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Adult ADHD Medication in the UK In the UK in the United Kingdom, 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 include stimulants and non-stimulants. Methylphenidate is a popular medication used to treat symptoms of ADHD, along with two amphetamine-based drugs known as dexamfetamine and Lisdexamfetamine. Stimulants Stimulants are among the most popular treatment for ADHD in adults. These medications work by increasing the activity of brain regions that control attention and behavior. They are fast-acting and are often the first option considered by GPs. Methylphenidate is more commonly referred to as Ritalin is the most widely prescribed stimulant for adults as well as children. This medication increases the amount of neurotransmitters in the brain, thereby improving concentration and decreasing hyperactivity and impulsivity. It can also reduce depression and anxiety that may be associated with ADHD. In the past, stimulants were used to boost cognition, motivation, and performance. These include caffeine and nicotine amphetamines cocaine, methylphenidate and modafinil. These substances are used to suppress appetite and boost energy. However, they may cause severe psychological and physical effects when taken excessively. A psychiatrist will take care to adjust the doses for each patient. They will consider any other medical conditions that patients may have, and the effect of the medication on their sleeping patterns. They will also consider the effects of the medication on the diet of a patient and lifestyle. A large network meta-analysis carried out by the NIHR Oxford Health Biomedical Research Centre and Stichting Eunethydis, has found that the drug called lisdexamfetamine (commonly called Adderall) is more effective than other stimulants at reducing symptoms of ADHD. It is recommended by NICE and is available on prescription in the UK. Despite the evidence-based research however, there's a stigma that surrounds the use of medication to treat ADHD that is based on unhelpful framings that make it appear like child abuse and comparisons to controlled substances. This may cause people to be hesitant to take a test or even consider taking medication to treat their condition. The number of adults being treated for ADHD increased with the increase in the number referred to NHS psychiatry during the COVID-19 epidemic. Adult ADHD referrals now outnumber those for children. Boys are more likely to be referred, however the number of women seeking treatment for ADHD has quadrupled over the past two years. Unlicensed Medication A variety of medications are approved to treat ADHD for children and adults, with stimulant drugs like methylphenidate, and occasionally the more recent amphetamine based medication lisdexamfetamine being prescribed. These are classified as controlled drugs because they are addictive and abuse. Your consultant psychiatrist will only prescribe them if they feel they are the best option for you as part of your treatment. You will be given a written prescription that you can pick up at the local pharmacy. It will be for a month's supply of the medication and your pharmacist will be able to explain the procedure to you. In some instances, your doctor may decide that the medicines they have available are not suitable for you and recommend an unlicensed medicine. This is a decision which will be taken on a case-by-case basis. Your psychiatrist should only recommend non-licensed medications as a last resort. It is important to keep in mind that even though medication is a crucial component of treatment for ADHD however, talking therapy is also essential. Medication can help to manage your symptoms but therapy can also help you change longstanding negative coping mechanisms and behavior patterns. Medication used to treat ADHD in adults must be licensed in the UK and have a license known as marketing authorisation (MA) that will define the health conditions it's approved for. It will also 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 conduct an official assessment of any IMP before it is released, and the manufacturer is able to promote it under its MA, unless it has an exclusive license for paediatric medicine. This is where a medicine has been 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 have”manipulated products” – where the pharmacist creates an individual formulation for the patient by mixing ingredients, as in the event that they are unable to take tablets. Some psychiatrists have voiced their displeasure at the over-prescription of psychoactive medications to treat mental health problems, including ADHD. Licensing In the UK there are a variety of treatments are available to treat ADHD among adults. This includes a variety of stimulant medications, including methylphenidate (Ritalin) and the newest amphetamine-based medication called lisdexamfetamine (Elvanse). Typically, these are offered to patients diagnosed with the condition following consultation with a psychiatrist. The treatment is usually prescribed in capsules and patients should be closely monitored by their doctor to ensure that the appropriate dosage is identified. There are other ways to manage and treat the condition, in addition to medications. For example the use of behavioural therapy can help patients understand the cause of their symptoms and come up with strategies to manage the symptoms. Additionally, changes to the environment are also helpful in helping people to cope with the effects of their symptoms in daily activities. This can include organising seating arrangements at school or at work, arranging for frequent breaks in movement, and distributing “I need a break” cards, as well as cutting down on 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 can greatly improve the quality of life of many people who suffer from the condition. They aren't a cure-all and should only form part of a comprehensive care plan that includes psychoeducation, psychiatric treatment and medications. It is essential that anyone with the potential of becoming pregnant undergoes an examination for pregnancy prior to starting medication and inform their GP immediately if they are pregnant or plan to become pregnant. Patients should also consult their GP in the event of any adverse effects or if they don't feel they are benefiting. A national patient safety alert concerning the shortage of methylphenidate prolonged-release tablets, guanfacine extended release tablets, and lisdexamfetamine capsules was issued on the 27th of September, 2023. On May 8, 2024 a Medicine Supply Notification was issued, which lifted the restrictions on prescribing Elvanse capsules. It is an Schedule 2 drug, so it is only prescribed by a registered doctor and is subject to the Misuse of Drugs Regulations of 2001. The guidelines recommend that an ADHD patient be assessed 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, based on the local arrangements. This review should include monitoring of blood pressure and heart rate, a discussion on the need for continued treatment, and continuous evaluation and monitoring of symptom improvement. Side Effects ADHD medication is generally safe and well accepted by adults, but it does not cure the condition. It can help reduce symptoms of behavioural disorder and improve quality of life. It can also help with learning, work and relationships. It is important that anyone who is beginning treatment be aware of any possible side effects. They should discuss these with their doctor prior to taking the medication. Side-effects can include a change in appetite, headaches, and sleepiness. Certain medications can increase heart rate. This is usually not a problem and is mild but it's worth telling your doctor if you have an history of heart disease or issues. The effects of stimulants increase the levels of dopamine and norepinephrine in the brain. This alters the way that the brain receives and transmits messages, and increases concentration and attention. These drugs are the first line treatment of adult ADHD. Nonstimulant medications such as buproprion and atomoxetine are available, but they have more complex effects on the brain and take longer to start working. The latter block dopamine reuptake into nerve cells, and helps with 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 develop coping skills to manage their symptoms, or because they become less active. A large portion of them continue to struggle with a world that was not built to meet their needs. Nice suggests doctors prescribe ADHD medication only when they are absolutely necessary and check on their patients frequently. There are a number of other methods to alleviate ADHD symptoms, such as psychoeducational and lifestyle modifications. These therapies can be utilized in conjunction with medications to decrease the need to refer adults with ADHD to specialist services. The stigma attached to ADHD can make it difficult to open about medication and many adults are reluctant to admit that they are taking it to their friends, family or employers. But, there is growing dealing with adhd without medication that talking about the disorder and raising awareness of its symptoms can help to break down barriers to treatment.