Adult ADHD Medication in the UK
In the UK, there are guidelines to diagnose ADHD among adults. During the pandemic, the number of referrals to the adult ADHD clinic quadrupled.
Both stimulants and non-stimulants are used to treat ADHD. Methylphenidate is a popular medication to treat the symptoms of ADHD, along with two amphetamine-based drugs called dexamfetamine and lisdexamfetamine.
Stimulants
Stimulants are the most common medication used to treat ADHD in adults. These drugs work by increasing the activity in brain areas that regulate attention and behavior. They are quick-acting and are frequently the first choice of GPs. Methylphenidate (also called Ritalin) is the most frequently prescribed stimulant for children and adults.
This drug boosts the levels of neurotransmitters in the brain, thereby improving concentration and decreasing impulsivity and hyperactivity. adhd medication names helps reduce anxiety and depression, which can co-occur with ADHD.
In the past, stimulant substances are used for both medicinal purposes as well as recreationally to improve cognition, motivation, performance, and mood. These include nicotine, caffeine amphetamines and cocaine, methylphenidate, and modafinil. These substances are used to suppress appetite and boost energy. However, they can also have severe psychological and physical effects if taken in excess.
There are a variety of different medications that are used to treat adults with ADHD and psychiatrists will usually carefully titrate the dosages for each patient they visit. They will also consider any other medical conditions a patient may have, 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, 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 efficient than other stimulants in decreasing symptoms of ADHD. It is recommended by NICE and is available in the UK on prescription.
Despite the evidence-based research that supports it, there is a certain stigma attached to the use of medications to treat ADHD, with unhelpful framings that refer to it as child abuse and compare it to controlled substances. This can make people hesitant to get an assessment or even think about taking medication for their condition.
The number of adults being treated for ADHD increased as the number referred to NHS psychiatry during the COVID-19 epidemic. In fact adults' ADHD referrals have now overtaken those for children. Boys are still more likely to be referred for ADHD treatment however the number of women who receive it has quadrupled over the past two years.
Unlicensed Medication
A variety of medications are licensed for treating ADHD in children and adults including stimulant drugs such as methylphenidate and, sometimes, the newer amphetamine-based drug lisdexamfetamine being prescribed. These drugs are categorized as 'controlled medications' because they can be addictive and abuse. Your doctor will prescribe them if they believe they are the best choice for you as part of your treatment. Then, you will be given an order to visit your local pharmacy and pick up. It will be for a month's supply of the medication and your pharmacist should be able explain it to you.
In some cases, your doctor may decide that the drugs they offer aren't right for you and will recommend an unlicensed medication. This is a case by case decision and your doctor should only recommend unlicensed medication as the last option. Be aware that although medication is an important part of treating ADHD, talking therapy also plays a crucial role. Therapy can alter your coping mechanisms and behaviour patterns. Medication can manage your symptoms.
In the UK, medication used to treat ADHD for adults requires an authorization for marketing (MA), which specifies the conditions under which it's approved. It will also include information about the age of those who are eligible to receive the medication and how it should be taken. The MHRA will assess any IMP prior to its release and the manufacturer is only permitted to promote it under their MA, except if they have a specific license to market paediatric medicines.
Off label prescribing is when a psychiatrist believes that it is appropriate to prescribe a medication for an adult, even though it was prescribed for a child. It is also possible to have"manipulated" products - in which the pharmacist makes up an individual formulation for the patient by mixing ingredients, as 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 complaining about the excessive prescribing of psychoactive drugs for mental health issues.
Licensing
In the UK there are various medicines that are approved to treat ADHD in adults. There are a number stimulant drugs, such as methylphenidate (Ritalin) and the more recent amphetamine-based medication lisdexamfetamine (Elvanse). These are typically offered to patients who have been diagnosed with the condition by a psychiatrist. The treatment is usually prescribed in the form of capsules and patients are closely monitored by their doctor to ensure that the right dose is found.
In addition to these medications in addition, there are a variety of other methods by which the condition can be treated and managed. For instance, behavioural therapy can assist patients in understanding the underlying causes of their symptoms and devise strategies to overcome these. Environmental modifications can also help people cope with the impact their symptoms affect their daily lives. This includes making seating arrangements at school or work and distributing cards that read "I Need a Break" and scheduling frequent movement breaks, as well as decreasing noise and distractions.
The medications that have been licensed in the UK to treat ADHD among adults aren't intended to cure but can improve the quality-of-life for many people. However, they are 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 pregnant potential undergoes an examination for pregnancy prior to starting medication and inform their GP immediately in the event that they are pregnant or plan to become pregnant. Patients should also talk to their GP for any side effects or if they do not believe they are benefiting from.
A national patient safety alert concerning the shortage of methylphenidate prolong-release tablets, extended-release guanfacine tablets and lisdexamfetamine capsules were released on September 27, 2023. It was replaced by an Medicine Supply Notification (MSN) on May 8, 2024. The MSN lifted restrictions on prescribing Elvanse capsules and advised ADHD services to resume initiations.
It is a Schedule 2 controlled drug so it must be prescribed by an accredited physician and is subject to the Misuse of Drugs Regulations 2001. The guidelines recommend that an ADHD patient be assessed annually by a healthcare professional with expertise and training in managing the disorder. This can be done in primary or secondary care, based on the local arrangement. The review should include monitoring 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 can not cure this condition. It can help to reduce behavioural symptoms and improve people's quality of life. It also helps improve learning, work and relationships.
It is important that anyone beginning treatment be aware of any possible side effects. They should discuss these with their doctor prior to beginning the medication. Side-effects can include a change in appetite, headaches, and sleeplessness. Certain medications can also raise the heart rate. This is usually harmless and mild, but it is important to inform your doctor if you have any history of heart disease or problems.
The effects of stimulants increase the levels of dopamine and norepinephrine in the brain. This changes the way the brain processes and transmits messages, improving concentration and attention. These are the first-line treatment of adult ADHD. Buproprion and Atomoxetine, which are medications that do not stimulate are more complex in their action on the brain. They also take longer to begin working. The latter block dopamine reuptake into nerve cells, and helps with concentration.
According to research, approximately half of the children diagnosed with ADHD will be free of symptoms in adulthood. It could be due to the fact that they manage their symptoms, or perhaps because they are less hyperactive. A large portion of them struggle with a society that is not designed for their needs. Nice suggests doctors prescribe ADHD medication only when they are needed and continue to keep track of their patients frequently.
There are a number of other methods to alleviate ADHD symptoms, such as lifestyle changes and psychoeducational therapies. These therapies can be utilized in conjunction with 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 associated with it. However, there is growing evidence that discussing the condition and raising awareness of its symptoms can help overcome barriers to treatment.