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Adult ADHD Medication in the UK In the UK In the UK, the NHS has guidelines for diagnosing ADHD in adults. In the course of the pandemics, referrals to the adult ADHD clinic quadrupled. The medications used to treat ADHD comprise stimulants and non-stimulants. Methylphenidate is the most commonly used medication used to treat symptoms of ADHD as are two amphetamine-based drugs called dexamfetamine and lisdexamfetamine. Stimulants Stimulants are among the most popular treatment for ADHD in adults. These medications work by increasing the activity in brain areas that regulate attention and behavior. They are quick-acting and are often the first choice for GPs. Methylphenidate, more commonly known as Ritalin is the most frequently prescribed stimulant for adults and children. This drug increases the levels of neurotransmitters in the brain, which improves the quality of attention and reducing hyperactivity and impulsivity. It also helps to reduce depression and anxiety that may be associated with ADHD. In the past, stimulant drugs were used to improve cognitive function, motivation, and performance. These include caffeine and nicotine, amphetamines modafinil, methylphenidate, and cocaine. These substances are used to control appetite and increase energy. However, they may also have serious physical and psychological consequences if they are taken in large quantities. A psychiatrist will be careful to adjust dosages for each patient. They will also take into consideration any other medical conditions a patient might be suffering from, and the impact of the medication on sleep patterns. They will also consider the effects of the medication on a patient's diet as well as lifestyle. A large meta-analysis of networks conducted by the NIHR Oxford Health Biomedical Research Centre and Stichting Eunethydis, has found that the drug called lisdexamfetamine (commonly referred to as Adderall) is more effective than other stimulants in reducing symptoms of ADHD. It is recommended by NICE and is available in the UK on prescription. Despite the evidence-based findings however, there's a stigma attached to the use of medication to treat ADHD, with unhelpful framings that compare it to child abuse, and even comparisons to controlled substances. This can make many people not want to request an assessment or to consider taking medication to treat their condition. The number of adults being treated for ADHD increased with the increase in the number of patients referred to NHS psychiatry increased during the COVID-19 epidemic. Adult ADHD referrals are now more than those for children. Boys are still more likely to receive ADHD treatment however, the number of women receiving it has quadrupled in the past two years. Unlicensed Medication A variety of drugs are licensed for treating ADHD in adults and children with stimulant drugs such as methylphenidate and sometimes the newer amphetamine-based medication lisdexamfetamine prescribed. These are classified as 'controlled' medications because they are prone to abuse and addictive. Your consultant psychiatrist will only prescribe these medications if he or believes that they are the most effective choice for your treatment. Then, you will be given a prescription which you can go to a local pharmacy and pick up. It is for a month's worth of the drug. Your pharmacist should be able explain it to you. In certain situations, your doctor may decide that the drugs they offer aren't suitable for you and recommend a medication that is not licensed. This is a decision which will be taken on a case-by-case basis. Your doctor should only use nonlicensed medications as a last option. It is crucial to remember that even though medication is an integral part of treatment for ADHD however, talking therapy is also essential. The use of medication can help manage your symptoms but therapy can also help you change longstanding negative coping mechanisms and behavioural patterns. Medication used to treat ADHD for adults must be licensed in the UK with a license known as marketing authorisation (MA) which will state the health conditions it is approved for. This will include information about the age of the people who can be prescribed the medication as well as the manner in which it must be administered. The MHRA will conduct an official assessment of any IMP before it is made available and the manufacturer is able to advertise it under its MA unless it holds an exclusive licence for paediatric medicine. Off label prescribing occurs when a psychiatrist believes that it is appropriate to prescribe a medicine for an adult, even though it was approved for use by a child. It is also possible to get”manipulated products” – where the pharmacist makes up an individual formulation for the patient by mixing ingredients, for example if they can't swallow tablets. Some psychiatrists have been critical of the excessive use of psychoactive drugs to treat mental health problems, including ADHD. Licensing In the UK, a number of treatments are available to treat ADHD among adults. There are a number stimulant medications such as methylphenidate (Ritalin), and the more recent amphetamine-based medication lisdexamfetamine (Elvanse). They are usually prescribed to patients who have been diagnosed with the condition by psychiatrists. The treatment is typically prescribed in capsules, and patients should be closely monitored by their doctor to ensure that the correct dosage is determined. There are other ways to treat and manage the condition, aside from medications. For example the use of behavioural therapy can help patients understand the cause of their symptoms and develop strategies to overcome these. Changes in the environment can also help people cope with the impact their ailments affect their daily lives. This could include arranging seating arrangements at work or school or at home, scheduling frequent breaks for movement and providing 'I need a break' cards, as well as making it easier to avoid the amount of distractions and noise. non prescription adhd medication that are licensed to treat ADHD in adults in the UK are not designed to be an effective cure, but they can greatly improve the quality of life for many people with the condition. But, they're not an instant cure, and should only be used as part of a holistic care plan that includes psychiatric and psychoeducational care. Patients who are able to bear children should take a pregnancy test prior to taking any medication. They should also inform their GP in the event that they fall pregnant or want to become pregnant. Patients should also talk to their GP for any side effects or if they don't think they are gaining. A national alert for patient safety concerning the shortage of methylphenidate prolonged-release tablets, extended-release guanfacine tablets and lisdexamfetamine capsules were released on September 27, 2023. On 8 May 2024, an Medicine Supply Notification was issued that lifted the restrictions on prescribing Elvanse capsules. managing adhd without medication 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 is evaluated annually by a healthcare provider who has the expertise and experience in managing the disorder. This can be done in primary care or secondary care, depending on the local arrangement. The review should include a monitoring of heart rate and blood-pressure, a discussion on the need for ongoing treatment, and ongoing monitoring and evaluation of symptom improvements. Side Effects ADHD medication is generally well-tolerated and safe by adults. However, it will not cure the condition. It can help reduce symptoms of behavioural and improve the quality of life of people. It can also aid in learning, work and relationships. However, it's essential for anyone who is starting treatment to be aware of the potential adverse reactions and discuss them with their doctor prior to when they begin taking the medication. Some of the side effects include headaches, sleeplessness and changes in appetite. Some medications can increase heart rate. This is usually mild and harmless, but is worth mentioning to your doctor if there is a prior history of heart problems or cardiovascular disease. Stimulants boost levels of dopamine and norepinephrine in the brain. This alters the way that the brain receives and transmits messages, enhancing attention and focus. They are regarded as the first line treatment for adult ADHD. Buproprion and Atomoxetine which are nonstimulant medications have a more intricate effect on the brain. They also take longer to start working. The latter is a drug that blocks dopamine reuptake in nerve cells, and aids in the improvement of concentration. Research suggests that half of children diagnosed with ADHD grow out of their symptoms as they grow older. It could be due to the fact that they manage their symptoms, or because they become less hyperactive. But a significant number continue to struggle in the society that was not made for them. This is why Nice recommends that doctors prescribe ADHD drugs only when they are necessary and continue to monitor patients regularly. There are other methods to treat ADHD symptoms. These include psychoeducational therapy and lifestyle changes. These can be used alongside medication to reduce the need for doctors to refer people suffering from ADHD to specialist services. The stigma associated with ADHD can make it difficult to open about treatment and many adults are reluctant to disclose that they take it to family members, friends or employers. But, there is growing evidence that talking about the condition and raising awareness of its symptoms can help to overcome barriers to treatment.