Adult ADHD Medication in the UK
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.
Both stimulants and non-stimulants are used to treat ADHD. Methylphenidate, dexamfetamine and Lisdexamfetamine are amphetamine-based medicines that help manage ADHD symptoms.
Stimulants
The most popular type of medication used to treat adult ADHD is a stimulant. They increase the activity of parts of the brain that regulate the behaviour and attention. They are quick-acting and often the first option considered by GPs. Methylphenidate (also called Ritalin) is the most frequently prescribed stimulant for adults and children.
The drug boosts neurotransmitter levels in the brain. It improves attention span, and decreases the amount of impulsivity and hyperactivity. It can also reduce anxiety and depression that may occur with ADHD.
In the past, stimulants were used to enhance cognition, motivation and performance. These include nicotine and caffeine amphetamines, modafinil, methylphenidate, cocaine and methylphenidate. These substances are used to suppress appetite and boost energy levels. However, they can cause serious physical and psychological effects if taken in excess.
There are a number of different medications that are used to treat adults with ADHD, and a psychiatrist will typically carefully adjust the doses on each person they visit. They will also consider any other medical conditions that a patient may have, and the impact of the medication on sleep patterns. They will also take into consideration the effects of medication on the patient's diet and lifestyle.
A massive meta-analysis of the network 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 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 compare it to child abuse and comparisons to controlled substances. This can make people hesitant to take a test or even consider taking medication to treat their condition.
The number of adults treated for ADHD increased as did the number referred to NHS psychiatry during the COVID-19 epidemic. Adult ADHD referrals now surpass those for children. Boys are more likely to be referred, however the number of women who receive treatment for ADHD has quadrupled in the last two years.
Unlicensed Medication
There are many medicines that can be prescribed to treat ADHD in both adults and children. These include stimulant medications like methylphenidate and the more recent amphetamine-based medicine lisdexamfetamine. These drugs are classed as controlled drugs because they can be open to abuse and can be addictive. Your doctor will prescribe these drugs if he or she believes they are the most effective solution for your treatment. You will then receive an order to go to a local pharmacy and pick up. This will be for a month's worth of the drug and your pharmacist will be able to explain the procedure to you.
In some instances, your doctor might decide that the medications that are available to them aren't suitable for you and recommend an unlicensed drug. This is an individual decision and your psychiatrist should only use unlicensed medication as a last resort. Be aware that although medication is a crucial component of treating ADHD and related disorders, therapy plays a significant role. Therapy can alter your coping mechanisms and behaviour patterns. Medication can manage your symptoms.
Treatment for ADHD in adults has to be licensed in the UK with a license known as marketing authorisation (MA) which will specify the health conditions it's approved for. This will include information on the age of people who are eligible to receive the medication and the method by which it should be taken. The MHRA will assess any IMP before its release and the manufacturer is permitted to market it under their MA, in the event that they do not have a special license to market paediatric medicines.
Off label prescribing is when a psychiatrist feels it is appropriate to prescribe a medicine for an adult even if it was prescribed for use by a child. A "manipulated product" is a possibility in the event that a pharmacist mixes ingredients to create a formula for a patient that is unable to swallow tablets. Some psychiatrists have criticized the over-prescription of psychoactive drugs to treat mental health issues, including ADHD.
Licensing
In the UK, there are a range of medicines that are approved to treat ADHD in adults. There are several stimulant drugs, such as methylphenidate, (Ritalin) and the newer 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 capsules and patients should be monitored carefully by their doctor to ensure that the correct dosage is identified.
There are other ways to treat and manage the condition, in addition to medications. For example, behavioural therapies can assist patients in understanding the underlying causes of symptoms and develop strategies to overcome these. Additionally, changes to the environment are also helpful in helping people deal with the impact of their symptoms on daily activities. This could include arranging seating arrangements at work or school and distributing cards that read 'I Need a Break' and arranging frequent movement breaks, as well as reducing noise and distractions.
The medications that have been approved by the UK to treat ADHD in adults aren't intended to cure, but they can enhance the quality of life for many. They are not a cure-all and should only be a part of a comprehensive care plan that includes psychoeducation, psychiatric treatment, and medication.
Patients who are able to bear children should take a pregnancy test prior to taking any medication. They should also inform their GP if they fall pregnant or want to become pregnant. Patients should also speak to their GP if there are any side effects or if they do not believe they are benefiting from.
On the 27th of September, 2023, a national patient safety alert was issued about the shortage of extended-release guanfacine tablets, tablets of lisdexamfetamine and methylphenidate tablets. On Read the Full Write-up , 2024, a Medicine Supply Notification was issued that lifted the restrictions on prescribing Elvanse capsules.
It is classified as a Schedule 2 drug, so it can only be prescribed by a registered doctor and is subject to the Misuse of Drugs Regulations of 2001. The guidelines recommend that an ADHD patient be evaluated annually by a healthcare provider who is knowledgeable and trained in managing the disorder. This can be performed in primary care or secondary care, based on local arrangements. The review should include monitoring for blood pressure and heart rate and a discussion of the need for ongoing treatment and ongoing evaluation of symptoms and monitoring improvement.
Side Effects
ADHD medication is generally safe and well accepted by adults, however it does not cure the condition. It can help reduce symptoms of behavioural disorder and improve quality of life. It can also aid in learning, work and relationships.
It's essential for anyone who is starting treatment to be aware of the potential adverse reactions and discuss them with their physician prior to when they begin taking the medication. Some of the side effects include a change in appetite, headaches, and sleeplessness. Some medications can increase heart rate. This is usually minor and harmless but is something to mention to your doctor if there is a prior history of heart problems or cardiovascular disease.
Stimulants increase levels of dopamine and norepinephrine in the brain. This alters the way that the brain receives and transmits messages, improving focus and attention. They are considered first-line treatments for adults suffering from ADHD. Nonstimulant medications such as buproprion and atomoxetine also available, however they have more complex effects on the brain and take longer to begin working. The latter block dopamine reuptake in nerve cells, and aids in enhancing concentration.
According to for beginners , around half of children diagnosed with ADHD will overcome their symptoms in adulthood. It could be because they manage their symptoms, or simply because they become less active. A large portion of them struggle with a society that is not designed to meet their needs. This is why Nice recommends doctors prescribe ADHD medications only when they are appropriate and to keep a close eye on patients.
There are many other methods to alleviate ADHD symptoms, such as lifestyle changes and psychoeducational therapies. These therapies can be used alongside medication to lessen the necessity of referring adults with ADHD to specialist services.
The stigma associated with ADHD can make it difficult to be open about medication and many adults are reluctant to disclose that they take it to family members, friends or employers. However, there is growing evidence that discussing the condition and raising awareness of its symptoms can help reduce barriers to treatment.