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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. Non-stimulants and stimulants can both be used to treat ADHD. Methylphenidate is the most commonly used medication used to treat symptoms of ADHD as are two amphetamine-based medications called dexamfetamine and lisdexamfetamine. Stimulants The most commonly used kind of medication used to treat adult ADHD is stimulants. These drugs work by increasing the activity in the brain regions that regulate behavior and attention. They are quick-acting and are often the first option to be considered by GPs. Methylphenidate is also known as Ritalin is the most frequently prescribed stimulant for adults and children. This drug increases neurotransmitter levels in the brain. It increases concentration and decreases the amount of impulsivity and hyperactivity. It can also reduce depression and anxiety that may occur with ADHD. In the past, stimulants were used to boost cognition, motivation and performance. They include nicotine, caffeine amphetamines, cocaine modafinil and methylphenidate. These substances are used to control appetite and increase energy. However, they can also cause serious physical and psychological effects when taken excessively. A psychiatrist will carefully adjust the doses for each patient. They'll also consider any other medical issues a patient may have, and the effects of the medication on their sleep patterns. They will also look at the impact of the medication on a patient's diet as well as lifestyle. A large network meta-analysis, conducted by the NIHR Oxford Health Biomedical Research Centre and Stichting Eunethydis, has found that the drug Lisdexamfetamine (commonly known as Adderall) is more efficient than other stimulants in decreasing symptoms of ADHD. It is recommended by NICE and is available for prescription in the UK. 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 exploitation and controlled substances. This can make many people not want to request an assessment, or even to consider taking medication for their condition. The number of adult patients treated for ADHD increased with the increase in the number referred to NHS psychiatrists during the COVID-19 epidemic. Adult ADHD referrals now surpass those for children. Boys are still more likely to be referred, however the number of women receiving treatment for ADHD has quadrupled over the past two years. Unlicensed Medication There are a variety of medications that are prescribed to treat ADHD in both adults and children. These include stimulant medications such as methylphenidate, and occasionally the more recent amphetamine-based drug lisdexamfetamine. These are classified as controlled medications because they are addicting and addictive. Your doctor will prescribe them if they think they are the most appropriate choice for you as part of your treatment. You will then be given an order to visit your local pharmacy and pick up. It is for a month's supply the drug. Your pharmacist should be able to explain the procedure to you. In certain instances, your doctor might decide that the drugs available to them are not suitable for you and suggest an unlicensed medication. This is a choice that is made on an individual basis. Your doctor should only recommend non-licensed medications as a last resort. Be aware that although medication is a crucial component of treating ADHD however, talking therapy also plays a crucial role. Therapy can change your coping mechanisms as well as behavior patterns. Treatment with medication can alleviate your symptoms. In the UK medications used to treat ADHD among adults must have a marketing authorisation (MA), which specifies the conditions under which it's approved. This includes the ages of the people who are treated and the method by which the medication should be administered. The MHRA will assess any IMP prior to its launch and the manufacturer is only permitted to market it under their MA, unless they have a special license to market paediatric medicines. This is where a medicine is approved for children but a psychiatrist believes it may be 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, for instance when they are unable to swallow tablets. Some psychiatrists have criticized the excessive use of psychoactive drugs to treat mental health problems, including ADHD. Licensing In the UK there is several medicines that are approved to treat ADHD in adults. This includes a range of stimulant medicines such as methylphenidate (Ritalin) and the newer amphetamine-based medication called lisdexamfetamine (Elvanse). Typically, these are offered to patients who have been diagnosed with the condition after consulting with a psychiatrist. The treatment is prescribed in capsules, and patients must be closely monitored by their physician to determine the appropriate dosage. In adhd stimulant medication to these medications, there are a number of other ways in which the disease can be managed and treated. For example the use of behavioural therapy can help individuals to understand the causes of their symptoms and to develop strategies to overcome them. In addition, environmental modifications can also be useful in helping people cope with the effects of their symptoms on daily activities. This could include setting up seating arrangements at work or school and distributing cards that read “I Need a Break” and scheduling frequent movement breaks, as well as decreasing noise and distractions. The medications that are licensed to treat ADHD in adults in the UK are not intended as an effective cure, but they can greatly improve the quality of life of many people who suffer from the condition. However, they are not a magic bullet and should only be used as part of an integrated care package that includes psychiatric and psychoeducational care. Patients with childbearing capacity should undergo an examination for pregnancy prior to taking any medication. They must also inform their GP in the event that they fall pregnant or are planning to fall pregnant. It is also recommended that patients consult their GP in the event of significant side effects or do not believe they are getting the benefits from the medication. On the 27th of September, 2023, a national patient safety alert was issued regarding the lack of extended-release guanfacine tablets, lisdexamfetamine tablets and methylphenidate tablets. It was replaced by an Medicine Supply Notification (MSN) on May 8, 2024. It lifted restrictions on prescribing Elvanse capsules and urged ADHD services to resume initiations. It is a Schedule 2 controlled drug so it must be prescribed by a registered doctor and is subject to the Misuse of Drugs Regulations 2001. The guidelines recommend that an ADHD patient is evaluated annually by a healthcare professional who has the expertise and experience in managing the disorder. This can be done in primary or secondary care, based on local arrangements. The review should include monitoring for heart rate and blood pressure, a discussion about the need for ongoing treatment, as well as ongoing evaluation of symptoms and monitoring improvement. Side Effects ADHD medication is safe and generally tolerated by adults, but it is not a cure for the condition. It can help reduce symptoms of behavioural and improve the quality of life for those suffering from the condition. It can also enhance working, learning and relationships. However, it's crucial for anyone considering treatment to be aware of the potential adverse reactions and discuss them with their doctor prior to when they start taking the medicine. Some of the side effects include changes in appetite, headaches and sleepiness. Certain medications can increase heart rate. It is usually harmless and mild but it's important to tell your doctor if you have a history of heart disease or problems. The effects of stimulants increase the levels of dopamine and norepinephrine in the brain. This alters the way the brain processes and transmits messages, increasing focus and attention. These are the first-line treatment of adult ADHD. Atomoxetine and Buproprion, which are nonstimulant medications have a more intricate effect on the brain. They also take longer to start working. The latter block the reuptake of dopamine by nerve cells, which aids in concentration. Research suggests that about half of children diagnosed with ADHD grow out of their symptoms in adulthood. It could be due to the fact that they manage their symptoms or simply because they become less hyperactive. A significant number of them are still struggling with a world that was not designed for their needs. Nice recommends that doctors prescribe ADHD medications only when they are absolutely necessary and continue to keep track of their patients regularly. There are a variety of alternatives to treat ADHD symptoms, such as psychoeducational therapies and lifestyle changes. These therapies can be utilized alongside medication to lessen the need to refer adults who suffer from ADHD to specialist services. The stigma attached to ADHD can make it difficult to open about medication and many adults are hesitant to reveal that they are taking it to their friends, family or employers. However, there is growing evidence that discussing the disorder and promoting awareness of its symptoms can help to break down barriers to treatment.