Adult ADHD Medication in the UK
In the UK, the NHS has guidelines for diagnosing ADHD in adults. During the pandemic, referrals to the adult ADHD clinic quadrupled.
The medications used to treat ADHD include stimulants as well as non-stimulants. Methylphenidate is a popular medication used to treat symptoms of ADHD, along with two amphetamine-based drugs known as dexamfetamine and Lisdexamfetamine.
Stimulants
The most common kind of medication used to treat adult ADHD is a stimulant. They work by enhancing activity in parts of the brain that regulate the behaviour and attention. They are fast-acting and are often the first choice of GPs. Methylphenidate is also known as Ritalin, is the most frequently prescribed stimulant for adults and children.
This drug increases the levels of neurotransmitters in the brain, improving the quality of attention and reducing hyperactivity and impulsivity. It can also reduce anxiety and depression, which may co-occur with ADHD.
In the past, stimulants were used to boost cognitive function, motivation, and performance. These include nicotine and caffeine amphetamines modafinil, methylphenidate, cocaine and methylphenidate. They are also used for appetite suppressants and energy boosters, and can have significant physical and psychological side effects when taken in excess.
There are a number of different medications 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 conditions that a patient might have, as well as the impact of the medication on sleep patterns. They will also look at the impact 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 in reducing symptoms of ADHD. It is recommended by NICE, and it is available on prescription in the UK.
Despite the evidence-based research that supports it, there is a certain stigma attached to the use of medications to treat ADHD and other disorders, with unhelpful frames that refer to it as child abuse and comparisons to controlled substances. This makes many unwilling to seek an assessment, or even to consider taking medications to treat their condition.
As over the counter adhd medication of referrals to NHS psychiatry increased during the COVID-19 pandemic, also did the number of adults being treated for ADHD. In fact the number of adult ADHD referrals have now overtaken those for children. Boys remain more likely to receive referrals, but the number of women seeking treatment for ADHD has quadrupled in the past two years.
Unlicensed Medication
A variety of drugs are approved for treating ADHD in adults and children, with stimulant drugs such as methylphenidate and sometimes the newer amphetamine-based medication lisdexamfetamine prescribed. These drugs are categorized as 'controlled medications' because they can be addictive and abused. Your consultant psychiatrist will only prescribe these drugs if he / believes that they are the most effective choice for your treatment. You will be provided with an official prescription that you can pick up at your local pharmacy. This will be for a month's supply of the drug. Your pharmacist will be able to explain the procedure to you.
In certain situations, your doctor may determine that the medications they have available are not suitable for you and recommend a medication that is not licensed. This is an individual decision and your doctor should only prescribe unlicensed medications as an option last resort. It is important to keep in mind that even though medication is an integral part of treatment for ADHD however, talking therapy is also vital. Therapy can alter your coping mechanisms and behavior patterns. The use of medication can help manage your symptoms.
In the UK the medication used to treat ADHD in adults must be accompanied by an authorisation to market (MA) that outlines the conditions under which it is approved. This will include information about the age of those who can be prescribed the medication as well as the manner in which it must be taken. The MHRA will conduct an official assessment of any IMP before it is released and the manufacturer is able to promote it under its MA unless it holds a special license for paediatric medicine.
This is the situation where a drug has been approved for use by a child, but a psychiatrist believes it's appropriate to prescribe it for an adult. This is also known as off label prescribing. A'manipulated product' is possible, where a pharmacist mixes ingredients to create a formula for a patient that is unable to swallow tablets. Some psychiatrists have criticized the excessive use of psychoactive drugs to treat mental health issues, such as ADHD.
Licensing
In the UK, there are a range of medications that are authorised to treat ADHD in adults. This includes a range of stimulant medicines such as methylphenidate (Ritalin) and the newer amphetamine-based medicine called lisdexamfetamine (Elvanse). Typically, these are offered to patients suffering from the condition after consulting a psychiatrist. The treatment is prescribed in capsules and the patient must be closely monitored by their doctor to determine the proper dosage.
In addition to these medicines however, there are a myriad of other ways in which the disease can be treated and controlled. For instance, behavioural therapy can help people understand the causes of symptoms and develop strategies to combat these. Environment-related changes can aid people in coping with the impact their symptoms affect their daily lives. This can include organising seating arrangements at work or school or at home, scheduling frequent breaks in movement, and distributing "I need a break" cards, as well as making it easier to avoid distractions and noise.
The medications 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 many. But, they're not an all-purpose cure and should only be used as a part of a comprehensive care package that includes psychiatric and psychoeducational care.
It is crucial that anyone with the potential of becoming pregnant undergoes a pregnancy test prior to beginning medication, and should inform their GP immediately in the event that they become pregnant or want to become pregnant. Patients should also speak to their GP if there are any side effects or if they do not think they are gaining.
On 27 September 2023, a national patient safety alert was issued about the shortage of extended-release guanfacine tablets, lisdexamfetamine tablets, and methylphenidate tablets. On May 8, 2024, a Medicine Supply Notification was issued, which lifted the prescribing restrictions on Elvanse capsules.
It is classified as a Schedule 2 drug, so it is only prescribed by a registered doctor and is subject to the Misuse of Drugs Regulations of 2001. The guidelines recommend that people suffering from ADHD should be evaluated annually by a healthcare professional with training and expertise in managing the disorder, either in primary or secondary care based on the local arrangement. This review should include monitoring of heart rate and blood-pressure as well as a discussion about the need for continued treatment, and continuous monitoring and evaluation of symptoms improvements.
Side Effects
ADHD medication is generally well tolerated and safe by adults. However, it will not cure the condition. It can help reduce symptoms of behavioural, and improve the quality of life for people. It can also assist with learning, work and relationships.
However, it's important for anyone starting treatment to be aware of the potential adverse reactions and discuss them with their doctor before they begin taking the medication. Some of the side effects include headaches, sleeplessness and changes in appetite. Certain medications can raise your heart rate. It is generally harmless and not harmful however, it is important to inform your doctor if there's any history of heart disease or issues.
how does medication for adhd work boost the levels of dopamine and norepinephrine within the brain. This alters the way that the brain processes and transmits messages, increasing concentration and attention. They are considered first-line treatments for adults with ADHD. Atomoxetine and Buproprion, which are non-stimulant drugs have a more intricate effect on the brain. They also take longer to start working. The latter works by blocking dopamine reuptake by nerve cells, and aids in enhancing concentration.
According to research, around half of children diagnosed with ADHD will overcome their symptoms by adulthood. It could be because they manage their symptoms or because they become less active. However, a large portion remain in an environment that isn't made to accommodate them. Nice recommends doctors prescribe ADHD medications only when they are necessary and continue to keep track of their patients on a regular basis.
There are other ways to treat ADHD symptoms. These include psychoeducational therapy and lifestyle changes. These therapies can be utilized alongside medication to lessen the need to refer people who suffer from ADHD to specialist services.
Many adults are hesitant to inform their families, friends or employers that they use ADHD medication because of the stigma that surrounds it. But, there is growing evidence that discussing the disorder and promoting awareness of its symptoms can help break down barriers to treatment.