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ADHD Medication For Adults in the UK In the UK there are a variety of medicines are licensed to treat ADHD. The stimulant methylphenidate as well as the amphetamine-based medicine lisdexamfetamine are two of the most frequently prescribed drugs. The dose will be closely monitored in the beginning stages of treatment. What is an Licensed Medication (L.M.)? A medicine that is licensed has been through all the necessary clinical tests and trials and the MHRA (Medicines and Healthcare Products Regulatory Authority) has granted it approval to use it in Great Britain. The medicine will also be clearly identified as being suitable for specific conditions on its packaging or in the leaflet that is included with it. All licensed medicines are carefully regulated and monitored, even after they've entered the market, meaning that any problems can be spotted quickly and any risk reduced. Unlicensed medications are sometimes prescribed to people with ADHD however they are seldom prescribed to adolescents or children. The unlicensed medication may be prescribed for other conditions that have been proven to be effective (known as off-label prescribing), or it might be a specific formula that isn't available on the market, for instance an oral liquid instead of tablets or something that is free of certain additives. It could also be an experimental medicine that is being tested in the UK. The term “experimental drugs” is used to describe Medicines that have an Marketing Authorisation(MIA) (IMP) or Investigational Medicinal Products. These medicines are not yet licensed and can only be purchased through an order from a doctor. They will have undergone an assessment in a formal manner by the MHRA as part of the Early Access to Medicines Scheme (EAMS) and so the quality of pharmaceuticals is guaranteed. Atomoxetine is a medication that's not stimulant that is commonly prescribed in the UK and Europe for ADHD. This medication is a specific blocker of noradrenaline's absorption, so it works differently than other ADHD medication. It increases noradrenaline in the brain which is a type of chemical that passes messages between nerve cells, which improves concentration and helps control impulses. It is taken in capsule form once or twice daily. Only psychiatrists are able to diagnose ADHD and prescribe medication for adults. It is important to remember that ADHD isn't just a condition which can be treated with medication alone, and therapy is frequently included in treatment plans for people with the disorder. Psychoeducation can aid children, teens and adults recognize their diagnosis as well as behavioural therapy which teaches techniques for managing symptoms. What is an Unlicensed Medication? The term “unlicensed medicine” refers to any medicine that has not been granted a license by the MHRA. This could be due to the fact that the medicine has not been developed by a UK company, or it has been prescribed in violation of the terms of its licence (ie off-label). The GMC's guidelines say that 'unlicensed medicines are typically employed when a licensed product is not available, or when a treatment that is clinically effective is not available with the medication that the doctor is most comfortable with'. The label of a medicine will include the conditions it treats and the age ranges that it is able to treat. The licence will also state the manner and method by which the medicine should be used. The MHRA will only issue an approval when the drug is believed to be safe and effective for the use, which is based on medical research and clinical trials. The manufacturers of drugs are not permitted to promote or promote any uses that are not covered by the license. In the UK It is not illegal for healthcare professionals to prescribe unlicensed drug provided that the patient is informed about the risks and benefits. They must keep a record of the use of unlicensed medications and provide the patient sufficient information to make an informed decision. Hospitals tend to provide unlicensed drugs because they have more experiences with them than GP surgeries. The hospital will have procedures in place to ensure the safety of the medication, including keeping detailed patient records and making sure that any adverse reactions are documented. They are required to adhere to MHRA guidelines on the safe supply unlicensed medicine. Specials are prescribed by doctors who must communicate with their patients, their parents or caregivers of the medication it is prescribed for, its purpose, and any possible adverse consequences. They should be able answer any questions and provide written information about any medication they prescribe, including the reasons for it. What is a Shared Care Agreement? The number of adults who are suspected to have ADHD has been increasing in recent years, so have demanded to be referred for an NHS assessment and receive medication for the condition. The waiting lists for NHS assessments can be lengthy and a lot of patients choose to pay privately for ADHD assessments in specialist private clinics. It is hoped that once a diagnosis has been confirmed through this process, the GP will sign an agreement of shared care (SCA). A SCA is an agreement between your psychiatrist and your GP in which the responsibility for monitoring, prescribing and basic health checks for medicines is handed over to your GP. This is a recognised and accepted method of transferring the responsibility for managing a patient suffering from ADHD from a hospital or a specialist service setting to general practice, provided it is in line with NHS England guidelines. These SCA guidelines must be negotiated between the doctor and the GP before the responsibility is handed over and this should be clearly in any referral form. It should also be made clear that the GP retains responsibility for ongoing titration and monitoring requirements of the medication. Unfortunately, a large number of GPs do not accept SCAs. This isn't due to an inability to accept, but because the work involved in SCAs could be outside of their core budget and is often an additional task in addition to their busy schedule. The doctor must be informed about the reasoning behind SCA, the expectations of all parties involved, and the role of the patients and carers. It should also be clear that the decision to participate in SCA should be made by the prescriber who initiated treatment. The GP should be told if they are not willing to participate in the SCA. If a physician does not want to accept responsibility for SCA or SCA, they may refuse. However, this can result in patients being sent back to the private ADHD clinic and psychiatrist who provided their initial diagnosis. This could lead to prescriptions for medication being issued privately, rather than via the NHS. This can be more costly. What is a titration period? The tration phase is an important step to find the appropriate medication for ADHD. It is the process of gradually increasing your dosage until you reach a level that maximizes the benefits of your medication while minimizing adverse effects. It takes time, but your healthcare professional should be in close contact with you to ensure that the titration process goes as smooth as is possible. Certain patients may experience an increase in their symptoms during the titration period. Hyperactive people, for example might become restless and angry. For this reason, it is vital that family members are aware of any changes and offer support. It is also crucial to maintain a healthy diet and to create a consistent sleep routine to minimize the side effects of ADHD medications. It is important to remember that medication isn't the only option for ADHD treatment. However it is recommended as a first-line treatment option for adults. Talk therapy is a useful tool to address underlying depression and anxiety that could cause some of the symptoms of ADHD. It is important to remember that medication is only able to treat the symptoms, not alter longstanding negative coping mechanisms. Some patients decide not to take any medication, instead focusing on self-help techniques such as fitness, nutrition and stress reduction. It is crucial to know the adverse effects and how they affect your body. Certain medications can reduce appetite and cause headaches, as well as cause you to become drowsy. Make sure you use your medications as directed and consult your doctor if there are any adverse reactions. A lot of the drugs used to treat adult ADHD are currently in short supply because of shortages. This has led to delays in the diagnosis process as well as appointments with psychiatrists. NHS England has set up a taskforce to investigate the issue and recommend methods to speed up the process of waiting for medications. Ask best adhd medication for adults with anxiety what options are available for you. You may be able get the same medications privately or they could suggest alternatives with similar results.