD medication. It increases noradrenaline, a chemical that helps to transmit messages between brain cells. This aids concentration and helps to control impulses. It is usually taken as a capsule every day or twice a day.
Only a psychiatrist can diagnose ADHD and prescribe medication for adults. It is crucial to understand that ADHD isn't just a disorder that can be treated with medication alone. Therapy is frequently included in treatment plans for those suffering from the disorder. Psychoeducation can assist children, teens, and adults recognize their diagnosis and behavioural therapy which teaches techniques to manage symptoms.
What is an Unlicensed Medication?
The term "unlicensed medicines" refers to drugs that are not licensed by the MHRA. It could be because the drug was not developed by a company based in the UK or it was prescribed in violation of the terms of licence (off-label). The GMC's guidelines state that 'unlicensed medications are typically used when a suitably licensed product is not available or when a clinically effective treatment cannot be found with the product with which the prescriber feels at ease'.
The medical license will include the conditions it treats, and the age ranges it can be administered to. The licence will also specify the manner and method by which the medicine is to be administered. The MHRA only grants a licence if it is deemed safe and effective in that particular use, based on clinical trials and medical research. The drug manufacturers are not allowed promote or advertise any uses that are not covered under the licence.
In the UK It is not illegal for a healthcare professional prescribe an unlicensed medication provided that the patient is informed of the potential risks and benefits. They must keep an account of the use of non-licensed medications and give the patient enough information to make an informed decision.
The majority of unlicensed medications are offered in hospitals, where there is more experience using them than in GP surgeries. The hospital will have procedures in place to ensure the safety of the medication, which includes keeping detailed patient records and making sure that any adverse reactions are documented. They will be required to follow MHRA guidelines on the safe supply of unlicensed medications.
Specials are prescribed by doctors who must be clear with their patients, their parents or caregivers of the medication, its purpose and any possible adverse effects. They should be able to answer any questions they receive and always provide written information about any medication they prescribe along with the reasons for prescribing it.
What is a Shared Care Agreement?
In recent years as the number of people who are suspected of being suffering from ADHD increased and so did the requests for referrals to the NHS for an assessment and treatment to treat the condition. The waiting lists for NHS assessments are long and this means that a large number of patients are turning to self-funding private ADHD assessments at specialist private clinics. The hope is that after the diagnosis is confirmed by this process, the GP will sign an agreement of shared care (SCA).
A SCA is a contract between your psychiatrist and GP, whereby the responsibility for prescribing medications, monitoring, and basic health checks are transferred to your GP. This is a recognised and agreed method of transferring responsibility for managing a patient with ADHD from a hospital or specialist service to general practice, provided that it is in accordance with NHS England guidelines.
Before transferring responsibility the specialist and GP must agree on the SCA guidelines and this must be clearly stated on any referral form. It should be made clear to the GP that he or she is responsible for the continual monitoring of the medication as well as the monitoring requirements.
Unfortunately, a lot of GPs are reluctant to accept SCAs. It is not because they are not interested or desire, but because the work involved in SCAs isn't part of their regular funding.
The GP should be informed about the reasoning of SCA and the expectations of all participants, and the role of patients and carers. It should be clear that the decision to go ahead with SCA should be made by the doctor who is initiating treatment. The GP should be informed that the patient isn't willing to participate in SCA.
If a physician does not want to accept 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 can mean that medication prescriptions are issued privately, rather than through the NHS which, naturally, is more expensive.
What is a Titration Period?
The tration phase is a crucial step in determining the best medication to treat your ADHD. It is the process of gradually increasing your dosage until you reach a dose that maximises your benefits while minimising your adverse effects. It takes time, but your healthcare specialist should work closely with you to ensure that the process of titrating is as smooth as is possible.
Some patients might notice an increase in their symptoms during the titration time. For instance, people who are hyperactive might become more restless and angry than they normally are. It is essential that loved ones are aware of any changes in behavior and provide support. most effective adhd medication for adults is also important to have a healthy diet and to establish a regular sleep routine in order to reduce the adverse effects of ADHD medication.
It is important to note that medication is not the only option for ADHD treatment. However, it is recommended as a first-line management method for 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 can only treat the symptoms, not change long-standing negative coping mechanisms. Some patients opt to not take any medication and instead focus on self-help strategies such as exercise, nutrition and stress reduction.
It is crucial to look over the side effects of any medicine you are prescribed, and understand how the medication will affect your body. Certain medications can cause a decrease in appetite and cause headaches. Others can cause you to become drowsy. Make sure you take your meds as directed, and talk to your doctor if there are any adverse reactions.
Today, many of the treatments for adults with ADHD are in short supply. This has resulted in delays in diagnosis and a backlog in appointments with psychiatrists. NHS England has set up a taskforce to investigate the issue and recommend ways to reduce the time spent waiting for medications.
Ask your local GP what options are available to you. You may be able to obtain the same medications privately or they may recommend alternatives with similar results.