Adult ADHD Medication in the UK
In the UK, there are guidelines for diagnosing ADHD among adults. In the course of the pandemics, referrals to the adult ADHD clinic quadrupled.
Medications used to treat ADHD include stimulants as well as non-stimulants. Methylphenidate, dexamfetamine and lisdexamfetamine are two amphetamine-based medications that aid in managing ADHD symptoms.
Stimulants
Stimulants are among the most popular treatment for ADHD in adults. These medications increase the activity in brain areas that control attention and behavior. They are quick-acting and are often the first option considered by GPs. Methylphenidate is also known as Ritalin is the most commonly prescribed stimulant for adults as well as children.
This drug boosts the levels of neurotransmitters in the brain. It increases concentration and decreases hyperactivity and impulsivity. It also helps to reduce anxiety and depression that may be associated with ADHD.
In the past, stimulants were used to improve cognition, motivation, and performance. These include caffeine, nicotine amphetamines, cocaine modafinil and methylphenidate. They are also used to reduce appetite and as energy boosters. They may cause significant psychological and physical adverse effects when used in excess.
A psychiatrist will take care to adjust the dosages for each patient. They will take into account any other medical conditions patients may have, as well as the impact of the medication on their sleeping patterns. They will also look at the effects of the medication on the diet of a patient and lifestyle.
A massive meta-analysis of the network conducted 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 it is available on prescription in the UK.
Despite the evidence-based research however, there's a stigma attached to the use of medications to treat ADHD and other disorders, with unhelpful frames that compare it to child abuse and compare it to controlled substances. This may make some people unwilling to seek an assessment, or even to consider taking medication to treat their condition.
The number of adult patients treated for ADHD increased with the increase in the number referred to NHS psychiatry increased during the COVID-19 epidemic. Adult ADHD referrals now surpass those for children. Boys are still more likely to receive ADHD treatment, but the number women receiving treatment has quadrupled over the last two years.
Unlicensed Medication
There are a number of medicines that can be prescribed to treat ADHD in children and adults. These include stimulant drugs like methylphenidate and the more recent amphetamine-based drug lisdexamfetamine. These drugs are categorized as 'controlled medications' due to the fact that they can be addictive and abused. Your doctor will prescribe these drugs if he or believes that they are the most effective choice for your treatment. You will then be given a prescription which you can take to your local pharmacy and pick up. It will be for a month's supply the medication and your pharmacist should be able to explain it to you.
In some instances, your doctor might decide that the drugs they have available are not suitable for you and recommend an unlicensed drug. It's a case by case decision and your psychiatrist should only recommend unlicensed medication as the last option. Keep in mind that while medication is an essential component of treating ADHD and related disorders, therapy plays a significant role. Therapy can change your coping mechanisms and behavior patterns. Medication can manage your symptoms.
In the UK the medication used to treat ADHD for adults requires an authorization for marketing (MA), which specifies the specific conditions under which it's approved. This will include the age of those who can be treated and the method by which the medication is to be used. The MHRA will make an official evaluation of any IMP before it is made available and the manufacturer can only promote it under its MA unless it holds an exclusive licence for paediatric medicine.
This is the situation where a drug has been approved for children however a psychiatrist decides it is appropriate to prescribe it for an adult. This is also called off label prescribing. It is also possible to get a'manipulated product' - where the pharmacist makes up the formulation for a specific patient by mixing ingredients, for instance when they are unable to swallow tablets. Some psychiatrists have been critical of the over-prescription of psychoactive medications to treat mental health issues, including ADHD.
Licensing
In the UK there is various medications that are licensed to treat ADHD in adults. There are a number stimulant medications, including methylphenidate (Ritalin), and the more recent amphetamine-based medication lisdexamfetamine (Elvanse). These are typically prescribed to patients who have been diagnosed with the condition by a psychiatrist. The treatment is typically prescribed in the form of capsules and patients must be closely monitored by their doctor to ensure that the right dose is found.
In addition to these medicines, there are a number of other ways in which the disease can be managed and treated. For example, behavioural therapy can help patients understand the cause of their symptoms and to develop strategies to overcome the symptoms. Additionally, changes to the environment can be beneficial in helping people deal with the effects of their symptoms on daily activities. This could include setting up seating arrangements at school or work and distributing cards that read "I Need a Break" and scheduling frequent movement breaks as well as decreasing noise and distractions.
The medicines that are licensed to treat ADHD in adults in the UK are not intended to be a cure, but they can significantly improve the quality of life of many people with the condition. They are not a cure-all and should only form part of a complete care package that includes psychoeducation, psychiatric treatment, and medication.
Patients who are able to bear children should undergo an examination for pregnancy prior to beginning any medication. They must also inform their GP in the event that they fall pregnant or wish to fall pregnant. Patients should also talk to their GP for any adverse effects or if they don't believe they are benefiting from.
A national alert for patient safety concerning the shortage of methylphenidate prolonged-release tablets, guanfacine extended release tablets and lisdexamfetamine capsules were issued on 27 September 2023. On May 8, 2024 a Medicine Supply Notification was issued that lifted the restrictions on prescribing Elvanse capsules.
It is a Schedule 2 controlled drug so it must be prescribed by an accredited doctor and is subject to the Misuse of Drugs Regulations 2001. The guidelines recommend that anyone suffering from ADHD should be evaluated annually by a healthcare professional with training and expertise in managing the disorder, whether in primary or secondary care depending on the local arrangements. The review should include monitoring for blood pressure and heart rate as well as a discussion on the ongoing need for treatment, and continuous monitoring and evaluation of symptom improvement.
Side Effects
ADHD medication is generally well tolerated and safe for adults. However, it does not cure this condition. It can help reduce behavioural symptoms and improve people's quality of life. It can also help with learning, work and relationships.
However, it's crucial for anyone considering treatment to be aware of the potential side effects and discuss these with their doctor prior to when they begin taking the medication. Some side effects include sleeplessness, headaches and a change in appetite. Certain medications can also raise the heart rate. adhd medication for adults uk is usually harmless and mild but it's worth telling your doctor if there's a history of heart disease or problems.
Stimulants increase levels of norepinephrine and dopamine in the brain. This alters how the brain transmits and receives messages, which improves attention and focus. They are considered first-line treatments for adult ADHD. Buproprion and Atomoxetine, which are medications that do not stimulate are more complex in their effect on the brain. They also take longer to start working. The latter block dopamine reuptake in nerve cells, and helps with concentration.
Research suggests that half of children diagnosed with ADHD are able to overcome their symptoms as they grow older. It may be due to how they manage their symptoms or perhaps because they are less hyperactive. However, a large portion continue to struggle in the society that was not designed for them. That's why Nice recommends that doctors prescribe ADHD medications only when they are necessary and continue to monitor patients regularly.
There are many other options to treat ADHD symptoms. These include psychoeducational therapy and lifestyle changes. These can be combined with medication to reduce the need for GPs to refer adults with ADHD to specialist services.
The stigma associated with ADHD can make it difficult to open about treatment and many adults are reluctant to admit that they are taking it to their family, friends or employers. There is increasing evidence that talking about the disorder and raising awareness of its symptoms can help break down barriers to treatment.