Adult ADHD Medication in the UK
In the UK in the United Kingdom, the NHS has guidelines for diagnosing ADHD in adults. Referrals to the adult ADHD specialist clinic quadrupled during the pandemic.
Non-stimulants and stimulants are both used to treat ADHD. Methylphenidate and dexamfetamine as well as Lisdexamfetamine are three amphetamine-based drugs that help manage ADHD symptoms.
Stimulants
The most common type of medication used to treat adult ADHD is a stimulant. These medications work by increasing the activity of brain regions that regulate behavior and attention. They are fast-acting and are often the first option to be considered by GPs. Methylphenidate, more commonly known as Ritalin, is the most commonly 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 also helps to reduce depression and anxiety that can be a result of ADHD.
Throughout history, stimulant drugs have been used both medicinally as well as recreationally to improve cognitive function, motivation, performance, and mood. These include nicotine and caffeine amphetamines, modafinil, methylphenidate, cocaine and methylphenidate. These substances are used to control appetite and increase energy. However, they may also cause severe psychological and physical effects if taken in excess.
There are a variety of 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 issues a patient may be suffering from, and the effect 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 carried out 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 at reducing the symptoms of ADHD. It is recommended by NICE and is available in the UK by prescription.
Despite the evidence-based findings that supports it, there is a certain stigma associated with the use of medication to treat ADHD, with unhelpful framings that make it appear like child abuse and compare it to controlled substances. This may cause people to be hesitant to get an assessment or even consider taking medication to treat their condition.
The number of adult patients treated for ADHD increased as the number of people referred to NHS psychiatrists during the COVID-19 epidemic. In fact the number of adult ADHD referrals have now overtaken those for children. Boys are still more likely to be referred for ADHD treatment however, the number of women receiving treatment has quadrupled in the past two years.
Unlicensed Medication
There are a variety of medications that are prescribed to treat ADHD in both adults and children. These include stimulant medications like methylphenidate and the more recent amphetamine-based drug Lisdexamfetamine. These are classified as controlled drugs because they can be addictive and abused. Your consultant psychiatrist will only prescribe them if they feel they are the best option for you as part of your treatment. Then, you will be given the prescription to take to your local pharmacy and take home. It is for a month's worth of the drug and your pharmacist will be able to explain it to you.
In some cases your doctor might determine that the medications they offer aren't suitable for you and recommend an unlicensed medication. This will be a case-by-case decision, and your doctor should only use unlicensed medication as an option last resort. Keep in mind that while medication is an essential component of treating ADHD, talking therapy also plays a crucial role. The use of medication can help manage your symptoms, but therapy can work at changing the long-standing negative coping mechanisms and behavioural patterns.
In the UK, medication used to treat ADHD for adults requires a marketing authorisation (MA) that specifies the specific conditions under which it is approved. It will also include information about the age of people who are eligible to receive the medication as well as the manner in which it must be taken. The MHRA will conduct 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 occurs when a psychiatrist feels it is appropriate to prescribe a drug for an adult even though it was approved for a child. It is possible to manipulate a product, where pharmacists mix ingredients to create a formulation for a patient that is unable to swallow tablets. Some psychiatrists have criticized the over-prescription of psychoactive drugs to treat mental health issues, including ADHD.
Licensing
In the UK there is a range of medications that are licensed to treat ADHD in adults. There are a number stimulant medications such as methylphenidate, (Ritalin) and the newest amphetamine-based medication lisdexamfetamine, (Elvanse). Typically, they are given to patients who have been diagnosed with the condition after consulting a psychiatrist. The treatment is typically prescribed in the form of capsules and patients are closely monitored by their physician to ensure that the correct dosage is identified.
There are other options to treat and manage the illness, in addition to medication. For example, behavioural therapies can aid patients in understanding the underlying causes of their symptoms and devise strategies to overcome these. Additionally, changes to the environment can also be useful in helping people deal with the impact of their symptoms in daily activities. This includes arranging seating arrangements at school or work or even distributing cards that say 'I Need a Break' and scheduling frequent movement breaks as well as decreasing noise and distractions.
The drugs that have been approved by the UK to treat ADHD among adults aren't intended to cure but can improve the quality of life for a lot of people. But, they're not an all-purpose cure and should only be used as part of a holistic care plan that includes psychiatric treatment and psychoeducation.
Patients with childbearing capacity should take an examination for pregnancy prior to beginning any medication. They must also inform their GP if they fall pregnant or want to become pregnant. Patients should also consult their GP for any side effects or if they do not feel they are benefiting.
A national alert for patient safety concerning the shortage of methylphenidate prolong-release tablets, extended-release guanfacine tablets, and lisdexamfetamine capsules was issued on the 27th of September, 2023. This was replaced with an Medicine Supply Notification (MSN) on May 8, 2024. The MSN lifted prescribing restrictions for Elvanse capsules and urged ADHD services to resume initiations.
It is classified as a Schedule 2 drug, so it can only be prescribed by a registered physician and is subject to the Misuse of Drugs Regulations of 2001. The guidelines suggest that anyone suffering from ADHD should be evaluated every year by a healthcare professional who has training and experience in managing the disorder, whether in primary or secondary care based on local arrangements. This review should include a check for blood pressure and heart rate as well as a discussion on the need for ongoing treatment and ongoing evaluation of symptoms and monitoring improvement.
Side Effects
ADHD medication is generally well-tolerated and safe by adults. However, it does 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 improve working, learning and relationships.
It's crucial for anyone considering treatment to be aware of potential adverse reactions and discuss them with their doctor before they start taking the medicine. Side-effects can include an increase in appetite, headaches and sleepiness. Certain medications can raise your heart rate. This is usually mild and harmless but is worth noting to your doctor if you have any history of heart problems or cardiovascular disease.
Stimulants increase levels of dopamine and norepinephrine in the brain. This changes the way the brain receives and sends messages, improving focus and attention. best adhd medication for adults are the first-line treatment of adult ADHD. Non-stimulant drugs like buproprion and atomoxetine also available, but they have more complex actions on the brain and take longer to start working. The latter blocks the reuptake of dopamine into nerve cells, which aids in concentration.
According to research, around half of the children diagnosed with ADHD will overcome their symptoms by adulthood. This could be due to the fact that they are able to manage their symptoms, or because they are less hyperactive. But many continue to struggle in a society which is not specifically designed specifically for them. This is why Nice recommends doctors prescribe ADHD medications only when they are appropriate and to keep a close eye on patients.
There are adhd medication online of alternatives to treat ADHD symptoms, including lifestyle changes and psychoeducational therapies. These therapies can be used in conjunction with medications to decrease the necessity of referring adults who have ADHD to specialist services.
Many adults are hesitant to tell their friends, families or employers that they use ADHD medication because of the stigma associated with it. There is increasing evidence that discussing the disorder and raising awareness of its symptoms can help reduce barriers to treatment.