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Adult ADHD Medication in the UK

In the UK there are guidelines for diagnosing ADHD in adults. The number of referrals to the adult ADHD specialist clinic quadrupled in the course of the pandemic.

Non-stimulants and stimulants can both be used to treat ADHD. Methylphenidate is the most commonly used medicine to help manage symptoms of ADHD as are two amphetamine-based medications called dexamfetamine and lisdexamfetamine.

Stimulants


The most commonly used kind of medication used to treat adult ADHD is stimulants. They work by enhancing activity in parts of the brain that regulate attention and behaviour. These 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.

This drug boosts the levels of neurotransmitters in the brain, improving attention span and decreasing impulsivity and hyperactivity. It can also help decrease depression and anxiety which may co-occur with ADHD.

Throughout history, stimulant drugs have been used both medicinally and recreationally, to enhance performance, motivation, cognition, and mood. They include nicotine and caffeine, amphetamines cocaine, methylphenidate and modafinil. These substances are used to suppress appetite and increase energy. However, they can also have serious physical and psychological consequences if they are taken in large quantities.

A psychiatrist will take care to adjust dosages for each patient. They will consider any other medical conditions the patient might have, as well as the impact of the medication on their sleep patterns. They will also consider the effects of medication on the patient's diet 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 the drug lisdexamfetamine, also known as Adderall is more effective than any other stimulant in reducing symptoms of ADHD. It is recommended by NICE, and it is available on prescription in the UK.

Despite the positive evidence that supports it, there is a certain stigma attached to the use of medications to treat ADHD that is based on unhelpful framings that compare it to child abuse and compare it to controlled substances. This may make some people not want to request an assessment, or even to consider taking medication to treat their condition.

As the number of people referred to NHS mental health services increased during the COVID-19 pandemic so too did the number of adults being treated for ADHD. In fact, adult ADHD referrals have now surpassed those for children. Boys remain more likely to be referred, however the number of women receiving treatment for ADHD has quadrupled over the last two years.

Unlicensed Medication

A variety of drugs are approved for treating ADHD in adults and children, with stimulant drugs like methylphenidate and, sometimes, the newer amphetamine-based medication lisdexamfetamine prescribed. These drugs are classified as 'controlled medications' due to the fact that they can be addictive and abuse. Your doctor will prescribe these drugs if he or she believes they are the most effective option for your treatment. Then, you will be given an order to go to a local pharmacy and take home. Your pharmacist will be able explain to you that this prescription is for an ongoing supply of the medication.

In certain instances, your doctor might decide that the drugs that are available to them aren't suitable for you and recommend an unlicensed medication. This is a choice that will be made on an individual basis. Your doctor should only use nonlicensed medications as a last option. Be aware that although medication is a crucial component of treating ADHD however, talking therapy also plays a crucial role. concerta adhd medication of medication can help manage your symptoms, but therapy can work at changing the long-standing negative coping mechanisms and behavior patterns.

The medication used to treat ADHD for adults must be licensed in the UK, with a licence known as marketing authorisation (MA) which will specify the specific health conditions it is approved for. This will include information on the age of those who can be prescribed the medication as well as the manner in which it must be administered. The MHRA will make an official evaluation of any IMP before it is released and the manufacturer can only promote it under its MA, unless it has a special licence for paediatric medicine.

This is the situation where a drug is approved for a child but a psychiatrist believes it's appropriate to prescribe it for an adult. This is also called off label prescribing. A'manipulated product' is possible in the event that pharmacists mix ingredients to make a formula for a patient who is unable to take tablets. There's a stigma around the use of unlicensed drugs to treat ADHD in adults, with psychiatrists complaining about the excessive prescribing of psychoactive drugs for mental health issues.

Licensing

In the UK, there are various medications that are licensed to treat ADHD in adults. These include a number of stimulant drugs, such as methylphenidate (Ritalin) and the newest amphetamine-based medicine Lisdexamfetamine (Elvanse). These are typically offered to patients who have been diagnosed with the condition by psychiatrists. The treatment is usually prescribed in capsules and patients should be closely monitored by their doctor to ensure that the appropriate dose is found.

In addition to these medications however, there are a myriad of other ways that the condition can be treated and managed. For example behavioural therapy can assist patients understand the cause of their symptoms as well as develop strategies to overcome them. In addition, environmental modifications can also be useful in helping people deal with the impact of their symptoms on day-to-day activities. This includes arranging seating arrangements at work or school and arranging for frequent movement breaks and providing 'I need a break' cards, and cutting down on the amount of distractions and noise.

The medicines that are licensed to treat ADHD in adults in the UK are not intended as a cure, but they can significantly improve the quality of life for many people suffering from the condition. But, they're not an instant cure, and should only be used as a part of a comprehensive care package that includes psychiatric and psychoeducational care.

It is important that any patient with childbearing potential takes a pregnancy test prior to beginning medication, and should inform their GP immediately if they become pregnant or want to become pregnant. Patients should also consult their GP in the event of any side effects or if they do not believe they are benefiting from.

On 27 September 2023, a nationwide patient safety alert was issued in relation to the lack of extended-release guanfacine tablets, tablets of lisdexamfetamine and methylphenidate tablets. It was replaced by an Medicine Supply Notification (MSN) on May 8, 2024. It lifted restrictions on prescribing Elvanse capsules and urged ADHD services to resume the initiation of treatment.

It is an Schedule 2 drug, so it can only be prescribed by a licensed physician and is subject to the Misuse of Drugs Regulations of 2001. The guidelines suggest that a person with ADHD is reviewed annually by a healthcare professional who has training and experience in managing the disorder, either in primary or secondary care depending on local arrangements. The review should include monitoring for heart rate and blood pressure as well as a discussion on the continued need for treatment and ongoing evaluation of symptoms and monitoring improvement.

Side Effects

ADHD medication is generally safe and well tolerated by adults, but it is not a cure for the condition. It can reduce symptoms of behavioural disorder and improve quality of life. It can also aid in learning, work and relationships.

It is essential that those who are beginning treatment be aware of possible adverse effects. They should discuss them with their physician prior to starting the medication. Side-effects can include an increase in appetite, headaches and sleepiness. Certain medications can also increase the heart rate. This is usually mild and harmless but is worth mentioning to your doctor if there is a prior history of heart problems or cardiovascular disease.

Stimulants increase the levels of dopamine and norepinephrine that are present in the brain. This alters the way the brain receives and transmits messages, enhancing concentration and attention. These are the first-line treatment of adult ADHD. Non-stimulant drugs like buproprion and atomoxetine are also available, however they have more complex actions on the brain and take longer to begin working. The latter block dopamine reuptake by nerve cells, and helps in enhancing concentration.

According to research, approximately half of the children diagnosed with ADHD will be free of symptoms by adulthood. This could be due to the fact that they learn to manage their symptoms or because they are less hyperactive. However, a large portion remain in the society that was not made to accommodate them. Nice recommends doctors prescribe ADHD medication only when they are needed and continue to keep track of their patients on a regular basis.

There are many other options to treat ADHD symptoms. These include psychoeducational therapy and lifestyle changes. These can be used alongside medications to decrease the need for doctors to refer adults with ADHD to specialist services.

Many adults are hesitant to inform their families, friends or employers that they take ADHD medication due to the stigma that comes with it. There is increasing evidence that discussing the disorder and promoting awareness of its symptoms can help to overcome barriers to treatment.

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