Why ADHD Medication Is Harder Than You Think

ADHD Medication For Adults in the UK
In the UK, a number of medicines are licensed to treat ADHD. This includes the stimulant methylphenidate as well as the amphetamine-based medication called lisdexamfetamine. The dosage will be carefully checked in the initial stages of treatment.
What is an Licensed Medication?
A medicine that is licensed has gone through all necessary clinical tests and trials, and the MHRA (Medicines and Healthcare products Regulatory Authority) has granted it approval to be used in Great Britain. The packaging of the medicine or the leaflet included with it will clearly state whether it is suitable for a specific condition. All licensed medications are controlled even after they've been placed on the market, meaning that any problems can be identified quickly and risks minimized.
Certain people with ADHD might be prescribed unlicensed drugs, but these are rarely used on children and teenagers. Unlicensed medications can be prescribed for other ailments that have been shown to be effective (known as "off-label prescribing") or they could be a formulation that is not yet available in the market, such as liquid oral instead of a tablet. It could be an experimental drug that is being evaluated in the UK.
The term "experimental drugs" is used to refer to Medicines with a Marketing Authorisation(MIA) (IMP) or Investigational Medicinal Products. These drugs aren't yet licensed and can only be purchased through an order from a doctor. They will have been subject to a formal assessment by the MHRA as part of the Early Access to Medicines Scheme (EAMS) and therefore pharmaceutical quality is assured.
Atomoxetine is an anti-stimulant medication that's often prescribed in the UK and Europe for ADHD. This is a selective noradrenaline inhibitor, which works differently to other ADHD meds. It increases noradrenaline which is a chemical that helps to transmit messages between neurons in the brain. This helps improve concentration and helps to control impulses. It is taken as a capsule at least once or twice a day.
Only psychiatrists can diagnose ADHD and prescribe medication for adults. It is crucial to understand that ADHD isn't a condition which can be treated with medication alone, and therapy is very often included in treatment plans for people with the condition. This may include psychoeducation, which assists children, teenagers and adults make sense of their diagnosis, as well as behavioural therapy, which teaches techniques to manage symptoms.
What is an Unlicensed Medication?
The term "unlicensed medicine" refers to any medicine that has not been granted a licence by the MHRA. It could be that the medication was not developed by an UK company, or it has been prescribed in violation of the restrictions of its licence (ie off-label). The GMC's guidance states that 'unlicensed medicines are usually employed when a licensed product isn't readily available or a clinically effective treatment cannot be found with the product that makes the prescriber feel comfortable'.
The license of a medicine will list the conditions it treats, as well as the age ranges it is able to treat. The licence will also state how and by whom the medicine should be used. The MHRA will only grant permission if the drug is considered to be safe and effective for that use, which is founded on medical research and clinical studies. The drug manufacturers are not allowed advertise or promote any use that are not covered by the license.
In the UK it is not a crime to let a healthcare professional prescribe an unlicensed medicine provided that the patient is informed about the risks and benefits. They must keep a record of the use of non-licensed medications and give the patient enough information to make the decision.
Hospitals are more likely to give unlicensed medications because they have more experience with them than GP surgeries. The hospital will have procedures to ensure the safety and effectiveness of the medication. This includes keeping detailed patient records, and also recording any adverse reactions. They are required to adhere to MHRA guidelines regarding the safe supply unlicensed medicine.
Doctors who prescribe specials have to be transparent with patients and their parents or caregivers about the nature of the medication and why it is utilized and the possible adverse effects. They must be able answer any questions that they are asked and always provide written details of the medicine they prescribe as well as the reasons for it.
What is a Shared Care Agreement?
adhd and medication of adults who are suspected to have ADHD has been increasing in recent years, so are demanded to be referred for an NHS assessment and also to receive medication for the condition. Unfortunately, the waiting lists for NHS assessments are long, and this means that many patients are reverting to self-funding private ADHD assessments at private clinics. If a diagnosis is confirmed, the GP could sign an agreement of shared-care (SCA) with the patient.
A SCA is an agreement between your psychiatrist and your GP in which the responsibility for prescribing, monitoring and the basic health checks for medication is assigned to your GP. This is a well-known and agreed method of transferring the responsibility for managing a patient with ADHD from the hospital or specialist service setting to general practice, provided that it is in accordance with NHS England guidelines.
These SCA guidelines should be agreed between the doctor and the GP before the responsibility is handed to the GP and should be clearly written on any referral form. It should also be clarified that the GP retains responsibility for continuous monitoring and titration of the medication.
Unfortunately, a large number of GPs are not able to accept SCAs. This isn't because of the lack of motivation, but because the work involved in SCAs could be outside of their core funding and it is usually an additional project on top of their busy schedule.
The GP should be provided with good quality information on the rationale for SCA and what the expectations of both parties, including the role of the patient and their carer. It is important to be clear that the decision to go ahead with SCA should be made by the prescriber initiating treatment. The GP should also be informed of the patient's refusal to be willing to take part in SCA.
If a doctor doesn't want to assume the responsibility of SCA they can choose not to do so, but this could result in patients being sent back to the private ADHD assessment clinic and psychiatrist who carried out their initial diagnosis. This could mean that prescriptions for medication are issued privately rather than through the NHS, which of course is more expensive.
What is a Titration Period?
The tration phase is a crucial element to determine the appropriate medication to manage your ADHD. It is the process of gradually increasing your dosage until you reach a dose that maximises the benefits while minimizing adverse effects. It is a process that takes time. Your healthcare professional should work with you closely to ensure that the titration procedure is as effortless as it can be.
Some patients may experience worsening of their symptoms during the titration phase. People who are hyperactive, for instance might become restless and angry. Because of this, it is essential that family members are aware of any changes and offer support. It is also essential to eat a balanced diet and an established routine for sleeping to lessen the adverse effects of ADHD medication.
It is important to note that medication isn't the only option for ADHD treatment. However it is suggested as a first-line treatment option in adults. Talk therapy is an effective tool to treat depression and anxiety that could cause some of the symptoms of ADHD. It is crucial to remember that medication can only treat the symptoms, not change longstanding negative coping mechanisms. Some patients choose not to use meds at all and prefer to focus on self-help treatments such as exercise, nutrition as well as stress reduction and sleep strategies.
It is essential to read over the side effects of any medicine you are prescribed, and to understand how the medication affects your body. Certain medications can cause headaches or drowsiness, and also reduce appetite. Always follow the directions for your medication and speak to your doctor for any adverse effects that occur.
A lot of the drugs used to treat adult ADHD are currently in short supply due to supply issues. This has led to delays in the diagnosis process and appointments with psychiatrists. NHS England has created a taskforce that will investigate the issue and make recommendations on how to reduce waiting times for medications.
Ask your local GP what options are available for you. You may be able to obtain the same medication privately or they might suggest alternative medications that have similar results.