ADHD Medication For Adults in the UK
In the UK there are a range of drugs that are licensed to treat ADHD. This includes the stimulant methylphenidate, as well as the amphetamine-based drug lisdexamfetamine. The dosage will be closely monitored in the beginning stages of treatment.
What is a Licensed Medication?
A licensed medicine will have been through all the necessary clinical tests and trials and the MHRA (Medicines and Healthcare Products Regulatory Authority) has given it the go ahead for use in Great Britain. The packaging of the medicine or the leaflet included with it will clearly indicate whether it is suitable for a specific condition. All licensed medicines go through strict supervision even after they have been placed being sold. This allows for issues to be identified quickly and the risk to be minimized.
Some people with ADHD might be prescribed unlicensed drugs however, they are not often utilized on teenagers and children. Unlicensed medications can be prescribed for other ailments that have been shown to be effective (known as "off-label prescribing") or they could be a form of treatment not yet available on the market for example, a liquid oral instead of a tablet. It could also be an experimental drug being trialled in the UK.
Experimental drugs are known as Investigational Medicinal Products (IMPs) or Medicines with a Marketing Authorisation (MIA)(IMP). These drugs aren't yet licensed and can only be purchased through the prescription of a physician. The MHRA will have conducted a formal evaluation as part of the Early Access to Medicines Scheme.
Atomoxetine is a non-stimulant medication that is commonly prescribed in the UK and Europe for ADHD. This medication is a specific inhibitor of noradrenaline's uptake and therefore works in a different way than other ADHD medications. It boosts the levels of noradrenaline within the brain, which is a sort of chemical that sends messages between nerve cells, which improves concentration and helps control impulses. It is taken in capsules every day, either once or twice.
Only psychiatrists are able to diagnose ADHD and prescribe medication for adults. It is important to keep in mind that ADHD isn't a condition that can be treated through medication alone. Therapy is often included in treatment plans. Psychoeducation can assist children, teens, and adults understand their diagnosis as well as the use of behavioural therapy to teach techniques to manage symptoms.
What is an unlicensed drug?
The term "unlicensed medicine" refers to drugs that have not been approved by the MHRA. This could be due to the fact that the medicine has not been created by an UK company, or because it has been prescribed in violation of the terms of its licence (ie off-label). The GMC's guidelines state that 'unlicensed drugs are generally used when a suitable licensed product is unavailable or a clinically effective treatment cannot be found with the product the prescriber feels most comfortable using'.
non prescription adhd medication will list the conditions it treats and the ages of patients it can be prescribed to. The licence will also outline what and how the medicine is to be administered. The MHRA only grants a license when it is considered safe and effective for that particular use, based on clinical trials and medical research. The manufacturers of drugs are not permitted to advertise or promote any use that are not covered by the license.
In the UK it is not a crime to let a healthcare professional prescribe an unlicensed medicine as long as the patient is informed of the potential risks and benefits. They must keep records of the use of unlicensed medication and provide the patient with sufficient information to make an informed decision regarding whether or not they wish to accept it.
Hospitals are more likely to give unlicensed medications because they have had more experience with them than GP surgeries. The hospital will have procedures to ensure the safety and effectiveness of the medication. This includes keeping thorough patient records, and also recording any adverse reactions. They are required to adhere to MHRA guidelines for the safe supply of unlicensed medications.
Doctors who prescribe specials have to be open with patients and parents or carers about the nature of the medication, why it is being used, and the possible side consequences. They must be able answer any questions asked and always provide written information about any medicine that they prescribe, and the reason for it.
What is an Shared Care Agreement?
In recent years as the number of adults suspected of being suffering from ADHD increased, so did the requests for a referral to the NHS for an assessment and medication to treat the condition. Unfortunately, waiting lists for NHS assessments are long and this means that a large number of patients are reverting to self-funding private ADHD assessments at specialist private clinics. The hope is that once a diagnosis has been confirmed by this process, the GP will sign an agreement for shared care (SCA).
A SCA is an agreement between your psychiatrist and GP and GP, in which the responsibility for medication prescribing monitoring, prescribing, and basic health checks is transferred to your GP. This is a recognized accepted method of transferring the responsibility of managing ADHD patients from a specialist service or hospital to general practice.
These SCA guidelines should be discussed between the doctor and the GP before responsibility is passed over, and this should be clearly stated on any referral form. It should be made clear to the GP that he or she is responsible for the continual adjustment of the medication and the monitoring requirements.
Unfortunately, many GPs aren't keen on accepting SCAs. It's not due to a lack of desire, but rather that the work involved in SCAs isn't part of their regular funding.
The GP must be informed about the reasoning of SCA as well as the expectations of all participants, and the roles of patients and their caregivers. It is important to be clear that the decision to proceed with SCA should be taken by the prescriber initiating treatment. The GP should also be informed of the patient's refusal to be willing to participate in SCA.
If a GP does not want to accept responsibility for SCA, they can refuse. However, this could result in patients being sent back to the private ADHD clinic and psychiatrist that made their initial diagnosis. This can lead to prescriptions for medication being issued privately, rather than via the NHS. This could be more expensive.
What is Titration Period?
The tration period is an important step in finding the right medication to help manage your ADHD. It involves increasing the dosage gradually until you get to the level that maximizes the benefits and minimizes adverse effects. It takes time, but your healthcare professional should work closely with you to ensure the titration process is as smooth as possible.
Certain patients may experience an increase in their symptoms during the titration time. People who are hyperactive, for instance can become agitated and irritable. It is essential that loved ones are aware of any changes in behavior and provide support. It is also important to eat a balanced diet and to create a regular sleep routine to lessen the adverse effects of ADHD medications.
It is important to keep in mind that medication isn't the only option for ADHD treatment. However, it is recommended as a first-line treatment method in adults. Talk therapy can be a helpful tool to address depression and anxiety, which can be the cause of certain symptoms of ADHD. It is essential to keep in mind that medication only treats the symptoms and doesn't alter negative coping mechanisms. Some patients choose not to take meds in the first place and instead focus on self-help treatments such as exercise, nutrition and stress reduction strategies.
It is essential to be aware of the side effects and how they will affect your body. Certain medications can reduce appetite and cause headaches, as well as cause you to become drowsy. Be sure to use your medications as directed, and talk to your doctor if you experience any adverse reactions.
Presently, a lot of drugs used to treat adult ADHD are out of stock. This has led to delays in the diagnosis process as well as appointments with psychiatrists. NHS England has set up a taskforce to investigate the issue and suggest methods to speed up the process of waiting for prescriptions.
Ask your local GP what options are available to you. You may be able to obtain the same medication privately or they could suggest alternatives with similar results.