Adult ADHD Medication in the UK
In the UK, there are guidelines to diagnose ADHD among adults. In the course of the pandemics, referrals to the adult ADHD clinic quadrupled.
Non-stimulants and stimulants are both used to treat ADHD. Methylphenidate is a popular medication to treat the symptoms of ADHD as are two amphetamine-based medications known as dexamfetamine and Lisdexamfetamine.
Stimulants
The most common kind of medication used to treat adult ADHD is stimulants. They work by enhancing activity in the parts of the brain that control the behaviour and attention. They are quick-acting and are frequently the first choice to be considered by GPs. medication for adhd and anxiety is more commonly referred to as Ritalin, is the most frequently prescribed stimulant for adults as well as children.
This drug boosts the levels of neurotransmitters in the brain, which improves the quality of attention and reducing impulsivity and hyperactivity. It can also reduce depression and anxiety, which may co-occur with ADHD.
Throughout history, stimulant drugs are used for both medicinal purposes and recreationally, to enhance cognitive function, motivation, performance and mood. These include nicotine and caffeine amphetamines, modafinil, methylphenidate, and cocaine. These substances are used to suppress appetite and increase energy. However, they can also cause serious physical and psychological effects when taken excessively.
There are a number of different medications used to treat adults suffering from ADHD, and a psychiatrist will typically carefully adjust the dosages for each patient they visit. They will consider any other medical conditions patients may have, and the effect of the medication on their sleeping patterns. They will also consider the impact of the medication on the diet of a patient 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, commonly known as Adderall is more effective than any other stimulant at reducing the symptoms of ADHD. It is recommended by NICE, and it is available on prescription in the UK.
Despite the positive evidence that supports it, there is a certain stigma attached to the use of medications to treat ADHD, with unhelpful framings that compare it to child abuse and compare it to controlled substances. This may make some people not want to request an assessment, or to consider taking medications to treat their condition.
The number of adults being treated for ADHD increased as did the number of people referred to NHS psychiatrists during the COVID-19 epidemic. Adult ADHD referrals now outnumber those for children. Boys are still more likely to be referred for ADHD treatment however the number of women receiving it has quadrupled in the past two years.
Unlicensed Medication
A range of medicines are licensed for treating ADHD in children and adults with stimulant drugs such as methylphenidate, and occasionally the more recent amphetamine based medication lisdexamfetamine being prescribed. These drugs are classed as 'controlled' medications because they can be open to abuse and become addictive. Your consultant psychiatrist will only prescribe these drugs if he or believes that they are the most effective choice for your treatment. You will be given a written prescription that you can pick up at your local pharmacy. This will be for a month's supply the medication and your pharmacist should be able explain the procedure to you.
In certain situations your doctor might decide that the drugs they have available are not right for you and will recommend a medication that is not licensed. This is a decision which will be taken on a case-by-case basis. Your psychiatrist should only prescribe non-licensed drugs as a last option. It is crucial to remember that although medication is a key part of treatment for ADHD however, 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 license known as marketing authorisation (MA) that will define the specific health conditions it is approved for. This will include information about the age of people who can be prescribed the medication as well as the manner in which it must be administered. The MHRA will review any IMP before its release and the manufacturer is only permitted to market it under their MA, in the event that they do not have a special license to market paediatric medications.
This is the situation where a drug has been approved for a child however a psychiatrist decides it may be appropriate to prescribe it to an adult. This is also called off label prescribing. A'manipulated product' is possible, where a pharmacist mixes ingredients to make a formula for a patient who can't take tablets. Some psychiatrists have been critical of the over-prescription of psychoactive drugs to treat mental health issues, such as ADHD.
Licensing
In the UK, there are a range of medications that are licensed to treat ADHD in adults. This includes a range of stimulant drugs, such as methylphenidate (Ritalin) and the newer amphetamine-based medicine Lisdexamfetamine (Elvanse). They are usually prescribed to patients who have been diagnosed with the condition by a psychiatrist. The treatment is prescribed in capsules, and the patient must be closely monitored by their doctor in order to find the proper dosage.
In addition to these medications, there are a number of other ways in which the disease can be managed and treated. For example, behavioural therapies can help people understand the underlying causes of their symptoms and devise strategies to combat these. Environment-related changes can help people cope with the impact that their symptoms can affect their daily lives. This includes arranging seating arrangements at work or school, providing cards that say "I Need a Break" and scheduling frequent movement breaks, as well as making sure that there is less noise and distraction.
The medications that have been licensed in the UK to treat ADHD among adults are not intended to be a cure, but they can enhance the quality-of-life for many people. However, they aren't an all-purpose cure and should only be used as part of an integrated care package that includes psychiatric and psychoeducational care.
It is crucial that any patient with childbearing potential takes an examination for pregnancy prior to starting medication, and should inform their GP immediately if they become pregnant or wish to become pregnant. It is also recommended that patients consult their GP when they experience significant side-effects or do not believe they are getting the benefits from the medication.
On 27 September 2023, a nationwide patient safety alert was issued in relation to the lack of extended-release guanfacine tablets, tablets of lisdexamfetamine and methylphenidate tablets. On May 8, 2024 an Medicine Supply Notification was issued, which 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 every year by a healthcare professional who has the expertise and experience in managing the disorder. This can be done in primary care or secondary care, depending on local arrangements. The review should include monitoring for blood pressure and heart rate and a discussion of the need for ongoing treatment, as well as ongoing evaluation of symptoms and monitoring improvement.
Side Effects
ADHD medication is safe and generally well tolerated by adults, but it is not a cure for the condition. It can reduce behavioural symptoms and improve the quality of life for people. It can also enhance working, learning and relationships.
It is essential that anyone beginning treatment be aware of possible adverse side effects. They should discuss these with their physician prior to starting the medication. Some of the side effects include headaches, sleeplessness and changes in appetite. Certain medications may also increase the heart rate. It is usually harmless and mild, but it is important to tell your doctor if there is a history of heart disease or heart problems.
The effects of stimulants increase the levels dopamine and norepinephrine within the brain. This changes the way the brain receives and transmits messages, increasing focus and attention. These medications are first-line treatments of adult ADHD. Nonstimulant medicines like buproprion and atomoxetine are also available, but they perform more complex actions on the brain and take longer to start working. The latter block the reuptake and release of dopamine into nerve cells and helps with concentration.
Research suggests that around half of children diagnosed with ADHD grow out of their symptoms in adulthood. This may be because they learn to manage their symptoms or they are less active. Many of them are still struggling with a society not designed for their needs. Nice suggests doctors prescribe ADHD medications only when they are absolutely necessary and to continue to check on their patients on a regular basis.
There are other methods to treat ADHD symptoms. These include lifestyle changes and psychoeducational therapy. These therapies can be utilized together with medication to reduce the need to refer adults who suffer from ADHD to specialist services.
Many adults are hesitant to reveal to their family, friends or employers that they use ADHD medication due to the stigma that surrounds it. There is increasing evidence that speaking out about the disorder can help to break down barriers to treatment.