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Adult ADHD Medication in the UK In the UK in the United Kingdom, the NHS has guidelines for diagnosing ADHD in adults. During the pandemic, the number of referrals to the adult ADHD clinic quadrupled. The medications used to treat ADHD include stimulants as well as non-stimulants. Methylphenidate, dexamfetamine and Lisdexamfetamine are amphetamine-based medicines which help to manage ADHD symptoms. Stimulants Stimulants are among the most popular treatment for ADHD in adults. These work by increasing the activity of parts of the brain that control the behavior and attention. I Am Psychiatry are fast-acting, and are frequently the first choice of GPs. Methylphenidate (also called Ritalin) is the most commonly prescribed stimulant in both adults and children. This drug boosts the levels of neurotransmitters in the brain, improving concentration and decreasing impulsivity and hyperactivity. It can also reduce depression and anxiety that may occur with ADHD. Throughout history, stimulant drugs have been used both medicinally and for recreational purposes, to enhance performance, motivation, cognition and mood. These include caffeine, nicotine amphetamines, cocaine modafinil, methylphenidate and others. These substances are used to control appetite and boost energy levels. However, they may cause severe psychological and physical consequences if they are taken in large quantities. There are many different medications that are used to treat adults suffering from ADHD and psychiatrists will typically carefully adjust the doses on each person they visit. They will also consider any other medical conditions a patient might be suffering from, and the impact of the medication on sleep patterns. They will also look at the impact of the medication on a patient's diet as well as lifestyle. A large network meta-analysis carried out by the NIHR Oxford Health Biomedical Research Centre and Stichting Eunethydis, has found that the drug lisdexamfetamine (commonly known as Adderall) is more effective than other stimulants at reducing symptoms of ADHD. It is recommended by NICE and is available in the UK by prescription. Despite the positive evidence that supports it, there is a certain stigma attached to the use of medications to treat ADHD and other disorders, with unhelpful frames that make it appear like child abuse, and even comparisons to controlled substances. This can make people hesitant to take a test or even consider taking medication for their condition. As the number of people referred to NHS psychiatry increased during the COVID-19 pandemic also did the number of adults being treated for ADHD. Adult ADHD referrals now outnumber those for children. Boys are still more likely to receive referrals, but the number of women receiving treatment for ADHD has quadrupled in the last two years. Unlicensed Medication There are a number of medications that are prescribed to treat ADHD in children and adults. These include stimulant drugs such as methylphenidate, and occasionally the more recent amphetamine-based drug called lisdexamfetamine. These are classified as controlled medications since they are susceptible to abuse and can be addictive. Your consultant psychiatrist will only prescribe these drugs if he / she believes they are the most effective choice for your treatment. You will be given a written prescription that you can get at the local pharmacy. This will be for a month's worth of the drug and your pharmacist should be able to explain it to you. In certain instances, your doctor may decide that the medications they offer aren't right for you and will suggest a non-licensed medication. This will be a case by case decision and your psychiatrist should only prescribe unlicensed medications as an option last resort. It is important to remember that, while medication is a crucial component of treatment for ADHD and ADD, therapy with a therapist is also essential. Medicine can aid in managing your symptoms but therapy can work at changing longstanding negative coping mechanisms and behaviour patterns. In the UK medications used to treat ADHD for adults requires an authorisation to market (MA) that specifies the conditions under which it is approved. This includes the ages of those who can be treated and the method by which the medication should be taken. The MHRA will provide an official evaluation of any IMP before it is made available and the manufacturer can only advertise it under its MA or if it has a special licence for paediatric medicine. Off label prescribing happens when a psychiatrist believes that it is appropriate to prescribe a drug for an adult even though it was prescribed for children. It is also possible to create"manipulated" products - in which the pharmacist creates the formulation for a specific patient by mixing ingredients, for instance in the event that they are unable to take tablets. Some psychiatrists have criticized the over-prescription of psychoactive medications to treat mental health problems, including ADHD. Licensing In the UK there are a range of medications that are licensed to treat ADHD in adults. This includes a variety of stimulant drugs, such as methylphenidate (Ritalin) and the newest amphetamine-based drug lisdexamfetamine (Elvanse). Typically, these are offered to patients diagnosed with the condition after consulting a psychiatrist. The treatment is usually prescribed in capsules and patients are closely monitored by their physician to ensure that the right dose is found. There are other methods to treat and manage the condition, aside from medications. For instance, behavioural therapy can help patients understand the cause of their symptoms and come up with strategies to manage them. In addition, environmental modifications can also be useful in helping people cope with the impact of their symptoms on daily activities. This could include setting up seating arrangements at work or school or even distributing cards that say 'I Need a Break' and arranging frequent movement breaks as well as decreasing 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 aren't a cure-all and should only form part of a comprehensive care plan that includes psychoeducation, psychiatric treatment, and medication. It is essential that any patient of childbearing potential takes a pregnancy test before starting medication and inform their GP immediately if they become pregnant or want to become pregnant. It is also recommended that patients consult their GP when they experience significant side effects or do not feel that they are benefiting from the medication. On the 27th of September, 2023, a national patient safety alert was issued in relation to the shortage of extended-release guanfacine tablets, lisdexamfetamine tablets, and methylphenidate tablets. On May 8, 2024 a Medicine Supply Notification was issued that lifted the prescribing restrictions on Elvanse capsules. It is a Schedule 2 controlled drug so it requires the prescription of a registered physician and is subject to the Misuse of Drugs Regulations 2001. The guidelines recommend that an ADHD patient be evaluated annually by a healthcare provider who is knowledgeable and trained in managing the disorder. This can be done in primary care or secondary care, based on the local arrangement. This review should include monitoring for heart rate and blood pressure and a discussion of the need for ongoing treatment, and continuous monitoring and assessment of symptom improvement. Side Effects ADHD medication is generally well-tolerated and safe for adults. However, it does not cure the condition. It can help reduce symptoms of behavioural, and improve the quality of life for people. It can also aid in learning, work and relationships. However, it's important for anyone starting treatment to be aware of the potential adverse effects and to discuss them with their doctor prior to when they start taking the medicine. Some side effects include headaches, insomnia and changes in appetite. Certain medications may increase heart rate. This is usually mild and harmless, but is worth noting to your doctor if you have a prior history of heart problems or cardiovascular disease. Stimulants increase the levels of dopamine and norepinephrine within the brain. This alters the way that the brain sends and receives messages, which improves attention and focus. They are considered to be the first-line treatment for adults with ADHD. Nonstimulant medicines like buproprion and atomoxetine are also available, but they perform more complex effects on the brain and take longer to start working. The latter works by blocking the reuptake of dopamine into nerve cells and aids in concentration. According to research, about half of children diagnosed with ADHD will overcome their symptoms by the time they reach adulthood. It could be due to the fact that they manage their symptoms or perhaps because they are less active. A significant number of them struggle with a society not designed to meet their needs. That's why Nice recommends doctors prescribe ADHD drugs only where they are appropriate and to keep a close eye on patients. There are other methods to treat ADHD symptoms. These include lifestyle changes and psychoeducational therapy. These can be utilized in conjunction with medications to decrease the need for GPs to refer people suffering from ADHD to specialist services. Many adults are hesitant tell their friends, families or employers that they use ADHD medication because of the stigma associated with it. There is increasing evidence that speaking out about the disorder can help break down barriers to treatment.
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