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ADHD Medication For Adults in the UK In the UK there are a variety of medications that are approved for treating ADHD. These include the stimulant methylphenidate, as well as the amphetamine-based drug Lisdexamfetamine. The exact dose will need to be monitored carefully in the beginning stages of treatment (titration) and then the stable prescriptions can be handled by your GP as part of an agreed'shared care' arrangement. What is what is Licensed Medication (L.M.)? A medicine that is licensed has passed all of the necessary tests and clinical trials and the MHRA, the Medicines and Healthcare Products Regulatory Authority (MHRA) has given the green light for its use in Great Britain. The medicine will also be clearly identified as being suitable for specific conditions on its packaging or in a leaflet which comes with it. All licensed medicines are controlled, even after they're on the market, so problems are quickly identified and risks minimized. Certain people with ADHD might be prescribed medications that are not licensed, but these are rarely used for teenagers and children. The unlicensed medication may be used for other conditions which have been found to be effective (known as off-label prescribing), or it might be a specific formula that isn't available on the market, for instance an oral liquid instead of tablets or a product that is free of certain additives. It could also be an experimental medicine currently being evaluated in the UK. The term “experimental drugs” is used to describe Medicines with an Marketing Authorisation(MIA) (IMP) or Investigational Medicinal Products. These medicines haven't been granted a license yet and can therefore only be sold on an order from a doctor. The MHRA will have conducted a formal evaluation as part of the Early Access to Medicines Scheme. There is one non stimulant medication that is commonly prescribed for ADHD in the UK and Europe and this is Atomoxetine. This is a selective noradrenaline-reuptake inhibitor, which differs from other ADHD medication. It increases noradrenaline, which is a chemical that helps to transmit messages between neurons in the brain. This improves concentration and also helps control impulses. It is taken in capsule form once or twice daily. Only psychiatrists are able to diagnose ADHD and prescribe medication for adults. It is important to remember that ADHD isn't just a disease that can be treated with medication alone. Therapy is often included in treatment plans. Psychoeducation is a way to aid children, teens and adults understand their diagnosis as well as behavioural therapy which teaches techniques to manage symptoms. What is an unlicensed drug? The term “unlicensed medicines” refers to medicines that are not licensed by the MHRA. It could be that the medicine was not developed by a company based in the UK or was prescribed outside of the terms of licence (off-label). adhd medication and pregnancy say that 'unlicensed medicines are typically employed when a licensed product is unavailable or when a clinically-effective treatment cannot be found with the medication that the doctor feels most comfortable using'. The license of a medicine will include the conditions it treats and the ages it is able to treat. The licence will also specify what and how the medicine is to be administered. The MHRA only grants a license when it is considered safe and effective in that particular application, based on clinical trials and medical research. adhd medication and pregnancy are not allowed to promote or advertise any use that isn't covered by the licence. In the UK It is not a crime to let medical professionals to prescribe an unlicensed medicine as long as the patient is aware of the risks and benefits. They must also keep records of the use of medications that are not licensed and provide the patient with sufficient information to make an informed decision on whether or not to take it. Unlicensed medications are often offered in hospitals, as there is more experience of using them than in GP surgeries. The hospital will have procedures in place to ensure the safety of the medication, which includes keeping detailed patient records and ensuring that any adverse reactions are documented. They will also have to follow the MHRA's guidance on the safe supply of non-licensed medicines. Specials are prescribed by doctors who must communicate with their patients, their parents or caregivers about the medicine as well as its purpose and potential side consequences. They should be able to answer any questions that they are asked, and should always provide written information about any medicine that they are prescribing, and the reason for prescribing it. What is a Shared-Care agreement? In recent years, as the number of people suspecting 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. Unfortunately, the waiting lists for NHS assessments are lengthy and this means that a lot of patients are turning to self-funding private ADHD assessments at specialist private clinics. The hope is that after a diagnosis has been confirmed by this process, the GP will sign an agreement of shared care (SCA). A SCA is a contract between your psychiatrist and GP, whereby the responsibility for prescribing medications monitoring, as well as basic health checks is transferred to your GP. This is a well-known and accepted method of transferring the responsibility of managing a patient suffering from ADHD from a hospital or a specialist service setting to general practice, provided that it is in line with NHS England guidelines. Before responsibility is transferred, the specialist and GP should agree on these SCA guidelines. This should be clearly stated in any referral form. It should be made clear to the GP that the GP is accountable for the continuous titration of the medication as well as the monitoring requirements. Unfortunately, many GPs are not able to accept SCAs. This is not due to the lack of motivation, but because the work involved with SCAs could be outside of their core funding, and usually an additional project on top of their busy schedule. The doctor should be provided with good quality information on the rationale for SCA and what the expectations of both parties are including the roles of the patient and their caregivers. It should be made clear that the decision to go ahead with SCA should be taken by the prescriber initiating treatment. The GP must also be informed if the patient is not willing to participate in SCA. If a doctor does not want to accept responsibility for SCA and/or SCA, they are able to refuse. However, this can result in patients being referred back to the private ADHD clinic and psychiatrist that provided their initial diagnosis. This could mean that prescriptions for medication are issued privately rather than through the NHS which, of course, can be more costly. What is a titration time? The tration time is a crucial step to determine the appropriate medication to manage your ADHD. It is the process of gradually increasing your dose until you reach a dose that maximises your benefits while minimising your negative side effects. It takes time, but your healthcare professional should be in close contact with you to ensure the titration process goes as smooth as it can be. Certain patients may experience worsening of their symptoms during the titration phase. Hyperactive people, for example, may become restless and irritable. It is essential that loved ones are aware of any changes in behavior and provide assistance. It is also crucial to eat a balanced diet and to create a regular sleep routine in order to reduce the adverse effects of ADHD medication. Medication is not the only treatment for ADHD however it is typically recommended as the first option for management in adults. Talk therapy can be an effective tool to deal with anxiety and depression, which can be the cause of some symptoms of ADHD. It is crucial to remember that medication can only treat the symptoms, not alter long-standing negative coping mechanisms. Some patients choose not to take medication at all and prefer to focus on self-help treatments such as nutrition, exercise and stress reduction strategies. It is crucial to look over the adverse effects of any medication you are prescribed, and to understand how the medication will affect your body. Certain medications can cause a decrease in appetite and cause headaches, as well as cause you to become drowsy. Be sure to take your meds as directed and speak to your doctor if you experience any adverse reactions. Today, many of the treatments for adults with ADHD are in short supply. This has resulted in delays in the diagnosis process and appointments with psychiatrists. NHS England has set up an inquiry taskforce to look into the issue and recommend ways of reducing waiting times for prescriptions. Ask your local GP what options are available for you. You might be able to take the same medications privately, or they could suggest alternative treatments that will produce similar results to those you are used to.