Adult ADHD Medication in the UK
In the UK there are guidelines for diagnosing ADHD among adults. The number of referrals to the adult ADHD specialist clinic quadrupled during the time of the pandemic.
Both stimulants and non-stimulants are used to treat ADHD. Methylphenidate is the most commonly used medication to treat the symptoms of ADHD and is accompanied by two amphetamine-based medications known as dexamfetamine and Lisdexamfetamine.
Stimulants
Stimulants are the most common treatment for ADHD in adults. These medications work by increasing the activity in brain areas that control attention and behavior. They are fast-acting and are frequently the first choice of GPs. Methylphenidate, more commonly known as Ritalin, is the most frequently prescribed stimulant for adults and children.
This drug increases the levels of neurotransmitters in the brain, which improves concentration and decreasing impulsivity and hyperactivity. It can also reduce anxiety and depression, which may be a co-morbidity with ADHD.
In the past, stimulant drugs were used to enhance cognitive function, motivation, and performance. They include nicotine and caffeine, amphetamines modafinil, methylphenidate, cocaine and methylphenidate. They also serve to reduce appetite and as energy boosters. They can cause significant psychological and physical side effects when taken in excessive amounts.
There are adhd without medication that are used to treat adults with ADHD and psychiatrists will typically be careful to adjust the doses on each person they visit. They'll also consider any other medical conditions that a patient may be suffering from, and the effect of the medication on their sleep patterns. They will also take into consideration the effects of medications on the patient's diet and lifestyle.
A massive meta-analysis of the network carried out by the NIHR Oxford Health Biomedical Research Centre and Stichting Eunethydis, has found that the drug called lisdexamfetamine (commonly known as Adderall) is more effective than other stimulants in reducing symptoms of ADHD. It is recommended by NICE and is available in the UK with a prescription.
Despite evidence-based research that supports the use of medications for ADHD is still stigmatized. Ineffective framings refer to it as child exploitation and controlled substances. This makes many unwilling to seek an assessment or to consider taking medication for their condition.
The number of adult patients treated for ADHD increased with the increase in the number of people referred to NHS psychiatry during the COVID-19 epidemic. Adult ADHD referrals now outnumber those for children. Boys are still more likely to receive ADHD treatment however, the number of women who receive it has quadrupled in just the last two years.
Unlicensed Medication
There are many medicines that can be prescribed to treat ADHD in both adults and children. These include stimulant medications such as methylphenidate, and occasionally the more recent amphetamine-based medication Lisdexamfetamine. These are classified as controlled drugs because they are susceptible to abuse and can be addictive. Your consultant psychiatrist will only prescribe them if they feel they are the best choice for you as part of your treatment. You will receive an approved prescription in writing that you can get at your local pharmacy. It will be for a month's supply of the drug. Your pharmacist will be able to explain it to you.
In adhd medication list might determine that the medications they have available are not appropriate for you and suggest a non-licensed medication. This is a decision that will be made on a case-by-case basis. Your psychiatrist should only use nonlicensed medications as a last resort. Remember that while medication is a crucial component of treating ADHD and related disorders, therapy plays a crucial role. Therapy can change your coping mechanisms and behavior patterns. Medication can manage your symptoms.
In the UK the medication used to treat ADHD in adults must be accompanied by an authorisation to market (MA), which specifies the conditions under which it's approved. This will include the age of the people who are treated and the method by which the medication should be administered. The MHRA will make an official assessment of any IMP before it is made available and the manufacturer is able to promote it under its MA unless it holds a special license for paediatric medicine.
Off label prescribing happens when a psychiatrist believes it is appropriate to prescribe a drug for an adult even though it was approved for a child. It is possible to manipulate a product, where a pharmacist mixes ingredients to create a formula for a patient who can't take tablets. Some psychiatrists have voiced their displeasure at the excessive use of psychoactive drugs to treat mental health issues, including ADHD.
Licensing
In the UK there are several medications that are licensed to treat ADHD in adults. This includes a variety of stimulant medications, including methylphenidate (Ritalin) and the more recent amphetamine-based medicine Lisdexamfetamine (Elvanse). They are typically offered to patients who have been diagnosed with the condition after consulting a psychiatrist. The treatment is prescribed in capsules and the patient should be closely monitored by their doctor in order to find the appropriate dosage.
In addition to these medications, there are a number of other ways that the condition can be treated and controlled. For example the use of behavioural therapy can help people to understand the root cause of their symptoms and to create strategies to combat them. Environmental modifications can also help people cope with the impact their symptoms affect their daily lives. adhd without medication includes setting up seating arrangements at work or at school and distributing cards that read "I Need a Break" and arranging frequent movement breaks and decreasing noise and distractions.
The medicines that are licensed to treat ADHD in adults in the UK are not intended to be an effective cure, but they can greatly improve the quality of life for many people suffering from the condition. However, they are not a magic bullet and should only be used as a part of a holistic care plan that includes psychiatric treatment and psychoeducation.
It is essential that any patient of childbearing potential takes a pregnancy test before starting medication and inform their GP immediately when they are pregnant or plan to become pregnant. Patients should also talk to their GP in the event of any adverse reactions or if they don't think they are gaining.
A national patient safety alert 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, a Medicine Supply Notification was issued, which lifted the restrictions on prescribing Elvanse capsules.
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 suggest that a person with ADHD should be reviewed annually by a healthcare professional with training and expertise in managing the disorder, whether in primary or secondary care depending on the local arrangement. This review should include monitoring for heart rate and blood pressure, a discussion about the ongoing need for treatment, as well as ongoing evaluation of symptoms and monitoring improvement.
Side Effects
ADHD medication is safe and generally accepted by adults, but it does not cure the condition. It can reduce behavioural symptoms, and improve the quality of life of people. It can also help with working, learning and relationships.
Having said that, it's essential for anyone who is starting treatment to be aware of possible side effects and discuss these with their doctor prior to when they begin taking the medication. Some side effects include headaches, insomnia and changes in appetite. Certain medications may increase heart rate. This is usually harmless and mild, but it is important to inform your doctor if you have an history of heart disease or issues.
Stimulants increase levels of dopamine and norepinephrine in the brain. This alters the way that the brain receives and transmits messages and improves concentration and attention. They are regarded as the first line treatment for adult ADHD. Buproprion and Atomoxetine, which are medications that do not stimulate are more complex in their action on the brain. They also take longer to start working. The latter works by blocking dopamine reuptake by nerve cells and assists in enhancing concentration.
According to research, approximately half of the children diagnosed with ADHD will grow out of symptoms in adulthood. It may be due to how they manage their symptoms or because they become less hyperactive. A large portion of them struggle with a world that was not designed to meet their needs. That's why Nice suggests that doctors prescribe ADHD drugs only where they are necessary and keep a close eye on patients.
There are many other options to treat ADHD symptoms. These include lifestyle changes and psychoeducational therapy. These can be combined with medications to decrease the need for doctors to refer adults with ADHD to specialist services.
The stigma attached to ADHD can make it difficult to be open about treatment and many adults are reluctant to admit the fact that they have ADHD to their friends, family or employers. However, there is growing evidence that talking about the disorder and promoting awareness of its symptoms can help break down barriers to treatment.