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Adult ADHD Medication in the UK In the UK, the NHS has guidelines for diagnosing ADHD in adults. During the pandemic, referrals to the adult ADHD clinic quadrupled. 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 popular type of medication used to treat adult ADHD is stimulants. These work by increasing the activity of parts of the brain that control the behavior and attention. They are quick-acting and are frequently the first choice of GPs. Methylphenidate, more commonly known as Ritalin, is the most widely prescribed stimulant for adults and children. This drug boosts the levels of neurotransmitters in the brain, improving concentration and decreasing hyperactivity and impulsivity. inattentive adhd medication can also reduce depression and anxiety, which may co-occur with ADHD. Through time, stimulant drugs are used for both medicinal purposes and for recreational purposes, to enhance performance, motivation, cognition, and mood. These include nicotine and caffeine amphetamines, modafinil, methylphenidate, and cocaine. They also serve for appetite suppressants and energy boosters. They may have serious physical and mental adverse effects when used in excessive amounts. A psychiatrist will be careful to adjust dosages for each patient. They will also consider any other medical conditions that a patient might be suffering from, and the effect of the medication on their sleep patterns. They will also consider the effects of the medication on the diet of a patient and lifestyle. A large network meta analysis, conducted by NIHR Oxford Health Biomedical Research Centre (NIHR Oxford Health Biomedical Research Centre) and Stichting Eunethydis has found that Lisdexamfetamine, more commonly referred to as Adderall is more effective than any other stimulant at reducing the symptoms of ADHD. It is recommended by NICE and is available in the UK on prescription. Despite the evidence-based evidence that supports the use of medications for ADHD is still stigmatized. Unhelpful framings refer to it as child exploitation and the use of controlled substances. This can cause people to be reluctant to take a test or even consider taking medication for their condition. The number of adult patients treated for ADHD increased with the increase in the number of patients referred to NHS psychiatrists during the COVID-19 epidemic. In fact adults' ADHD referrals have now overtaken those for children. Boys remain more likely to be referred, but the number of women receiving treatment for ADHD has quadrupled over the last two years. Unlicensed Medication There are a variety of medicines that can be prescribed to treat ADHD in adults and children. These include stimulant medications like methylphenidate and the more recent amphetamine-based medication Lisdexamfetamine. These drugs are classed as controlled medications since 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 option for your treatment. Then, you will be given a prescription which you can take to your local pharmacy and pick up. Your pharmacist will explain to you that this prescription is for a monthly supply of medication. In certain instances your doctor might decide that the drugs they have available are not suitable for you and recommend an unlicensed medication. This is a choice that will be made on a case-by-case basis. Your psychiatrist should only prescribe non-licensed drugs as a last option. It is important to remember that even though medication is an integral part of treatment for ADHD, talking therapy is equally important. Medication can help to manage your symptoms, but therapy can work at changing long-standing negative coping mechanisms as well as behavioural patterns. In the UK the medication used to treat ADHD in adults must be accompanied by a marketing authorisation (MA), which specifies the specific conditions for which it's approved. This will include the age of the people who are treated and how the medication should be taken. The MHRA will conduct an official evaluation of any IMP before it is made available and the manufacturer can only advertise it under its MA, unless it has a specific licence for paediatric medicine. This is where a medicine is approved for a child however a psychiatrist decides it may be appropriate to prescribe it for an adult. This is also called off label prescribing. A'manipulated product' is possible, where a pharmacist mixes ingredients to make a formula for a patient who is unable to swallow tablets. There is a stigma around using unlicensed medications to treat ADHD in adults, with psychiatrists criticising the over-prescribing of psychoactive medications for mental health issues. Licensing In the UK, there are a range of medicines that are approved to treat ADHD in adults. There are many stimulant medications such as methylphenidate, (Ritalin), and the newer amphetamine based medication lisdexamfetamine (Elvanse). Typically, they are given to patients suffering from the condition after consulting with a psychiatrist. The treatment is given in capsules and the patient must be closely monitored by their doctor to determine the right dosage. There are other methods to treat and manage the condition, aside from medication. For instance the use of behavioural therapy can help patients understand the cause of their symptoms as well as create strategies to combat these. Changes in the environment can also aid in reducing the impact that their symptoms can have on their day-to-day lives. This can include organising seating arrangements at work or school and arranging for frequent breaks for movement and providing “I need a break” cards, and making it easier to avoid distractions and noise. The medications that have been approved in the UK to treat ADHD among adults aren't intended to cure but can improve the quality-of-life for many people. They are not a panacea and should only be a part of a comprehensive treatment plan that includes psychoeducation, psychiatric treatment, and medications. Patients who are pregnant should take a pregnancy test prior to starting any medication. They should also inform their GP when they become pregnant or are planning to fall pregnant. Patients should also consult their GP for any side effects or if they don't believe they are benefiting from. On the 27th September 2023, a national safety alert was issued in relation to 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 prescribing restrictions for Elvanse capsules and advised ADHD services to resume initiations. It is classified as a 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 suggest that anyone suffering from ADHD should be evaluated every year by a healthcare professional with training and expertise in managing the disorder, either in primary or secondary care depending on the local arrangement. This review should include monitoring of heart rate and blood-pressure, a discussion on the need to continue treatment, and continuous monitoring and evaluation of symptom improvements. Side Effects ADHD medication is generally well-tolerated and is safe for adults. However, it can not cure the condition. It can reduce behavioural symptoms and improve the quality of life for those suffering from the condition. It can also help with learning, work and relationships. However, it's essential for anyone who is starting treatment to be aware of potential adverse reactions and discuss them with their physician prior to when they start taking the medicine. The side effects can include an increase in appetite, headaches and sleeplessness. Some medications can increase heart rate. It is generally harmless and not harmful however, it is worth telling your doctor if there's an history of heart disease or heart problems. The effects of stimulants increase the levels dopamine and norepinephrine in the brain. This alters the way the brain processes and transmits messages, enhancing concentration and attention. They are considered to be the first-line treatment for adults suffering from ADHD. Atomoxetine and Buproprion, which are medications that do not stimulate, have a more complex action on the brain. They also take longer to begin working. The latter blocks the reuptake and release of dopamine into nerve cells and aids in concentration. According to research, approximately half of children diagnosed with ADHD will be free of symptoms in adulthood. This could be due to the fact that they are able to manage their symptoms or because they become less hyperactive. A large portion of them struggle with a society that is not built to meet their needs. Nice recommends doctors prescribe ADHD medications only when they are absolutely necessary and monitor their patients frequently. There are a variety of other ways to help with ADHD symptoms, including lifestyle changes and psychoeducational therapies. These can be utilized in conjunction with medications to decrease the need for doctors to refer patients suffering from ADHD to specialist services. The stigma attached to ADHD can make it difficult to be open about the medication. Many adults are hesitant to reveal the fact that they have ADHD to their friends, family or employers. There is increasing evidence that talking openly about the disorder can help to break down barriers to treatment.