ADHD Medication For Adults in the UK
In the UK there is a variety of drugs that are licensed to treat ADHD. The stimulant methylphenidate and the amphetamine-based medicine lisdexamfetamine are two of the most commonly prescribed medications. The dose will be closely monitored in the beginning stages of treatment.
What is a Licensed Medication (L.M.)?
A medicine that is licensed has undergone all the appropriate 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 medication will also be clearly listed as suitable for a particular condition on its packaging or in a leaflet that is provided with it. All licensed medications are controlled even after they've been placed on the market, which means that any issues are quickly identified and any risks reduced.
Certain people with ADHD might be prescribed unlicensed medications, but these are rarely used on children and teenagers. The unlicensed medication could be prescribed for other conditions that have been proven to be effective (known as off-label prescribing) or it could be a specific formula that isn't available on the market, for instance an oral liquid in place of tablets or a product that is free of certain additives. It could also be an experimental medication currently being evaluated in the UK.
The term "experimental drugs" is used to describe Medicines with a Marketing Authorisation(MIA) (IMP) or Investigational Medicinal Products. These medicines are not yet licensed and can only be purchased through a prescription from a doctor. They will have been subject to an assessment in a formal manner by the MHRA as part of the Early Access to Medicines Scheme (EAMS) and thus the quality of pharmaceuticals is guaranteed.
Atomoxetine is a non-stimulant medication that is often prescribed in the UK and Europe for ADHD. It is a selective inhibitor of noradrenaline uptake and therefore works in a different way than other ADHD medications. It increases noradrenaline, which is a chemical that helps transmit messages between brain cells. This helps improve concentration and aids in controlling impulses. It is usually taken as a capsule every day or twice daily.
Only psychiatrists can diagnose ADHD and prescribe medication for adults. It is crucial to remember that ADHD isn't a condition that can be treated through medication by itself. Therapy is often included in treatment plans. Psychoeducation is a form of therapy which helps adolescents, children, and adults understand their diagnosis, and the behavioural therapy, which helps teach methods to manage symptoms.
What is an Unlicensed Medication?
how does medication for adhd work ' refers to medications that are not licensed by the MHRA. This could be due to the fact that the medication was not developed by an UK company, or it has been prescribed in violation of the terms of its licence (ie off-label). The GMC's guidance states that 'unlicensed medicines are usually employed when a licensed product is not available or a clinically effective treatment can't be found using the product with which the prescriber feels comfortable'.
The license of a medicine will specify the conditions it treats, as well as the age ranges that it can be administered to. It will also indicate how it should be used and by whom. The MHRA will only grant an approval when the drug is believed to be safe and effective for that usage, built on research in medical science and clinical trials. The drug's manufacturers are not permitted to promote or market any use that isn't covered by the licence.
It is not illegal in the UK for healthcare professionals to prescribe a non-licensed medication provided they can explain the dangers and benefits of this to the patient. They must also keep records of the use of non-licensed medications and provide the patient enough information to make an informed decision.
Unlicensed medicines are usually offered in hospitals, where there is more experience of using them than in GP practices. The hospital will follow procedures to ensure the safety and effectiveness of the medication. This includes keeping detailed patient records, as well as noting any adverse effects. They are required to adhere to MHRA guidelines on the safe supply of unlicensed medications.
Doctors who prescribe specials must to be clear with patients and their parents or caregivers about the purpose of the medicine, why it is being utilized and the possible negative side effects. They must be able answer any questions asked and always write down the details of the medicine they prescribe, as well as the reasons for prescribing it.
What is a Shared-Care Agreement?
The number of adults who are suspected of having ADHD has increased in recent years, so are demanded to be referred for an NHS assessment and to receive medication for the condition. The waiting lists for NHS assessments can be very long and a lot of patients choose to pay for their ADHD assessments in specialist private clinics. It is hoped that once the diagnosis is confirmed through this process, the GP will sign an agreement for shared care (SCA).
A SCA is an agreement between your psychiatrist and your GP where the responsibility of monitoring, prescribing and basic health checks for medications is handed over to your GP. This is a recognized, agreed method of transferring responsibility for managing ADHD patients from a specialist clinic or hospital to a general practice.
Before the responsibility is transferred the specialist and GP should be in agreement on these SCA guidelines. This should be clearly stated in any referral form. It should also be made clear that the GP is responsible for the continuous monitoring and titration of the medication.
Unfortunately, many GPs aren't keen on accepting SCAs. This is not due to the lack of motivation however, the work involved in SCAs can be out of their normal funding, and often an additional task in addition to their busy schedule.
The GP should be informed about the reasoning behind SCA and the expectations of all participants, and the role 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 if the patient is not willing to participate in SCA.
If a GP refuses to take responsibility for SCA, they can refuse. However, this may result in patients being referred back to the private ADHD clinic and psychiatrist that provided their initial diagnosis. This could result in prescriptions for medication being issued privately, instead of through the NHS. This can be more expensive.
What is a titration duration?
The tration stage is a crucial stage to find the right medication for ADHD. It is a process of increasing the dosage gradually until you reach a level that maximises benefits and minimizes the risk of side effects. It takes time however, your healthcare specialist should work closely with you to ensure the process of titrating is as smooth as it can be.
Certain patients may experience an increase in their symptoms during the titration phase. For example, those who are hyperactive may become more restless and anxious than normal. It is essential that loved ones be aware of any changes in behavior and provide support. To lessen the negative side effects from ADHD medication, it is important to live a healthy life and a regular sleeping schedule.
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 for adults. Talk therapy is a helpful tool to address depression and anxiety that can cause certain symptoms of ADHD. It is important to remember that medication can only treat the symptoms, not change longstanding negative coping mechanisms. Some patients prefer not to take meds at all and prefer to concentrate on self-help methods such as exercise, nutrition as well as stress reduction and sleep strategies.
It is essential to read over the side effects of any medicine you are prescribed, and understand how the medication will affect your body. Certain medications can cause headaches or drowsiness and can also cause a decrease in appetite. Always use your medication according to the instructions and consult your doctor in the event of any adverse reactions.
Presently, a lot of medications used for treating adult ADHD are in short supply. This has resulted in delays in diagnosis as well as a lag in appointments with psychiatrists. NHS England has set up a taskforce to investigate the issue and suggest ways of reducing waiting times for prescriptions.
Despite the lack of certain popular medications, it is still possible to receive ADHD treatment through the NHS, and it's worth speaking with your local GP about your options. You may be able to take the same medications privately, or they may suggest alternatives that can provide similar results to what you're accustomed to.