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Adult ADHD Medication in the UK In the UK, there are guidelines for diagnosing ADHD in adults. The number of referrals to the adult ADHD specialist clinic quadrupled in the course of the pandemic. Non-stimulants and stimulants can both be used to treat ADHD. Methylphenidate is a popular medication used to treat symptoms of ADHD and is accompanied by two amphetamine-based medicines called dexamfetamine and lisdexamfetamine. Stimulants The most popular kind of medication used to treat adult ADHD is a stimulant. They increase the activity of parts of the brain that control attention and behaviour. They are quick-acting and are frequently the first choice of GPs. Methylphenidate is also known as Ritalin is the most widely prescribed stimulant for adults as well as children. This drug boosts the levels of neurotransmitters in the brain. It improves concentration and decreases hyperactivity and impulsivity. It can also reduce depression and anxiety that may occur with ADHD. In the past, stimulant drugs were used to enhance cognition, motivation and performance. They include nicotine and caffeine, amphetamines modafinil, methylphenidate, and cocaine. They also serve to reduce appetite and as energy boosters, and can have significant physical and psychological adverse effects when used in excessive amounts. A psychiatrist will take care to adjust the dosages for each patient. knowing it will also take into consideration any other medical conditions that a patient might be suffering from, and the effects of the medication on sleep patterns. They will also take into consideration the impact of medication on the patient's lifestyle and diet. A massive meta-analysis of the network carried out by the NIHR Oxford Health Biomedical Research Centre and Stichting Eunethydis, has found that the drug called lisdexamfetamine (commonly known as Adderall) is more effective than other stimulants at reducing symptoms of ADHD. It is recommended by NICE, and it is available on prescription in the UK. Despite the evidence-based findings that supports it, there is a certain stigma associated with the use of medication to treat ADHD, with unhelpful framings that make it appear like child abuse, and even comparisons to controlled substances. This makes many not want to request an assessment, or to consider taking medication for their condition. The number of adults being treated for ADHD increased with the increase in the number of people referred to NHS psychiatrists during the COVID-19 epidemic. In fact adults' ADHD referrals have now surpassed those for children. Boys are still more likely to receive ADHD treatment however the number of women who receive it has quadrupled in the last two years. Unlicensed Medication A variety of medications are licensed for treating ADHD in adults and children including stimulant drugs such as methylphenidate and, sometimes, the newer amphetamine-based medication lisdexamfetamine prescribed. These drugs are categorized as controlled medications because they can be addictive and abuse. Your psychiatrist will only prescribe them if they feel they are the best option for you as part of your treatment. You will be provided with a written prescription that you can get at the local pharmacy. This will be for a month's worth of the drug. Your pharmacist should be able explain the procedure to you. In some cases your doctor might decide that the medicines that are available to them aren't suitable for you, and may recommend an unlicensed medicine. This is a decision which will be taken on an individual basis. Your psychiatrist should only use nonlicensed medications as a last option. Be aware that although medication is a crucial component of treating ADHD, talking therapy also plays a vital role. The use of medication can help manage your symptoms but therapy can work at changing long-standing negative coping mechanisms as well as behavior patterns. Medication used to treat ADHD in adults has to be licensed in the UK with a license known as marketing authorisation (MA) which will specify the specific health conditions it is approved for. This will include the age of people who can be treated and how the medication is to be used. The MHRA will conduct an official assessment of any IMP before it is made available and the manufacturer can only promote it under its MA, unless it has a special licence for paediatric medicine. Off label prescribing occurs when a psychiatrist feels it is appropriate to prescribe a drug for an adult even though it was originally approved for a child. It is also possible to get”manipulated products” – where the pharmacist creates an individual formulation for the patient by mixing ingredients, as when they are unable to swallow tablets. Some psychiatrists have criticized the excessive use of psychoactive drugs to treat mental health issues, such as ADHD. Licensing In the UK there are a variety of treatments are available to treat ADHD for adults. There are several stimulant medications such as methylphenidate, (Ritalin) and the newer amphetamine based medication lisdexamfetamine (Elvanse). These are typically prescribed to patients who have been diagnosed with the condition by psychiatrists. The treatment is prescribed in capsules, and patients must be closely monitored by their doctor to determine the right dosage. In addition to these medications in addition, there are a variety of other ways that the illness can be managed and treated. For instance, behavioural therapies can aid patients in understanding the underlying causes of their symptoms and devise strategies to overcome these. Additionally, changes to the environment are also helpful in helping people deal with the impact of their symptoms on day-to-day activities. This could include setting up seating arrangements at school or work or even distributing cards that say “I Need a Break” and scheduling frequent movement breaks as well as reducing noise and distractions. The medications that have been approved by the UK to treat ADHD among adults are not intended to cure, but they can enhance the quality-of-life for many people. However, they aren't a magic bullet and should only be used as part of a holistic care plan that includes psychoeducation and psychiatric care. It is essential that any patient of childbearing potential takes an examination for pregnancy prior to starting medication, and that they inform their GP immediately in the event that they become pregnant or want to become pregnant. Patients should also consult their GP in the event of any side effects or if they do not believe they are benefiting from. On the 27th of September, 2023, a nationwide patient safety alert was issued about the lack of extended-release guanfacine tablets, tablets of lisdexamfetamine and methylphenidate tablets. This was replaced with a Medicine Supply Notification (MSN) on 08 May 2024 that lifted prescribing restrictions for Elvanse capsules and advised ADHD services to resume initiations. It is a Schedule 2 controlled drug so it must be prescribed by an authorized practitioner and is subject to the Misuse of Drugs Regulations 2001. The guidelines suggest that people suffering from ADHD should be evaluated every year by a health expert with experience and training in managing the disorder, either in primary or secondary treatment based on local arrangements. This review should include monitoring of heart rate and blood-pressure, a discussion on the need for continued treatment, and continuous monitoring and evaluation of symptom improvement. Side Effects ADHD medication is generally well-tolerated and safe by adults. However, it does not cure this condition. It can help to reduce behavioural symptoms and improve people's quality of life. It can also enhance the quality of work, relationships and learning. It's crucial for anyone considering treatment to be aware of the potential adverse effects and to discuss them with their physician prior to when they begin taking the medication. Side-effects can include an increase in appetite, headaches, and sleepiness. Certain medications can raise your heart rate. This is usually minor and harmless, but is worth noting to your doctor if you have a history of heart problems or cardiovascular disease. The effects of stimulants increase the levels of norepinephrine and dopamine in the brain. This alters the way the brain receives and sends messages, enhancing concentration and attention. These drugs 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 block the reuptake of dopamine by nerve cells, which aids in concentration. According to research, around half of the children diagnosed with ADHD will grow out of symptoms by the time they reach adulthood. This could be due to the fact that they learn to manage their symptoms, or because they become less active. A significant number of them are still struggling with a society not designed for their needs. This is why Nice recommends doctors prescribe ADHD medications only when they are necessary and keep monitoring patients on a regular basis. There are other methods to treat ADHD symptoms. These include psychoeducational therapy and lifestyle changes. These therapies can be utilized together with medication to reduce the necessity of referring adults with ADHD to specialist services. Many adults are hesitant tell their friends, families or employers that they are taking ADHD medication due to the stigma that surrounds it. There is increasing evidence that talking openly about the disorder can help break down barriers to treatment.