Adult ADHD Medication in the UK
In the UK in the United Kingdom, the NHS has 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 are both used to treat ADHD. Methylphenidate is the most commonly used medication used to treat symptoms of ADHD and is accompanied by two amphetamine-based drugs known as dexamfetamine and Lisdexamfetamine.
Stimulants
Stimulants are the most commonly used medication used to treat ADHD in adults. They work by enhancing the activity of parts of the brain that regulate attention and behaviour. They are quick-acting and frequently the first choice to be 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, which improves concentration and decreasing hyperactivity and impulsivity. It also helps reduce depression and anxiety, which may co-occur with ADHD.
In the past, stimulants were used to boost cognition, motivation and performance. These include caffeine, nicotine, amphetamines, cocaine, modafinil, methylphenidate and others. They also serve to reduce appetite and as energy boosters. They may have significant physical and psychological adverse effects when used in excessive amounts.
There are many different medications that are used to treat adults with ADHD, and a psychiatrist will typically be careful to adjust the dosages for each patient they see. They will also consider any other medical issues a patient might have, as well as the effects of the medication on their sleep patterns. They will also look at the effects of the medication on a patient's diet and lifestyle.
A massive meta-analysis of the network, conducted by the NIHR Oxford Health Biomedical Research Centre and Stichting Eunethydis, has found that the drug called lisdexamfetamine (commonly called Adderall) is more effective than other stimulants in decreasing symptoms of ADHD. It is recommended by NICE and is available in the UK with a prescription.
Despite evidence-based research that support the use of drugs for ADHD is still viewed as a stigma. Falsely framed arguments compare it to child abuse and controlled substances. This can make people hesitant to take a test or even consider taking medication to treat their condition.
The number of adults treated for ADHD increased with the increase in the number of patients referred to NHS psychiatrists during the COVID-19 epidemic. In fact, adult ADHD referrals have now surpassed those for children. Boys are still more likely to be referred for ADHD treatment, but the number women who receive it has quadrupled in just the last two years.
Unlicensed Medication
There are a number of medicines that can be prescribed to treat ADHD in adults and children. These include stimulant medications like methylphenidate and the more recent amphetamine-based drug Lisdexamfetamine. These are considered 'controlled' medications because they are susceptible to abuse and can be addictive. Your consultant psychiatrist will only prescribe these drugs if he or she believes they are the most effective choice for your treatment. Then, you will be given a prescription which you can go to a local pharmacy and pick up. This will be for a month's worth of the medication and your pharmacist should be able to explain the procedure to you.
In some cases your doctor may feel that the drugs that are available to them aren't suitable for you and suggest an unlicensed medication. This is a decision that will be made on a case-by-case basis. Your doctor should only use nonlicensed medications as a last resort. It is crucial to remember that, while medication is a crucial component of treatment for ADHD, talking therapy is also essential. Medication can help to manage your symptoms but therapy can also help you change long-standing negative coping mechanisms as well as behavioural patterns.
In the UK the medication used to treat ADHD for adults requires a marketing authorisation (MA), which specifies the conditions under which it is approved. This will include information on the age of the people who can be prescribed the medication as well as the manner in which it must be administered. The MHRA will evaluate any IMP prior to its launch and the manufacturer is permitted to market it under their MA, except if they have a specific license to market paediatric medications.
Off label prescribing occurs when a psychiatrist believes it is appropriate to prescribe a medicine for an adult even though it was approved for a child. A "manipulated product" is a possibility when a pharmacist mixes ingredients to create a formula for a patient who is unable to take tablets. Some psychiatrists have voiced their displeasure at the excessive use of psychoactive drugs to treat mental health issues, such as ADHD.
Licensing
In the UK there are a variety of medications are available to treat ADHD among adults. There are several stimulant drugs, such as methylphenidate, (Ritalin), and the newest amphetamine-based medication lisdexamfetamine, (Elvanse). They are usually 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 are closely monitored by their doctor to ensure that the right dose is found.
There are other methods to manage and treat the illness, in addition to medications. For example, behavioural therapies can assist patients in understanding the causes of their symptoms and devise strategies to overcome these. In addition, environmental modifications are also helpful in helping people cope with the impact of their symptoms on daily activities. This can include making seating arrangements at school or work and distributing cards that read 'I Need a Break' and arranging frequent movement breaks, as well as decreasing noise and distractions.
The medications that have been approved in the UK to treat ADHD among adults are not intended to cure, but can improve the quality of life for many. But, adhd medication ritalin 're not an all-purpose cure and should only be used as part of a comprehensive care package that includes psychiatric treatment and psychoeducation.
It is important that any patient with childbearing potential takes an examination for pregnancy prior to starting medication, and that they inform their GP immediately if they are pregnant or plan to become pregnant. It is also recommended that patients see their GP if they experience any significant side effects or do not think they are benefiting from the medication.
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. On May 8, 2024, a Medicine Supply Notification was issued that lifted the prescribing restrictions on Elvanse capsules.
It is an Schedule 2 drug, so it can only be prescribed by a registered doctor and is subject to the Misuse of Drugs Regulations of 2001. The guidelines suggest that a person with ADHD should be reviewed every year by a health expert with experience and training in managing the disorder, either in primary or secondary care depending on the local arrangement. The review should include a monitoring of blood pressure and heart rate, a discussion on the need for continued treatment, and continuous monitoring and evaluation of symptom improvements.
Side Effects
ADHD medication is generally well-tolerated and is safe for adults. However, it can not cure this condition. It can help reduce symptoms of behavioural disorders and improve quality of life. It can also improve working, learning and relationships.
It's essential for anyone who is starting treatment to be aware of possible adverse effects and to discuss them with their physician prior to when they start taking the medicine. Side-effects can include changes in appetite, headaches, and sleeplessness. Some medications can also raise the heart rate. It is generally harmless and not harmful, but it is worth telling your doctor if there's a history of heart disease or issues.
The effects of stimulants increase the levels of dopamine and norepinephrine in the brain. This changes the way the brain receives and transmits messages, improving attention and focus. They are regarded as the first line treatment for adults suffering from ADHD. Atomoxetine and Buproprion, which are nonstimulant medications are more complex in their action on the brain. They also take longer to begin working. The latter blocks the reuptake of dopamine by nerve cells, which aids in concentration.
Research suggests that around half of children diagnosed with ADHD are able to overcome their symptoms in adulthood. It could be because they manage their symptoms or simply because they become less active. Many of them continue to struggle with a society not built to meet their needs. That's why Nice suggests that doctors prescribe ADHD medications only when they are needed and keep a close eye on patients.
There are a variety of other methods to alleviate ADHD symptoms, including psychoeducational and lifestyle modifications. These therapies can be used in conjunction with medication to lessen the necessity of referring adults who have ADHD to specialist services.
The stigma attached to ADHD can make it difficult to be open about the medication. Many adults are reluctant to disclose the fact that they have ADHD to their friends, family or employers. But, there is growing evidence that discussing the disorder and raising awareness of its symptoms can help to reduce barriers to treatment.