ADHD Medication For Adults in the UK
In the UK, a number of medications are approved for treating ADHD. This includes the stimulant methylphenidate, as well as the amphetamine-based drug lisdexamfetamine. The precise dose needs to be carefully monitored during the early stages of treatment (titration) and then, once stable, prescriptions will be administered by your GP as part of an agreed'shared care arrangement.
What is an Licensed Medication (L.M.)?
A medicine that is licensed will have undergone all the appropriate clinical tests and trials and the MHRA (Medicines and Healthcare Products Regulatory Authority) has given it the go ahead to be used in Great Britain. The medicine will also be listed as suitable for specific conditions on its packaging or in a leaflet which is provided with it. All licensed medicines are carefully regulated even after they've been placed on the market, meaning that any problems can be identified quickly and risks minimized.
Unlicensed medications are sometimes prescribed to people with ADHD however, they are rarely given to adolescents or children. The unlicensed medication could be prescribed for other conditions which have been found to work well with it (known as off-label prescribing) or it could be a specific formula that isn't yet on the market, such as an oral liquid in place of tablets or a product without certain additives. It could be an experimental medicine that is being tested in the UK.
The term "experimental drugs" is used to describe Medicines with a Marketing Authorisation(MIA) (IMP) or Investigational Medicinal Products. These medicines have not been granted a licence yet and can therefore only be sold on a doctor's prescription. The MHRA will have conducted a formal evaluation as part of the Early Access to Medicines Scheme.
Atomoxetine is a medication that's not stimulant that is often prescribed in the UK and Europe for ADHD. This medication is a specific inhibitor of noradrenaline's uptake which means it performs differently than other ADHD drugs. It increases noradrenaline in the brain, which is a sort of chemical that transmits messages between nerve cells and this aids concentration and assists in controlling impulses. It is taken as a capsule every day, either once or twice.
Only psychiatrists can diagnose ADHD and prescribe medication for adults. It is important to remember that ADHD isn't a condition that can be treated with medication by itself. Therapy is often incorporated in treatment plans. Psychoeducation, which aids children, teenagers and adults understand their diagnosis, and the behavioural therapy, which helps teach methods to manage symptoms.
What is an unlicensed drug?
The term "unlicensed medicine" refers to any medicine that has not been granted a licence by the MHRA. It could be that the drug was not developed by a UK company, or because it has been prescribed in violation of the terms of its licence (ie off-label). More suggestions that 'unlicensed medications are typically used when a suitably licensed product isn't available or a clinically effective treatment cannot be found using the product with which the prescriber feels comfortable'.
A medical license will specify the conditions it treats as well as the age of patients it may be given to. It will also state how it should be used and by whom. The MHRA will only grant an approval if the drug is considered to be safe and effective for that use, which is founded on medical research and clinical trials. The manufacturers of the drugs are not permitted to promote or promote any use that isn't 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 explain the risks and benefits of prescribing it to the patient. They must also keep records of the use of non-licensed medications and give the patient sufficient information to help them make an informed decision.
Hospitals tend to provide unlicensed drugs due to their more experience with them than GP surgeries. The hospital will implement procedures to ensure the safety and efficacy of the medication. This includes keeping thorough medical records of patients and also recording any adverse reactions. They must also follow the MHRA's guidance on the safe supply of non-licensed medicines.
Doctors who prescribe specials have to be clear with patients and their parents or carers about what the medicine is, why it is being used, and the possible negative side consequences. They should be able answer any questions and provide written details about any medication they prescribe, including the reasons for prescribing it.
What is what is a Shared Care Agreement?
In recent years as the number of adults suspected of being suffering from ADHD increased as did the demand for an appointment with the NHS for an assessment and treatment to treat the condition. The waiting lists for NHS assessments are lengthy and this means that a large number of patients are reverting to self-funding private ADHD assessments at specialist private clinics. The hope is that once a diagnosis has been confirmed through this process, the GP will enter into a shared care agreement (SCA).
A SCA is an agreement between your psychiatrist and your GP and GP, in which the responsibility for prescribing medication monitoring, as well as basic health checks is transferred to your GP. This is a recognised and accepted method for the transfer of the responsibility of managing a patient suffering from ADHD from an institution or specialist service setting to general practice, provided that it is in accordance with NHS England guidelines.
Before responsibility is transferred, the specialist and GP must agree on the SCA guidelines. This should be clearly stated on any referral form. It should also be made clear that the GP retains responsibility for ongoing titration and monitoring requirements of the medication.
Unfortunately, many GPs are not able to accept SCAs. It's not because they lack desire or desire, but because the work involved in SCAs is not part of their primary funding.
The GP should be provided with high-quality information about the motivation behind SCA and what the expectations of both parties are, including the role of the patient and their carers. It is important to be clear that the decision to pursue SCA should be taken by the physician who initiated treatment. The GP must also be informed of the patient's refusal to be willing to participate in SCA.
If a GP does not want to assume the responsibility of SCA they can choose not to do so, but this can lead to patients being sent back to the private ADHD assessment clinic and psychiatrist who made their initial diagnosis. This could lead to prescriptions for medication being issued privately, instead of through the NHS. This can be more expensive.
What is a Titration Period?
The tration phase is a crucial step to determine the appropriate medication to treat your ADHD. It involves increasing your dosage gradually until you get to the level that maximises benefits and minimizes adverse effects. It is an process that takes time. Your healthcare professional must collaborate closely with you to ensure that the titration procedure is as easy as it can be.
Some patients might notice an increase in their symptoms during the titration time. For example, hyperactive people may become more restless and anxious than normal. It is essential to let loved ones know of any changes in behavior and provide support. To minimize the adverse effects of ADHD medications it is crucial to live a healthy life and a regular sleep schedule.
It is important to note that medication is not the only option for ADHD treatment. However it is suggested as a first-line treatment option in adults. Talk therapy is an effective tool to deal with depression and anxiety that can be the cause of certain symptoms of ADHD. It is important to remember that medication can only treat the symptoms, not alter long-standing negative coping mechanisms. Some patients choose not to take meds at all and prefer to focus on self-help therapies like exercise, nutrition and stress reduction strategies.
It is crucial to know the effects of 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 to always use your medications as directed and consult your doctor if you notice any adverse reactions.
Currently, many of the treatments for adults with ADHD are in short supply. This has caused delays in diagnosis and appointments with psychiatrists. NHS England has set up an inquiry taskforce to look into the issue and suggest ways of reducing waiting times for medication.
Ask your local GP what options are available for you. You might be able to get the same medication privately or they may recommend alternatives that have similar results.