Adult ADHD Medication in the UK
In the UK In the UK, the NHS has guidelines for diagnosing ADHD in adults. Referrals to the adult ADHD specialist clinic quadrupled during the pandemic.
Medications used to treat ADHD include stimulants and non-stimulants. Methylphenidate and dexamfetamine as well as Lisdexamfetamine are three amphetamine-based drugs that aid in managing ADHD symptoms.
Stimulants
Stimulants are among the most popular treatment for ADHD in adults. These medications increase the activity in the brain regions that regulate attention and behavior. They are fast-acting and are often the first choice of GPs. Methylphenidate is more commonly referred to as Ritalin is the most commonly prescribed stimulant for adults as well as children.
add adhd medications increases the amount of neurotransmitters in the brain, improving attention span and decreasing hyperactivity and impulsivity. It can also help reduce anxiety and depression, which may co-occur with ADHD.
In the past, stimulant substances are used for both medicinal purposes and for recreational purposes, to enhance cognitive function, motivation, performance, and mood. They include nicotine and caffeine, amphetamines cocaine, methylphenidate and modafinil. They are also used as appetite suppressants and energy boosters. They can have significant physical and psychological side effects when taken in excessive amounts.
A psychiatrist will carefully adjust dosages for each patient. They'll also consider any other medical conditions a patient may have, and the effects of the medication on sleep patterns. They will also look at the impact of the medication on a patient's diet and lifestyle.
A massive meta-analysis of the network carried out by NIHR Oxford Health Biomedical Research Centre (NIHR Oxford Health Biomedical Research Centre) and Stichting Eunethydis has found that Lisdexamfetamine, more commonly referred to as Adderall, is more effective than other stimulant at reducing the symptoms of ADHD. It is recommended by NICE and is available in the UK with a prescription.
Despite the evidence-based evidence that support the use of drugs for ADHD is still viewed as a stigma. Unhelpful framings refer to it as child exploitation and controlled substances. This may make some people unwilling to seek an assessment, or to consider taking medication to treat their condition.
As the number of patients referred to NHS psychiatry grew during the COVID-19 pandemic so too did the number of adults being treated for ADHD. In fact the number of adult ADHD referrals are now surpassing those for children. Boys are more likely to receive referrals, but the number of women who receive treatment for ADHD has quadrupled over the last two years.
Unlicensed Medication
There are a number of medicines that can be prescribed to treat ADHD in both adults and children. These include stimulant drugs like methylphenidate, and sometimes the more recent amphetamine-based medicine Lisdexamfetamine. These drugs are classed as controlled medications since they are prone to abuse and become addictive. Your doctor will prescribe them if they think they are the best option for you as part of your treatment. Then, you will be given a prescription which you can go to a local pharmacy and take home. It will be for a month's supply the medication and your pharmacist should be able explain the procedure to you.
In some cases your doctor might decide that the medications available to them are not suitable for you and recommend an unlicensed medication. This is a decision which will be taken on an individual basis. Your psychiatrist should only recommend non-licensed medications as a last option. Keep in mind that while medication is a crucial component of treating ADHD however, talking therapy also plays a significant role. The use of medication can help manage your symptoms but therapy can help change longstanding negative coping mechanisms and behavioural patterns.
Treatment for ADHD for adults must be licensed in the UK, with a licence known as marketing authorisation (MA) which will state the health conditions it's approved for. It will also include information about the age of people who are eligible to receive the medication and the method by which it should be taken. The MHRA will provide an official evaluation of any IMP before it is released and the manufacturer can only promote it under its MA or if it has an exclusive license for paediatric medicine.
Off label prescribing is when a psychiatrist believes that it is appropriate to prescribe a medication for an adult even though it was prescribed for a child. It is also possible to have"manipulated" products - in which the pharmacist makes up a formulation for an individual patient by mixing ingredients, for example when they are unable to swallow tablets. Some psychiatrists have criticized the excessive use of psychoactive drugs to treat mental health issues, such as ADHD.
Licensing
In the UK there is a range of medications that are licensed to treat ADHD in adults. These include a number of stimulant medicines such as methylphenidate (Ritalin) and the newest amphetamine-based medication lisdexamfetamine (Elvanse). These are typically prescribed to patients who have been diagnosed with the condition by a psychiatrist. The treatment is prescribed as capsules, and the patient should be closely monitored by their doctor to determine the right dosage.
There are other methods to treat and manage the condition, in addition to medications. For example, behavioural therapies can aid patients in understanding the underlying causes of symptoms and develop strategies to deal with these. Environmental modifications can also aid in reducing the impact their symptoms affect their daily lives. This can include arranging seating arrangements at work or school and distributing cards that read "I Need a Break" and arranging frequent movement breaks and making sure that there is less noise and distraction.
The medicines that have been licensed in the UK to treat ADHD among adults aren't intended to be a cure but can improve the quality of life for a lot of people. They are not a panacea and should only form part of a complete treatment plan that includes psychoeducation, psychiatric treatment and medication.
Patients with childbearing capacity should undergo a pregnancy test prior taking any medication. They should also inform their GP when they become pregnant or wish to fall pregnant. Patients should also talk to their GP for any adverse effects or if they don't feel they are benefiting.
A national alert for patient safety concerning the shortage of methylphenidate extended-release tablets, guanfacine extended-release tablets and lisdexamfetamine capsules was issued on 27 September 2023. On May 8, 2024, an Medicine Supply Notification was issued that lifted the restrictions on prescribing Elvanse capsules.
It is a Schedule 2 controlled drug so it requires the prescription of an accredited practitioner and is subject to the Misuse of Drugs Regulations 2001. The guidelines recommend that people suffering from ADHD should be evaluated every year by a healthcare professional with training and expertise in managing the disorder, whether in primary or secondary care based on the local arrangements. This review should include a check for blood pressure and heart rate and a discussion of the ongoing need for treatment, as well as ongoing monitoring and evaluation of symptom improvement.
Side Effects
ADHD medication is generally well-tolerated and is safe for adults. However, it will not cure the condition. It can help to reduce symptoms of behavioural disorders and improve quality of life. It also helps improve learning, work and relationships.
It's essential for anyone who is starting treatment to be aware of the potential adverse effects and to discuss them with their doctor before they begin taking the medication. The side effects can include an increase in appetite, headaches, and sleeplessness. Certain medications can increase heart rate. This is generally harmless and not harmful, but it is worth telling your doctor if there is a history of heart disease or heart problems.
The effects of stimulants increase the levels dopamine and norepinephrine that are present in the brain. This alters the way the brain receives and transmits messages, improving attention and focus. These drugs are the first line treatment of adult ADHD. Atomoxetine and Buproprion, which are nonstimulant medications have a more intricate action on the brain. They also take longer to begin working. The latter block dopamine reuptake in nerve cells and assists with concentration.
According to research, approximately half of children diagnosed with ADHD will overcome their symptoms by the time they reach adulthood. It may be due to how they manage their symptoms or because they become less hyperactive. A significant number of them are still struggling with a world that was not designed for their needs. That's why Nice suggests that doctors prescribe ADHD drugs only where they are appropriate and to keep monitoring patients on a regular basis.
There are many other options to treat ADHD symptoms. These include lifestyle changes and psychoeducational therapy. These can be utilized in conjunction with medications to decrease the need for GPs to refer adults with ADHD to specialist services.
The stigma that surrounds ADHD can make it difficult to be open about the medication. Many adults are reluctant to disclose that they take it to their friends, family or employers. There is increasing evidence that talking openly about the condition can help break down barriers for treatment.