15 Shocking Facts About ADHD Medication That You've Never Heard Of
ADHD Medication For Adults in the UK
In the UK there is a variety of medications that are approved for treating ADHD. This includes the stimulant methylphenidate and the amphetamine-based drug lisdexamfetamine. The exact dose will need to be carefully monitored during the initial stages of treatment (titration) and then stable prescriptions can be managed by your GP as part of a'shared care' arrangement.
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A licensed medicine has gone through all the required tests and clinical trials and the MHRA, the Medicines and Healthcare Products Regulatory Authority (MHRA) has given the go ahead for its use in Great Britain. The medicine will also be clearly listed as suitable for a particular condition on its packaging or in a leaflet which comes with it. All licensed medicines are carefully monitored even after they've been placed on the market, meaning that any problems can be identified quickly and risks minimized.
Some people with ADHD might be prescribed medications that are not licensed however, they are not often utilized on teenagers and children. The medication that is not licensed may be used for other conditions that have been found to work well with it (known as off-label prescribing) or it could be a specific formulation that isn't available on the market, for instance an oral liquid in place of tablets or a product free from certain additives. It could also be an experimental drug being trialled in the UK.
The term "experimental drugs" is used to refer to medicines that have an Marketing Authorisation(MIA) (IMP) or Investigational Medicinal Products. These drugs aren't yet licensed and can only be purchased with a prescription from a doctor. The MHRA will conduct a formal assessment as part of the Early Access to Medicines Scheme.
Atomoxetine is an anti-stimulant medication that is commonly prescribed in the UK and Europe for ADHD. It is a selective blocker of noradrenaline's absorption which means it performs differently than other ADHD drugs. It increases noradrenaline in the brain which is a kind of chemical that transmits messages between nerve cells which improves concentration and assists in controlling impulses. It is usually taken in capsules once or twice a day.
Only psychiatrists can diagnose ADHD and prescribe medication for adults. It is crucial to remember that ADHD isn't a condition that can be treated with medication alone. Therapy is often included in treatment plans. This may include psychoeducation, which helps children, teenagers and adults comprehend their diagnosis, as well as behavioral therapy, which teaches strategies to manage symptoms.
What is an unlicensed medication?
The term "unlicensed medicine" refers to medicines that are not licensed by the MHRA. It could be that the drug was not developed by a UK-based company or it was prescribed outside of the terms of licence (off-label). The GMC's guidelines state that 'unlicensed medicine is usually employed when a licensed product is unavailable or a clinically effective treatment is not available with the product that the prescriber is most comfortable with'.
The license of a medicine will specify the conditions it treats, along with the ages it can be administered to. The licence will also outline the manner and method by which the medicine should be used. The MHRA only grants a license if it is deemed to be safe and effective in the specific use, based upon clinical studies and medical research. The drugs' manufacturers are not allowed to promote or promote any use that is not covered by the licence.
It is not illegal in the UK for medical professionals to prescribe a medication that is not licensed, as long as they can explain the risks and benefits of doing so to the patient. They must also keep records of the use of non-licensed medications and provide the patient sufficient information to make an informed decision.
Hospitals are more likely to offer unlicensed medications because they have more experience with them than GP surgeries. The hospital will have procedures to ensure the safety and efficacy of the medication. This includes keeping thorough records of patients, and noting any adverse effects. They must also follow the MHRA's guidance on the safe supply of medicines that are not licensed.
Specials are prescribed by doctors who must inform their patients, parents or caregivers about the medication it is prescribed for, its purpose, and any possible side consequences. They should be able to answer any questions and provide written information on any medicine they prescribe, including the reasons behind 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 requests to be referred for an NHS assessment and to receive treatment for the condition. Unfortunately, waiting lists for NHS assessments are long, and this means that a lot of patients are opting to pay for their own private ADHD assessments at private clinics. Once a diagnosis is confirmed, the GP may enter into a shared-care agreement (SCA) with the patient.
A SCA is an agreement between your psychiatrist and your GP where the responsibility for prescribing, monitoring and basic health checks for medication is assigned to your GP. This is a well-known and accepted method of transferring the responsibility for managing a patient with ADHD from the hospital or specialist service setting to general practice, provided it is in accordance with NHS England guidelines.
Before transferring responsibility, the specialist and GP should be in agreement on these SCA guidelines. This should be clearly stated on any referral form. It should be made clear to the GP that the GP is responsible for the continual monitoring of the medication and the monitoring requirements.
Unfortunately, a lot of GPs do not accept SCAs. This is not due to an inability to accept however, the work involved in SCAs could be outside of their core budget and is typically an additional task on top of their busy schedule.
The doctor should be provided with good quality information on the rationale for SCA and what the expectations of both parties, including the roles of the patient and their caregivers. It should also be made clear that a decision on SCA should be made by the doctor who initiated treatment and the doctor should be informed that they do not want to participate in the SCA.
If a physician refuses to accept the responsibility for SCA and/or SCA, they are able to refuse. However, this may result in patients being referred back to the private ADHD clinic and psychiatrist that provided their initial diagnosis. This could result in prescriptions for medication being issued privately, rather than through the NHS, which of course is more expensive.
What is a Titration Period?
The tration time is an important step to determine the appropriate medication to treat your ADHD. It involves increasing your dosage gradually until you reach a level that maximises benefits and minimises side effects. It takes time however, your healthcare professional should work closely with you to ensure the titration process is as smooth as possible.
Some patients may experience an increase in their symptoms during the titration time. For example, hyperactive people might become more restless and angry than they normally are. For this reason, it is crucial that family members are aware of any changes in behavior and provide assistance. It is also essential to have a healthy diet and to establish an established routine for sleeping in order to reduce the negative 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 method in adults. Talk therapy is an effective method to deal with depression and anxiety that may cause certain symptoms of ADHD. It is essential to keep in mind that medication only addresses symptoms and doesn't alter the negative coping mechanisms. Some patients opt not to use meds in the first place and instead focus on self-help treatments such as nutrition, exercise, stress reduction and sleep strategies.
It is essential to read over the adverse effects of any medication you are prescribed, and to understand how the medication will affect your body. Certain medications can cause headaches or drowsiness as well as decrease appetite. Make sure to always take your meds as directed and speak to your doctor if there are any adverse reactions.
Many of the medications used to treat adult ADHD are currently in short supply due to supply issues. This has led to delays in the diagnosis process and a backlog in appointments with psychiatrists. NHS England has created a taskforce to study the issue and offer suggestions regarding how to decrease waiting times for medications.
Ask your local GP what options are available for you. You may be able to get the same medications privately, or they might recommend alternatives that will have similar results to the ones you're accustomed to.