Adult ADHD Medication in the UK
In the UK, there are guidelines to diagnose ADHD among adults. Referrals to the adult ADHD specialist clinic quadrupled during the time of the pandemic.
The medications used to treat ADHD comprise stimulants and non-stimulants. Methylphenidate is a popular medication to treat the symptoms of ADHD as are two amphetamine-based medicines known as dexamfetamine and Lisdexamfetamine.
Stimulants
The most common kind of medication used to treat adult ADHD is stimulants. They increase activity in the parts of the brain responsible for the behavior and attention. They are quick-acting and are typically the first option to be considered by GPs. Methylphenidate, more commonly known as Ritalin is the most commonly prescribed stimulant for adults and children.
This drug boosts the levels of neurotransmitters in the brain, improving concentration and decreasing hyperactivity and impulsivity. It can also decrease depression and anxiety which may be a co-morbidity with ADHD.
In the past, stimulant drugs were used to enhance cognitive function, motivation, and performance. They include nicotine, caffeine, amphetamines, cocaine, modafinil and methylphenidate. These substances are used to reduce appetite and boost energy levels. However, they can also have negative psychological and physical consequences if they are taken in large quantities.
There are a number of different medications that are used to treat adults with ADHD and psychiatrists will typically be careful to adjust the dosages for each patient they visit. They'll also consider any other medical issues a patient may have, as well as the effects 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 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 at reducing the symptoms of ADHD. It is recommended by NICE and is available on prescription in the UK.
Despite evidence-based research, the use of medication for ADHD is still viewed as a stigma. Falsely framed arguments make it appear like child exploitation and the use of controlled substances. This may cause people to be hesitant to seek an assessment or to even think about taking medication for their condition.
The number of adults treated for ADHD increased with the increase in the number referred to NHS psychiatry increased during the COVID-19 epidemic. Adult ADHD referrals are now more than those for children. Boys remain more likely to be referred, but the number of women seeking treatment for ADHD has quadrupled in the past two years.
Unlicensed Medication
There are many medications that are prescribed to treat ADHD in adults and children. These include stimulant drugs such as methylphenidate, and occasionally the more recent amphetamine-based medication Lisdexamfetamine. These drugs are classified as controlled medications because they are addictive and abused. Your doctor will prescribe them if they believe they are the best option for you as part of your treatment. You will then be given the prescription to visit your local pharmacy and pick up. Your pharmacist will be able explain to you that this is for a monthly supply of the drug.
In certain instances, your doctor might decide that the drugs that are available to them aren't suitable for you and suggest an unlicensed drug. This is a decision that is made on a case-by-case basis. Your doctor should only use nonlicensed medications as a last resort. It is crucial to remember that although medication is an integral part of treatment for ADHD, talking therapy is equally important. Therapy can change your coping mechanisms as well as behavior patterns. Medication can manage your symptoms.
Treatment for ADHD in adults has to be licensed in the UK, with a licence known as marketing authorisation (MA) that will define the health conditions it is approved for. This will include the ages of the people who are treated and the method by which the medication should be administered. The MHRA will make an official evaluation of any IMP before it is released, and the manufacturer can only promote it under its MA, unless it has a special licence for paediatric medicine.
This is where a medicine is 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. It is also possible to create a'manipulated product' - where the pharmacist creates an individual formulation for the patient by mixing ingredients, for instance when they are unable to swallow tablets. There can be a stigma around using non-licensed medications to treat ADHD in adults, with psychiatrists complaining about the excessive prescribing of psychoactive drugs for mental health problems.
Licensing
In the UK there is several medications that are licensed to treat ADHD in adults. There are several 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 given in capsules, and the patient should be closely monitored by their physician in order to find the appropriate dosage.
In addition to these medicines in addition, there are a variety of other ways that the disease can be treated and controlled. For example, behavioural therapies can help people understand the root causes of their symptoms and devise strategies to overcome these. Changes in the environment can also aid people in coping with the impact their ailments affect their daily lives. This includes arranging seating arrangements at work or school or at home, scheduling frequent breaks in movement, and distributing "I need a break" cards, and cutting down on distractions and noise.
The drugs that have been approved by the UK to treat ADHD among adults are not intended to be a cure, but they can enhance the quality of life for many. But, they're not a magic bullet and should only be used as part of an integrated care package that includes psychoeducation and psychiatric care.
It is essential that any patient of pregnant potential undergoes a pregnancy test before starting medication, and should inform their GP immediately if they become pregnant or want to become pregnant. It is also recommended that patients should see their GP if they experience any significant side effects or do not believe they are getting the benefits from the medication.
A national alert for patient safety concerning the shortage of methylphenidate prolong-release tablets, extended-release guanfacine tablets, and lisdexamfetamine capsules was released on September 27, 2023. This was replaced with a Medicine Supply Notification (MSN) on 08 May 2024 that lifted the restrictions on prescribing for Elvanse capsules and advised ADHD services to resume initiations.
It is a Schedule 2 controlled drug so it requires the prescription of an accredited practitioner and is subject to the Misuse of Drugs Regulations 2001. The guidelines suggest that anyone suffering from ADHD should be reviewed annually by a healthcare professional with training and expertise in managing the disorder, whether in primary or secondary treatment based on local arrangements. The review should include monitoring for blood pressure and heart rate and a discussion of the ongoing need for treatment, and continuous evaluation of symptoms and monitoring improvement.
Side Effects
ADHD medication is generally well-tolerated and safe for adults. However, it does not cure this condition. best adhd medication for adults can help reduce symptoms of behavioural, and improve the quality of life for people. It can also improve working, learning and relationships.
However, it's essential for anyone who is starting treatment to be aware of potential adverse effects and to discuss them with their physician prior to when they begin taking the medication. Some of the side effects include headaches, sleeplessness and a change in appetite. Some medications can increase heart rate. This is usually minor and harmless, but it is worth mentioning to your doctor if there is a previous history of heart issues or cardiovascular disease.
Stimulants increase levels of dopamine and norepinephrine in the brain. This alters the way the brain sends and receives messages, and increases concentration and attention. These medications are first-line treatments 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 start working. The latter block the reuptake of dopamine into nerve cells and aids in concentration.
According to research, around half of the children diagnosed with ADHD will overcome their symptoms by the time they reach adulthood. This could be because they learn to manage their symptoms, or because they become less active. A significant number of them are still struggling with a world that was not designed to meet their needs. That's why Nice suggests that doctors prescribe ADHD drugs only when they are needed and keep a close eye on patients.
There are other ways to treat ADHD symptoms. These include lifestyle changes and psychoeducational therapy. These can be used alongside medications to decrease the need for GPs to refer patients suffering from ADHD to specialist services.
The stigma that surrounds ADHD can make it difficult to speak openly about treatment and many adults are reluctant to disclose that they take it to family members, friends or employers. There is growing evidence that talking openly about the condition can help to break down barriers for treatment.