Adult ADHD Medication in the UK
In the UK there are guidelines for diagnosing ADHD among adults. During the pandemic, referrals to the adult ADHD clinic quadrupled.
The medicines used to treat ADHD include stimulants and non-stimulants. Methylphenidate, dexamfetamine and lisdexamfetamine are two amphetamine-based medications that help manage ADHD symptoms.
Stimulants
The most commonly used kind of medication used to treat adult ADHD is stimulants. They increase activity in parts of the brain that control the behavior and attention. They are quick-acting and are frequently the first choice that is considered by GPs. Methylphenidate, more commonly known as Ritalin, is the most widely prescribed stimulant for adults and children.
This drug increases neurotransmitter levels in the brain. It increases the quality of attention, and reduces the amount of impulsivity and hyperactivity. It can also reduce depression and anxiety that can be a result of ADHD.
In the past, stimulant substances have been used both medicinally and for recreational purposes, to enhance cognition, motivation, performance and mood. They include nicotine, caffeine 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 psychiatrists will typically be careful to adjust the doses of each patient they see. They will also consider any other medical issues a patient may have, and the effects of the medication on their sleep patterns. They will also examine the effects of the medication on the diet of a patient and lifestyle.
A large network meta analysis, conducted by NIHR Oxford Health Biomedical Research Centre (NIHR Oxford Health Biomedical Research Centre) and Stichting Eunethydis has found that Lisdexamfetamine, more commonly referred to as Adderall is more effective than any other stimulant at reducing the symptoms of ADHD. It is recommended by NICE and is available in the UK with a prescription.
Despite the evidence-based evidence that supports the use of medications for ADHD is still stigmatized. Unhelpful framings compare it to child exploitation and the use of controlled substances. This can make many people unwilling to seek an assessment, or even to consider taking medications to treat their condition.
The number of adult patients treated for ADHD increased as did the number of people referred to NHS psychiatrists during the COVID-19 epidemic. In fact the number of adult ADHD referrals are now surpassing those for children. Boys are still more likely to be referred, however the number of women seeking treatment for ADHD has quadrupled in the past two years.
Unlicensed Medication
A variety of medications are approved for treating ADHD for children and adults, with stimulant drugs such as methylphenidate and, sometimes, the newer amphetamine-based medication lisdexamfetamine prescribed. These drugs are categorized as controlled medications because they are addictive and abused. Your doctor will prescribe these drugs if he or she believes they are the most effective solution for your treatment. Then, you will be given an order to visit your local pharmacy and pick up. It will be for a month's worth of the drug. Your pharmacist should be able to explain it to you.
In certain situations, your doctor may decide that the drugs they have available are not appropriate for you and recommend a medication that is not licensed. This will be a case by case decision and your doctor should only use unlicensed medication as an option last resort. It is important to remember that although medication is a crucial component of treatment for ADHD and ADD, therapy with a therapist is equally important. Therapy can alter your coping mechanisms and behavior patterns. The use of medication can help manage your symptoms.
The medication used to treat ADHD for adults must be licensed in the UK with a license known as marketing authorisation (MA) which will state the specific health conditions it is approved for. This will include information about the age of people who can be prescribed the medication as well as the manner in which it must be taken. The MHRA will provide an official evaluation of any IMP before it is released and the manufacturer can only promote it under its MA or if it has an exclusive license for paediatric medicine.
Off label prescribing happens when a psychiatrist feels it is appropriate to prescribe a drug for an adult even if it was prescribed for children. It is possible to manipulate a product in the event that a pharmacist mixes ingredients to create a formula for a patient who can't swallow tablets. There's an unpopularity around using non-licensed medications to treat ADHD in adults, with some psychiatrists expressing concern about the over-prescribing of psychoactive medications for mental health issues.
Licensing
In the UK there are a variety of medicines are available to treat ADHD for adults. There are many stimulant medications such as methylphenidate, (Ritalin), and the newest amphetamine-based medication lisdexamfetamine (Elvanse). These are typically prescribed to patients who have been diagnosed with the condition by psychiatrists. The treatment is prescribed in capsules and the patient must be closely monitored by their physician to determine the proper dosage.
In addition to these drugs, there are a number of other methods by which the condition can be treated and controlled. For example, behavioural therapies can help people understand the causes of symptoms and develop strategies to combat these. Additionally, changes to the environment can also be useful in helping people deal with the effects of their symptoms in daily activities. adhd treatment medication can include making seating arrangements at work or school and distributing cards that read 'I Need a Break' and arranging frequent movement breaks and making sure that there is less noise and distraction.
The medications that are licensed to treat ADHD in adults in the UK are not designed to be a cure, but they can significantly improve the quality of life for many people who suffer from the condition. But, they're not an instant cure, and should only be used as part of a comprehensive care package that includes psychiatric and psychoeducational care.
Patients with childbearing capacity should have an examination for pregnancy prior to taking any medication. They should also inform their GP when they become pregnant or wish to fall pregnant. It is also recommended that patients should consult their GP in the event of significant side-effects or do not believe they are getting the benefits from the medication.
On 27 September 2023, a national safety alert was issued regarding the lack of extended-release guanfacine tablets, tablets of lisdexamfetamine and methylphenidate tablets. On May 8, 2024 an Medicine Supply Notification was issued, which lifted the restrictions on prescribing Elvanse capsules.
It is a Schedule 2 controlled drug so it requires the prescription of a registered doctor and is subject to the Misuse of Drugs Regulations 2001. The guidelines recommend that an ADHD patient is evaluated annually by a healthcare professional who is knowledgeable and trained in managing the disorder. This can be done in primary or secondary care, based on the local arrangements. This review should include a check for blood pressure and heart rate and a discussion of the continued need for treatment, as well as ongoing monitoring and assessment of symptom improvement.
Side Effects
ADHD medication is generally well-tolerated and is safe for adults. However, it will not cure this condition. It can help reduce symptoms of behavioural, and improve the quality of life for those suffering from the condition. It can also assist with learning, work and relationships.
It is important that those who are beginning treatment be aware of possible side effects. They should discuss them with their doctor prior to taking the medication. Some of the side effects include an increase in appetite, headaches and sleepiness. Certain medications may also raise the heart rate. It is usually mild and harmless, but it is worth noting to your doctor if you have a prior history of heart problems or cardiovascular disease.
The effects of stimulants increase the levels of dopamine and norepinephrine in the brain. This alters the way the brain transmits and receives messages, and increases focus and attention. These medications are first-line treatments of adult ADHD. Nonstimulant medicines like buproprion and atomoxetine are available, however they have more complex effects on the brain and take longer to start working. The latter block the reuptake and release of dopamine into nerve cells and aids in concentration.
Research suggests that half of children diagnosed with ADHD get rid of their symptoms by adulthood. This could be because they are able to manage their symptoms, or because they are less hyperactive. A significant number of them struggle with a society that is not designed to meet their needs. This is why Nice suggests that doctors prescribe ADHD drugs only when they are needed and keep a close eye on patients.
There are many other ways to help with ADHD symptoms, including psychoeducational therapies and lifestyle changes. These therapies can be used in conjunction with medication to reduce the need to refer people who have ADHD to specialist services.
The stigma attached to ADHD can make it difficult to speak openly about the medication. Many adults are reluctant to admit the fact that they have ADHD to family members, friends or employers. However, there is growing evidence that talking about the disorder and raising awareness of its symptoms can help to break down barriers to treatment.