ADHD Medication For Adults in the UK
In the UK there are a variety of medications are approved to treat ADHD. This includes the stimulant methylphenidate as well as the amphetamine-based medication lisdexamfetamine. The exact dosage will need to be monitored closely in the beginning stages of treatment (titration) and then, once stable, prescriptions will be administered by your GP as part of a shared care arrangement.
What is a Licensed Medication?
A licensed medicine will have gone through all necessary clinical tests and trials and the MHRA (Medicines and Healthcare Products Regulatory Authority) has granted it approval to use it in Great Britain. The packaging of the medicine or the leaflet included with it will clearly state the appropriateness of the medicine for a specific condition. All licensed medications are regulated, even after they're on the market, meaning that any problems can be identified quickly and any risks reduced.
Some people with ADHD might be prescribed unlicensed drugs however they aren't often used on children and teenagers. The unlicensed medication could be used for other conditions which have been proven to be effective (known as off-label prescribing) or it could be a specific formula that isn't available on the market, like an oral liquid in place of a tablet or something free from certain additives. It may be an experimental medication that is being studied in the UK.
Experimental drugs are known as Investigational Medicinal Products (IMPs) or Medicines with a Marketing Authorisation (MIA)(IMP). These medicines have not been granted a license yet and can therefore only be sold on an order from a doctor. They'll have been through an assessment in a formal manner by the MHRA as part of the Early Access to Medicines Scheme (EAMS) and therefore pharmaceutical quality is assured.
There is a non-stimulant medication that is often prescribed for ADHD in the UK and Europe and that is Atomoxetine. This is a selective noradrenaline-reuptake inhibitor, and so is different from other ADHD meds. It increases noradrenaline, a chemical that aids in transmitting messages between nerve cells in the brain. This improves concentration and aids in controlling impulses. It is typically taken as a capsule every day or twice daily.
A psychiatrist is the only mental health professional who can diagnose ADHD in adults, and prescribe medications to treat it. adhd medication pregnancy is important to keep in mind that ADHD isn't a condition that can be treated with medication by itself. Therapy is often incorporated in treatment plans. Psychoeducation is a form of therapy which aids teens, children and adults comprehend their diagnosis, and the behavioural therapy, which helps teach methods to manage symptoms.
What is an Unlicensed Medication?
The term "unlicensed medicine" refers to medicines that are not licensed by the MHRA. It could be that the medication was not created by a UK-based business or was prescribed outside of the terms of licence (off-label). The GMC's guidance states that 'unlicensed medicines are usually used when a suitable licensed product is not available or a clinically effective treatment can't be found using the product with which the prescriber feels comfortable'.
The label of a medicine will specify the conditions it treats, as well as the age ranges that it is able to treat. It will also indicate how it should be taken and by whom. The MHRA only issues a licence if it is deemed safe and effective for that specific use, based upon clinical trials and medical research. The drug manufacturers are not allowed promote or advertise any uses that are not covered by the licence.
In the UK it is not illegal for healthcare professionals to prescribe unlicensed medicine provided that the patient is aware of the potential risks and benefits. They must also keep records of the use of medications that are not licensed and provide the patient with enough information to make an informed decision on whether or not to accept the.
Unlicensed medications are often offered in hospitals, as there is more experience using these medications than in GP clinics. The hospital will follow procedures to ensure the safety and efficacy of the medication. This includes keeping detailed patient records, and also noting any adverse effects. They must follow MHRA guidelines on the safe supply unlicensed medicine.
Doctors who prescribe specials must to be transparent with patients and their parents or caregivers about the nature of the medication, why it is being used and the potential negative side consequences. They should be able to answer any questions asked, and should always provide written information about any medication they prescribe, and the reason for prescribing it.
What is an Shared Care Agreement?
In recent years as the number of adults suspected of having ADHD increased, so did the requests for a referral to the NHS for an assessment and treatment to treat the condition. The waiting lists for NHS assessments are long and this means that many patients are opting to pay for their own private ADHD assessments at specialist private clinics. The hope is that after a diagnosis has been confirmed through this process, the GP will sign an agreement of shared care (SCA).
A SCA is a contract between your psychiatrist and your GP which means that the responsibility for prescribing medication, monitoring, and basic health checks are transferred to your GP. This is a recognized and agreed method of transferring the responsibility of managing a patient with ADHD from a hospital or specialist service setting to general practice, provided it is in line with NHS England guidelines.
Before responsibility is transferred the specialist and GP must agree on the SCA guidelines and this should be clearly stated in any referral form. It should also be clarified that the GP retains responsibility for regular monitoring and titration of the medication.
Unfortunately, a large number of GPs are not able to accept SCAs. This isn't because they are not interested, but rather that the work involved in SCAs isn't part of their regular funding.
The doctor must be informed of the rationale for SCA, the expectations of all parties involved, as well as the role of the patients and their caregivers. It should also be clear that the decision to participate in SCA must be made by the doctor who initiated treatment and the doctor should be informed if they are not willing to take part in the SCA.
If a GP refuses to accept the responsibility for SCA, they can refuse. However, this may result in patients being sent back to the private ADHD clinic and psychiatrist who made their initial diagnosis. This could result in prescriptions for medication being issued privately, rather than through the NHS, which of course can be more costly.
What is a Titration Period?
The tration stage is a crucial step to determine the best medication for ADHD. It is the process of gradually increasing your dosage until you reach a level that maximises the benefits while minimizing side effects. It is an process that takes time. Your healthcare professional must collaborate closely with you to ensure that the titration procedure is as effortless as it can be.
Certain patients may experience worsening of their symptoms during the titration phase. People who are hyperactive, for instance might become restless and angry. This is why it is vital that loved ones are aware of any changes and offer support. To minimize the adverse effects from ADHD medication it is essential to maintain a healthy lifestyle and a regular sleeping schedule.
Medication isn't the sole treatment for ADHD, but it is typically suggested as the first line of management in adults. Talk therapy can be an effective tool to deal with anxiety and depression, which can be the cause of certain symptoms of ADHD. It is important to remember that medication can only treat the symptoms, and not alter long-standing negative coping mechanisms. Some patients choose not to take any medication and instead concentrate on self-help techniques such as fitness, nutrition and stress reduction.
It is crucial to know the side effects and how they will affect your body. Certain medications can cause headaches or drowsiness and also reduce appetite. Make sure to always take your meds as directed and consult your doctor if you notice any adverse reactions.
Today, many of the drugs used to treat adult ADHD are out of stock. This has caused delays in the diagnosis process and a backlog in appointments with psychiatrists. NHS England has set up an taskforce to study the issue and suggest ways to reduce the time spent waiting for medication.
Ask your local GP what options are available for you. You may be able get the same medication privately or they could suggest alternatives that provide similar results.