Adult ADHD Medication in the UK
In the UK there are guidelines for diagnosing ADHD in adults. During the pandemic, referrals to the adult ADHD clinic quadrupled.
Non-stimulants and stimulants can both be used to treat ADHD. Methylphenidate is a popular medicine to help manage symptoms of ADHD and is accompanied by two amphetamine-based medicines known as lisdexamfetamine and dexamfetamine.
Stimulants
The most commonly used kind of medication used to treat adult ADHD is stimulants. These drugs work by increasing the activity in brain areas that control attention and behavior. They are quick-acting and are frequently the first choice of GPs. Methylphenidate is also known as Ritalin, is the most widely prescribed stimulant for adults as well as children.
This drug increases the levels of neurotransmitters in the brain, which improves the quality of attention and reducing hyperactivity and impulsivity. It can also help decrease depression and anxiety which may be a co-morbidity with ADHD.
Throughout history, stimulant drugs have been used both medicinally and for recreational purposes, to enhance cognition, motivation, performance and mood. These include caffeine and nicotine amphetamines, modafinil, methylphenidate, and cocaine. They are also used as appetite suppressants and energy boosters. They can cause significant psychological and physical adverse effects when used in excess.
There are a number of different medications used to treat adults with ADHD and psychiatrists will typically be careful to adjust the dosages for each patient they visit. They will take into account any other medical conditions the patient might be suffering from, as well as the effects of the medication on their sleeping patterns. They will also consider the impact of the medication on the diet of a patient and lifestyle.
A massive meta-analysis of the network conducted by the NIHR Oxford Health Biomedical Research Centre and Stichting Eunethydis, has found that the drug Lisdexamfetamine (commonly referred to as Adderall) is more effective than other stimulants in decreasing symptoms of ADHD. It is recommended by NICE and is available in the UK by prescription.
Despite evidence-based research that support the use of drugs for ADHD is still stigmatized. Ineffective framings make it appear like child abuse and controlled substances. This may cause people to be hesitant to take a test or even think about taking medication for their condition.
The number of adults treated for ADHD increased as the number referred to NHS psychiatry during the COVID-19 epidemic. In fact adults' ADHD referrals have now surpassed those for children. Boys remain more likely to be referred, however the number of women seeking treatment for ADHD has quadrupled in the last two years.
Unlicensed Medication
There are many medications that are prescribed to treat ADHD in adults and children. These include stimulant medications like methylphenidate and the more recent amphetamine-based medication lisdexamfetamine. These drugs are categorized as controlled drugs due to the fact that they can be addicting and addictive. Your consultant psychiatrist will only prescribe them if they feel they are the best option for you as part of your treatment. You will be provided with a written prescription which you can pick up at the local pharmacy. The pharmacist will explain to you that this prescription is for a monthly supply of medication.
In some instances, your doctor may decide that the medicines they have available are not suitable for you and recommend an unlicensed drug. This is a choice that will be made on a case-by-case basis. Your doctor should only recommend non-licensed medications as a last option. 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. Treatment with medication can alleviate 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 specify the specific health conditions it is approved for. This will include information about the age of people who are eligible to receive the medication as well as the manner in which it must be administered. The MHRA will conduct an official evaluation of any IMP before it is released, and the manufacturer can only advertise it under its MA or if it has a specific licence for paediatric medicine.
adhd medications is where a medicine has been approved for use by a child, but a psychiatrist believes it is appropriate to prescribe it for an adult, this is also known as off label prescribing. A "manipulated product" is a possibility, where pharmacists mix ingredients to make a formula for a patient who is unable to swallow tablets. Some psychiatrists have been critical of the over-prescription of psychoactive medications to treat mental health problems, including ADHD.
Licensing
In the UK, there are several medications that are licensed to treat ADHD in adults. This includes a range of stimulant medicines such as methylphenidate (Ritalin) and the newest amphetamine-based drug called lisdexamfetamine (Elvanse). These are typically offered to patients who have been diagnosed with the condition by psychiatrists. The treatment is usually prescribed in capsules and patients are closely monitored by their doctor to ensure that the correct dose is found.
There are other methods to treat and manage the condition, in addition to medications. For example, behavioural therapies can aid patients in understanding the root causes of their symptoms and devise strategies to overcome these. Additionally, changes to the environment can also be useful in helping people cope with the effects of their symptoms on day-to-day activities. linked website can include organising seating arrangements at school or at work and arranging for frequent breaks in movement, and distributing 'I need a break' cards, as well as reducing distractions and noise.
The medications that have been licensed in the UK to treat ADHD among adults aren't meant to be a cure, but they can enhance the quality of life for many. But, they're not an all-purpose cure and should only be used as part of an integrated care package that includes psychiatric and psychoeducational care.
Patients with childbearing capacity should take a pregnancy test prior starting any medication. They must also inform their GP when they become pregnant or wish to fall pregnant. It is also recommended that patients visit their GP in the event of significant side effects or do not think they are benefiting from the medication.
A national alert for patient safety regarding the shortage of methylphenidate prolonged-release tablets, guanfacine extended-release tablets and lisdexamfetamine capsules was released on September 27, 2023. On May 8, 2024 a Medicine Supply Notification was issued that lifted the restrictions on prescribing Elvanse capsules.
It is an 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 a person with ADHD is reviewed every year by a health expert with experience and training in managing the disorder. This can be done in primary or secondary treatment based on local arrangements. This review should include a check for heart rate and blood pressure and a discussion of the ongoing need for treatment, as well as ongoing monitoring and evaluation of symptom improvement.
Side Effects
ADHD medication is generally well tolerated and safe by adults. However, it will not cure the condition. It can reduce behavioural symptoms, and improve the quality of life of people. It can also aid in learning, work and relationships.
Having said that, it's crucial for anyone considering treatment to be aware of potential side effects and discuss these with their physician prior to when they start taking the medicine. Some side effects include headaches, insomnia and changes in appetite. Certain medications can raise your heart rate. It is usually mild and harmless but is worth noting to your doctor if you have any prior history of heart problems or cardiovascular disease.
Stimulants boost the levels of dopamine and norepinephrine within the brain. This alters how the brain sends and receives messages and improves attention and focus. They are considered first-line treatments for adults suffering from ADHD. Buproprion and Atomoxetine which are non-stimulant drugs are more complex in their effect on the brain. They also take longer to start working. The latter block the reuptake of dopamine by nerve cells and helps with concentration.
Research suggests that about half of children who are diagnosed with ADHD grow out of their symptoms by adulthood. This may be because they are able to manage their symptoms or they become less active. But a significant number remain in an environment that isn't made specifically for them. That's why Nice recommends doctors prescribe ADHD drugs only where they are needed and continue to monitor patients regularly.
There are other methods to treat ADHD symptoms. These include psychoeducational therapy and lifestyle changes. These can be combined with medication to reduce the need for doctors to refer patients suffering from ADHD to specialist services.
Many adults are hesitant to inform their families, friends or employers that they are taking ADHD medication due to the stigma that surrounds it. But, there is growing evidence that discussing the condition and raising awareness of its symptoms can help to reduce barriers to treatment.