Adult ADHD Medication in the UK
In the UK, there are guidelines for diagnosing ADHD among adults. Referrals to the adult ADHD specialist clinic quadrupled during the pandemic.
The medicines used to treat ADHD include stimulants and non-stimulants. Methylphenidate, dexamfetamine, and Lisdexamfetamine are three amphetamine-based drugs that help manage ADHD symptoms.
Stimulants
The most common kind of medication used to treat adult ADHD is a stimulant. These work by increasing activity in parts of the brain responsible for the behavior and attention. They are quick-acting and are often the first choice of GPs. Methylphenidate, more commonly known as Ritalin is the most frequently prescribed stimulant for adults as well as children.
The drug boosts neurotransmitter levels in the brain. It increases attention span, and decreases the impulsivity and hyperactivity. It can also help reduce depression and anxiety, which may co-occur with ADHD.
Through time, stimulant drugs have been used medicinally and for recreational purposes, to enhance cognition, motivation, performance, and mood. These include caffeine and nicotine, amphetamines modafinil, methylphenidate, cocaine and methylphenidate. These substances are used to control appetite and increase energy levels. However, they may cause negative psychological and physical effects when taken excessively.
A psychiatrist will take care to adjust dosages for each patient. They will also take into consideration any other medical conditions a patient might have, as well as the impact of the medication on sleep patterns. They will also consider the effects of the medication on the diet of a patient and lifestyle.
A large meta-analysis of networks conducted by the NIHR Oxford Health Biomedical Research Centre and Stichting Eunethydis, has found that the drug lisdexamfetamine (commonly referred to as Adderall) is more efficient than other stimulants in reducing symptoms of ADHD. It is recommended by NICE, and it is available on prescription in the UK.
Despite the positive evidence, there is still some stigma associated with the use of medication to treat ADHD and other disorders, with unhelpful frames that make it appear like child abuse and compare it to controlled substances. This can cause people to be reluctant to seek an assessment or to even 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 receiving treatment for ADHD. Adult ADHD referrals now surpass those for children. Boys are still more likely to be referred for ADHD treatment, but the number women who receive it has quadrupled over the last two years.
Unlicensed Medication
There are a variety of medicines that can be prescribed to treat ADHD in both adults and children. These include stimulant drugs like methylphenidate and the more recent amphetamine-based drug Lisdexamfetamine. These are classified as controlled medications since they can be open to abuse and become addictive. Your doctor will prescribe these medications if he or she believes they are the most effective solution for your treatment. You will receive a written prescription that you can get at your local pharmacy. This will be for a month's worth of the medication and your pharmacist should be able to explain it to you.
In some instances, your doctor may feel that the medications they have available are not suitable for you and recommend an unlicensed medicine. This is a choice that will be made on an individual basis. Your doctor 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. Medicine can aid in managing your symptoms but therapy can help change long-standing negative coping mechanisms as well as behavior patterns.
Treatment for ADHD in adults has to be licensed in the UK and have a license known as marketing authorisation (MA) that will define the specific health conditions it's approved for. It will also include information about the age of the people who can be prescribed the medication as well as the manner in which it must be administered. The MHRA will evaluate any IMP prior to its launch and the manufacturer is only permitted to market it under their MA, in the event that they do not have a special license to market paediatric medicines.
This is where a medicine is approved for a child however a psychiatrist decides it's appropriate to prescribe it to an adult. This is also called off label prescribing. A'manipulated product' is possible, where a pharmacist mixes ingredients to make a formula for a patient that is unable to swallow tablets. There can be an unpopularity around using unlicensed medications to treat ADHD in adults, with some psychiatrists criticising the over-prescribing of psychoactive drugs for mental health problems.
Licensing
In the UK There are many medicines are available to treat ADHD in adults. This includes a range of stimulant drugs, such as methylphenidate (Ritalin) and the more recent amphetamine-based medication lisdexamfetamine (Elvanse). These are typically offered to patients who have been diagnosed with the condition by psychiatrists. The treatment is typically prescribed in the form of capsules and patients must be monitored carefully by their doctor to ensure that the appropriate dosage is determined.
In addition to these medicines, there are a number of other methods by which the disease can be managed and treated. For instance, behavioural therapies can help people understand the causes of symptoms and develop strategies to deal with these. Environmental modifications can also aid people in coping with the impact their ailments have on their day-to-day lives. This could include arranging seating arrangements at work or at school or even distributing cards that say 'I Need a Break' and arranging frequent movement breaks as well as reducing noise and distractions.
The drugs that have been approved in the UK to treat ADHD among adults are not meant to be a cure, but can improve the quality of life for many. They are not a cure-all and should be used as a component of a complete treatment plan that includes psychoeducation, psychiatric treatment, and medication.
Patients who are able to bear children should undergo an examination for pregnancy prior to starting any medication. They should also inform their GP when they become pregnant or wish to fall pregnant. It is also recommended that patients should consult their GP when they experience serious side-effects or don't believe they are getting the benefits from the medication.
On the 27th September 2023, a nationwide patient safety alert was issued in relation to the lack of extended-release guanfacine tablets, lisdexamfetamine tablets and methylphenidate tablets. This was replaced by an Medicine Supply Notification (MSN) on May 8, 2024. It lifted restrictions on prescribing Elvanse capsules and advised ADHD services to resume the initiation of treatment.
It is classified as a Schedule 2 drug, so it is only prescribed by a registered physician and is subject to the Misuse of Drugs Regulations of 2001. The guidelines recommend that an ADHD patient is evaluated every year by a healthcare professional who is knowledgeable and trained in managing the disorder. This can be done in primary care or secondary care, based on the local arrangements. This review should include the monitoring of heart rate and blood-pressure, a discussion on the need for ongoing treatment, and continuous monitoring and evaluation of symptoms improvements.
Side Effects
ADHD medication is generally well tolerated and is safe for adults. However, it will not cure the condition. It can ease the symptoms of behavioural, and improve the quality of life for people. It can also help with working, learning and relationships.
Having said that, it's crucial for anyone considering treatment to be aware of the potential adverse effects and to discuss them with their physician prior to when they start taking the medicine. Some of the side effects include headaches, sleeplessness and an increase in appetite. Certain medications can increase heart rate. It is usually not a problem and is mild but it's worth telling your doctor if you have a history of heart disease or heart problems.
The effects of stimulants increase the levels of norepinephrine and dopamine in the brain. This alters the way that the brain receives and sends messages, enhancing concentration and attention. They are regarded as the first line treatment for adults with ADHD. Non-stimulant drugs like buproprion and atomoxetine also available, but they perform more complex actions on the brain and take longer to start working. adhd medications is a drug that blocks dopamine reuptake by nerve cells and assists in enhancing concentration.
Research suggests that about half of children diagnosed with ADHD get rid of their symptoms in adulthood. This may be because they learn to manage their symptoms or because they become less active. However, a large portion remain in an environment that isn't specifically designed specifically for them. Nice suggests doctors prescribe ADHD medications only when they are needed and continue to monitor their patients frequently.
There are a variety of other ways to help with ADHD symptoms, such as psychoeducational and lifestyle modifications. These can be combined with medication to reduce the need for GPs to refer adults with ADHD to specialist services.
Many adults are hesitant inform their families, friends or employers that they use ADHD medication due to the stigma associated with it. But, there is growing evidence that discussing the disorder and promoting awareness of its symptoms can help to overcome barriers to treatment.