Adult ADHD Medication in the UK
In the UK, there are guidelines for diagnosing ADHD in adults. The number of referrals to the adult ADHD specialist clinic quadrupled during the pandemic.
Non-stimulants and stimulants are both used to treat ADHD. Methylphenidate is a popular medication to treat the symptoms of ADHD, along with two amphetamine-based drugs known as lisdexamfetamine and dexamfetamine.
Stimulants
The most popular kind of medication used to treat adult ADHD is stimulants. These work by increasing activity in parts of the brain that control the behaviour and attention. They are fast-acting and are often the first choice of GPs. Methylphenidate (also known as Ritalin) is the most commonly prescribed stimulant in both adults and children.
This drug increases the levels of neurotransmitters in the brain, which improves the quality of attention and reducing impulsivity and hyperactivity. It can also reduce anxiety and depression, which may co-occur with ADHD.
In the past, stimulant drugs were used to improve cognitive function, motivation, and performance. These include nicotine and caffeine amphetamines, modafinil, methylphenidate, and cocaine. These substances are used to control appetite and boost energy. However, they may also have serious physical and psychological effects when taken excessively.
A psychiatrist will be careful to adjust the dosages for each patient. They will consider any other medical issues patients may have, as well as the impact of the medication on their sleeping patterns. They will also take into consideration the effects of medication on the patients' lifestyle and diet.
A massive network meta analysis 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 in reducing symptoms of ADHD. It is recommended by NICE, and it is available for prescription in the UK.
Despite the evidence-based research however, there's a stigma associated with the use of medications to treat ADHD, with unhelpful framings that refer to it as child abuse, and even comparisons 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 adults being treated for ADHD increased as the number referred to NHS psychiatrists during the COVID-19 epidemic. Adult ADHD referrals now surpass those for children. Boys are still more likely to be referred for ADHD treatment however, the number of women who receive it has quadrupled in the past two years.
Unlicensed Medication
A variety of medications are approved for treating ADHD in children and adults, with stimulant drugs such as methylphenidate and, sometimes, the newer amphetamine-based drug lisdexamfetamine being prescribed. These drugs are categorized as 'controlled medications' because they are addicting and addictive. Your doctor will prescribe them if they feel they are the most appropriate choice for you as part of your treatment. You will then be given an order to take to your local pharmacy and take home. Your pharmacist will be able explain to you that this is for a monthly supply of medication.
In certain instances, your doctor may decide that the medications they have available are not suitable for you, and may recommend an unlicensed drug. This will be a case by case decision and your doctor should only recommend unlicensed medication as an option last resort. It is important to keep in mind that although medication is a crucial component of treatment for ADHD however, talking therapy is also essential. Therapy can alter your coping mechanisms and behavior patterns. Treatment with medication can alleviate your symptoms.
The medication used to treat ADHD in adults has to be licensed in the UK and have a license known as marketing authorisation (MA) which will state the health conditions it is approved for. 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 administered. The MHRA will make an official evaluation of any IMP before it is made available and the manufacturer can only promote it under its MA, unless it has a special licence for paediatric medicine.
This is when a medication is approved for use by a child, but a psychiatrist believes it's appropriate to prescribe it to an adult. This is also known as off label prescribing. It is also possible to have"manipulated" products - in which the pharmacist makes up the formulation for a specific patient by mixing ingredients, for instance in the event that they are unable to take tablets. There is a stigma around the use of unlicensed drugs to treat ADHD in adults, with some psychiatrists criticising the over-prescribing of psychoactive drugs to treat mental health problems.
Licensing
In the UK there are several medications that are authorised to treat ADHD in adults. These include a number of stimulant drugs, 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 as capsules and the patient must be closely monitored by their physician in order to find the right dosage.
In addition to these medicines in addition, there are a variety of other ways in which the illness can be treated and controlled. For example, behavioural therapy can help patients understand the cause of their symptoms and come up with strategies to manage these. Environment-related changes can aid in reducing the impact their symptoms have on their day-to-day lives. This can include organising seating arrangements at work or school, arranging for frequent movement breaks and providing 'I need a break' cards, and cutting down on distractions and noise.
The medications that are licensed to treat ADHD in adults in the UK are not intended to be an effective cure, but they can greatly improve the quality of life for many people suffering from the condition. However, they are not an instant cure, and should only be used as a part of a holistic care plan 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 that they inform their GP immediately in the event that they become pregnant or want to become pregnant. Patients should also consult their GP for any adverse reactions or if they do not feel they are benefiting.
On 27 September 2023, a nationwide patient safety alert was issued regarding the lack of extended-release guanfacine tablets, lisdexamfetamine tablets and methylphenidate tablets. On May 8, 2024 a Medicine Supply Notification was issued that lifted the prescribing restrictions on Elvanse capsules.
It is a Schedule 2 drug, so it is only prescribed by a licensed physician and is subject to the Misuse of Drugs Regulations of 2001. The guidelines recommend that an ADHD patient be assessed annually by a healthcare professional who has the expertise and experience in managing the disorder. This can be done in primary or secondary care, depending on the local arrangements. This review should include monitoring of heart rate and blood-pressure as well as a discussion about the need for ongoing treatment, and continuous evaluation and monitoring of symptom improvements.
Side Effects
ADHD medication is generally well tolerated and is safe for adults. However, it does not cure this condition. It can reduce behavioural symptoms, and improve the quality of life for those suffering from the condition. It can also help with working, learning and relationships.
Having said that, buy adhd medication online for anyone considering treatment to be aware of possible adverse reactions and discuss them with their doctor before they begin taking the medication. The side effects can include an increase in appetite, headaches and sleepiness. Certain medications may increase heart rate. It is generally harmless and not harmful but it's important to inform your doctor if you have an history of heart disease or heart issues.
Stimulants boost the levels of dopamine and norepinephrine that are present in the brain. This alters the way that the brain transmits and receives messages, which improves attention and focus. They are considered to be the first-line treatment for adults with ADHD. Nonstimulant medications such as buproprion and atomoxetine are available, but they have more complex effects on the brain and take longer to start working. The latter block the reuptake of dopamine by nerve cells and aids in concentration.
Research suggests that about half of children who are diagnosed with ADHD grow out of their symptoms as they grow older. This could be because they develop coping skills to manage their symptoms or they are less active. However, a large portion struggle to cope with a society which is not designed to accommodate them. This is why Nice suggests that doctors prescribe ADHD drugs only where they are necessary and keep monitoring patients on a regular basis.
There are a variety of other methods to alleviate ADHD symptoms, such as lifestyle changes and psychoeducational therapies. These therapies can be used in conjunction with medication to reduce the necessity of referring adults who have ADHD to specialist services.
Many adults are hesitant inform their families, friends or employers that they take ADHD medication due to the stigma associated with it. There is increasing evidence that speaking out about the disorder can help break down barriers for treatment.