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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. Referrals to the adult ADHD specialist clinic quadrupled during the time of the pandemic. The medicines used to treat ADHD include stimulants as well as non-stimulants. Methylphenidate is the most common medication used to treat symptoms of ADHD and is accompanied by two amphetamine-based drugs known as dexamfetamine and Lisdexamfetamine. Stimulants The most popular type of medication used to treat adult ADHD is a stimulant. These medications increase the activity in the brain regions that control attention and behavior. They are fast-acting and are frequently the first choice that is considered by GPs. Methylphenidate (also called Ritalin) is the most commonly prescribed stimulant in both adults and children. This drug increases the levels of neurotransmitters in the brain, improving concentration and decreasing impulsivity and hyperactivity. It can also reduce anxiety and depression that can be a result of ADHD. In the past, stimulant drugs were used to enhance cognition, motivation, and performance. These include caffeine and nicotine, amphetamines cocaine, methylphenidate and modafinil. They also serve as appetite suppressants and energy boosters. They can have serious physical and mental side effects when taken in excessive amounts. There are many different medications used to treat adults with ADHD and psychiatrists will usually carefully titrate the dosages for each patient they visit. They will also take into consideration any other medical issues a patient may have, as well as the effects of the medication on their sleep patterns. They will also examine the impact of the medication on a patient's diet 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 Lisdexamfetamine (commonly called Adderall) is more effective than other stimulants at reducing symptoms of ADHD. It is recommended by NICE and is available in the UK with a prescription. Despite the evidence-based evidence that supports the use of medications for ADHD is still viewed as a stigma. Falsely framed arguments compare it to child abuse and controlled substances. This may make some people reluctant to ask for an assessment, or to consider taking medications to treat their condition. As the number of referrals to NHS psychiatry grew during the COVID-19 pandemic, so too did the number of adults being treated for ADHD. In fact the number of adult ADHD referrals have now surpassed those for children. Boys are still more likely to be referred, but the number of women who receive treatment for ADHD has quadrupled in the last two years. Unlicensed Medication There are many medications that are prescribed to treat ADHD in adults and children. These include stimulant medications such as methylphenidate, and occasionally the more recent amphetamine-based drug called lisdexamfetamine. These are classified as controlled medications due to the fact that they can be addictive and abused. Your doctor will prescribe them if they feel they are the best choice for you as part of your treatment. You will then be given an order to visit your local pharmacy and pick up. Your pharmacist will be able explain to you that this prescription is for an ongoing supply of the medication. In certain instances, your doctor might decide that the medicines they have available are not suitable for you and recommend an unlicensed drug. This will be a case by case decision, and your doctor should only recommend unlicensed medication as the last option. It is crucial to remember that although medication is an integral part of treatment for ADHD and ADD, therapy with a therapist is equally important. Medicine can aid in managing your symptoms, but therapy can help change the long-standing negative coping mechanisms and behaviour patterns. In the UK the medication used to treat ADHD among adults must have a marketing authorisation (MA), which specifies the specific conditions under which it's approved. This will include the ages of people who can be treated and how the medication should be administered. The MHRA will make an official evaluation of any IMP before it is released and the manufacturer is able to promote it under its MA, unless it has a special license for paediatric medicine. This is the situation where a drug is approved for use by a child, but a psychiatrist believes it's appropriate to prescribe it for an adult. This is also called off label prescribing. A “manipulated product” is a possibility when pharmacists mix ingredients to create a formulation for a patient who is unable to swallow tablets. There's a stigma around using non-licensed medications to treat ADHD in adults, with some psychiatrists criticising the over-prescribing of psychoactive drugs to treat mental health issues. Licensing In the UK there is various medications that are licensed to treat ADHD in adults. There are several stimulant medications, including methylphenidate (Ritalin), and the newest amphetamine-based medication lisdexamfetamine, (Elvanse). They are typically offered to patients who have been diagnosed with the condition after consulting a psychiatrist. adhd stimulant medication is typically prescribed in the form of capsules and patients are closely monitored by their doctor to ensure that the correct dose is found. There are other options to manage and treat the illness, in addition to medications. For example, behavioural therapy can help patients understand the cause of their symptoms and create strategies to combat the symptoms. In addition, environmental modifications are also helpful in helping people to cope with the impact of their symptoms on daily activities. This includes making seating arrangements at work or at school, providing cards that say “I Need a Break” and arranging frequent movement breaks, as well as making sure that there is less noise and distraction. The medicines that have been approved in the UK to treat ADHD among adults aren't meant to be a cure, but they can enhance the quality-of-life for many people. They are not a panacea and should only be a part of a holistic treatment plan that includes psychoeducation, psychiatric treatment and medications. It is essential that anyone with the potential of becoming pregnant undergoes a pregnancy test prior to beginning medication and inform their GP immediately in the event that they become pregnant or wish to become pregnant. It is also recommended that patients should see their GP in the event of significant side-effects or do not believe they are getting the benefits from the medication. On 27 September 2023, a national safety alert was issued about the lack of extended-release guanfacine tablets, lisdexamfetamine tablets and methylphenidate tablets. It was replaced by a Medicine Supply Notification (MSN) on May 8, 2024. The MSN lifted the restrictions on prescribing for Elvanse capsules and advised ADHD services to resume initiations. It is a Schedule 2 controlled drug so it must be prescribed by a registered physician and is subject to the Misuse of Drugs Regulations 2001. The guidelines recommend that an ADHD patient be evaluated annually by a healthcare professional who is knowledgeable and trained in managing the disorder. This can be performed in primary care or secondary care, based on local arrangements. This review should include a check for heart rate and blood pressure, a discussion about the continued need for treatment, as well as ongoing evaluation of symptoms and monitoring improvement. Side Effects ADHD medication is generally well tolerated and safe by adults. However, it can not cure this condition. It can reduce behavioural symptoms, and improve the quality of life for those suffering from the condition. It can also improve the quality of work, relationships and learning. Having said that, it's important for anyone starting treatment to be aware of the potential adverse effects and to discuss them with their doctor before they begin taking the medication. Some of the side effects include headaches, insomnia and an increase in appetite. Certain medications can increase heart rate. It is usually not a problem and is mild but it's important to tell your doctor if there is an history of heart disease or problems. The effects of stimulants increase the levels dopamine and norepinephrine within the brain. This alters the way that the brain receives and transmits messages, which improves focus and attention. They are considered to be the first-line treatment for adult ADHD. Non-stimulant drugs like buproprion and atomoxetine are also available, however they have more complex effects on the brain and take longer to begin working. The latter blocks the reuptake and release of dopamine into nerve cells and helps with concentration. According to research, approximately half of the children diagnosed with ADHD will overcome their symptoms by adulthood. This could be because they are able to manage their symptoms, or because they are less hyperactive. A large portion of them are still struggling with a society that is not built to meet their needs. Nice recommends doctors prescribe ADHD medications only when they are absolutely necessary and check on their patients regularly. There are other ways to treat ADHD symptoms. These include psychoeducational therapy and lifestyle changes. These can be utilized in conjunction with medications to decrease the need for GPs to refer people suffering from ADHD to specialist services. The stigma that surrounds ADHD can make it difficult to speak openly about the medication. Many adults are reluctant to admit the fact that they have ADHD to their family, friends or employers. But, there is growing evidence that discussing the disorder and raising awareness of its symptoms can help break down barriers to treatment.