Adult ADHD Medication in the UK
In the UK there are guidelines for diagnosing ADHD in adults. During the pandemic, the number of referrals to the adult ADHD clinic quadrupled.
The medications used to treat ADHD comprise stimulants and non-stimulants. Methylphenidate, dexamfetamine and Lisdexamfetamine are three amphetamine-based drugs that aid in managing ADHD symptoms.
Stimulants
The most commonly used type of medication used to treat adult ADHD is a stimulant. These work by increasing the activity of parts of the brain responsible for attention and behaviour. They are quick-acting and often the first option considered by GPs. Methylphenidate is also known as Ritalin is the most widely prescribed stimulant for adults and children.
This drug increases neurotransmitter levels in the brain. It increases attention span, and decreases the amount of impulsivity and hyperactivity. It can also help reduce depression and anxiety, which may be a co-morbidity with ADHD.
Throughout history, stimulant drugs are used for both medicinal purposes and recreationally, to enhance performance, motivation, cognition and mood. These include nicotine and caffeine amphetamines, modafinil, methylphenidate, and cocaine. These substances are used to suppress appetite and increase energy levels. However, they can also have severe psychological and physical effects if taken in excess.
There are a number of different drugs used to treat adults suffering from ADHD, and a psychiatrist will typically carefully adjust the dosages for each patient they see. They will take into account any other medical issues the patient might have, as well as the impact of the medication on their sleep 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 other stimulant in reducing symptoms of ADHD. It is recommended by NICE and is available in the UK with a prescription.
Despite the evidence-based evidence, the use of medication for ADHD is still stigmatized. Ineffective framings refer to it as child abuse and controlled substances. This may cause people to be hesitant to seek an assessment or to even consider taking medication for their condition.
The number of adult patients treated for ADHD increased as the number of people referred to NHS psychiatrists during the COVID-19 epidemic. Adult ADHD referrals are now more than those for children. Boys are still more likely to receive ADHD treatment, but the number women who receive it has quadrupled in just the last two years.
Unlicensed Medication
There are a variety of medications that are prescribed to treat ADHD in both adults and children. These include stimulant drugs like methylphenidate and the more recent amphetamine-based drug Lisdexamfetamine. These drugs are classed as 'controlled' medications because they are susceptible to abuse and addictive. Your consultant psychiatrist will only prescribe these medications if he or she believes they are the most effective choice for your treatment. You will be provided with a written prescription that you can get at your local pharmacy. This will be for a month's worth of the drug and your pharmacist should be able explain it to you.
In certain instances, your doctor might decide that the drugs they have available are not suitable for you and suggest an unlicensed medication. This will be an individual decision, and your doctor should only recommend unlicensed medication as the last option. It is important to keep in mind that although medication is an integral part of treatment for ADHD, talking therapy is also essential. Therapy can change your coping mechanisms and behaviour patterns. The use of medication can help manage your symptoms.
The medication used to treat ADHD in adults has to be licensed in the UK with a license known as marketing authorisation (MA) which will state the specific health conditions it's approved for. This will include the ages of those who can be treated and how the medication should be administered. The MHRA will evaluate 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 licence to market paediatric medicines.
Off label prescribing occurs when a psychiatrist believes it is appropriate to prescribe a medication for an adult even though it was prescribed for children. It is also possible to create"manipulated products" - where the pharmacist makes up an individual formulation for the patient by mixing ingredients, for example when they are unable to swallow tablets. Some psychiatrists have criticized the excessive use of psychoactive drugs to treat mental health issues, including ADHD.
Licensing
In the UK There are many medicines are available to treat ADHD among adults. adhd medications includes a variety of stimulant medications, including methylphenidate (Ritalin) and the more recent amphetamine-based drug called lisdexamfetamine (Elvanse). They are usually prescribed to patients who have been diagnosed with the condition by psychiatrists. The treatment is prescribed in capsules and the patient must be closely monitored by their doctor to determine the right dosage.
There are other ways to treat and manage the illness, in addition to medications. For instance, behavioural therapies can help people understand the causes of symptoms and develop strategies to overcome these. Additionally, changes to the environment can also be useful in helping people cope with the impact of their symptoms on day-to-day activities. This could include arranging seating arrangements at school or at work or at home, scheduling frequent breaks in movement, and distributing 'I need a break' cards, as well as reducing the amount of distractions and noise.
The medications that are licensed to treat ADHD in adults in the UK are not intended to be a cure, but they can significantly improve the quality of life of many people with the condition. They are not a cure-all and should only form part of a comprehensive care plan that includes psychoeducation, psychiatric treatment, and medications.
Patients who are able to bear children should take a pregnancy test prior taking any medication. They should also inform their GP if they fall pregnant or are planning to fall pregnant. It is also recommended that patients should visit their GP if they experience any serious side-effects or don't believe they are getting the benefits from the medication.
On 27 September 2023, a national safety alert was issued regarding the shortage of extended-release guanfacine tablets, tablets of lisdexamfetamine and methylphenidate tablets. On 8 May 2024, a Medicine Supply Notification was issued, which lifted the prescribing restrictions on Elvanse capsules.
It is an Schedule 2 drug, so it can only be prescribed by a registered physician and is subject to the Misuse of Drugs Regulations of 2001. The guidelines suggest that people suffering from ADHD is reviewed annually by a healthcare professional who has training and experience in managing the disorder, either in primary or secondary care based on local arrangements. This review should include monitoring for heart rate and blood pressure as well as a discussion on the ongoing need for treatment, as well as ongoing monitoring and evaluation of symptom improvement.
Side Effects
ADHD medication is safe and generally well accepted by adults, however it does not cure the condition. It can help to reduce symptoms of behavioural disorders and improve quality of life. It can also help with working, learning and relationships.
It is essential that anyone beginning treatment be aware of any possible adverse side effects. They should discuss them with their doctor prior to beginning the medication. The side effects can include a change in appetite, headaches and sleeplessness. Some medications can increase heart rate. It is generally harmless and not harmful, but it is important to tell your doctor if you have any history of heart disease or issues.
Stimulants boost levels of norepinephrine and dopamine in the brain. This alters the way that the brain processes and transmits messages, increasing focus and attention. These are the first-line treatment of adult ADHD. Buproprion and Atomoxetine, which are medications that do not stimulate are more complex in their effect on the brain. They also take longer to start working. The latter works by blocking dopamine reuptake by nerve cells and assists in enhancing concentration.
According to research, around half of the children diagnosed with ADHD will grow out of symptoms by adulthood. It could be because they manage their symptoms, or perhaps because they are less active. A significant number of them struggle with a society not built to meet their needs. Nice suggests doctors prescribe ADHD medication only when they are needed and to continue to keep track of their patients frequently.
There are many other options to treat ADHD symptoms. These include psychoeducational therapy and lifestyle changes. These can be utilized in conjunction with medication to reduce the need for doctors to refer patients suffering from ADHD to specialist services.
Many adults are hesitant reveal to their family, friends or employers that they are taking ADHD medication because of the stigma that surrounds it. But, there is growing evidence that discussing the disorder and raising awareness of its symptoms can help to reduce barriers to treatment.