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most effective adhd medication for adults in the UK In the UK In the UK, the NHS has guidelines for diagnosing ADHD in adults. The number of referrals to the adult ADHD specialist clinic quadrupled during the time of the pandemic. Non-stimulants and stimulants are both used to treat ADHD. Methylphenidate is the most common medicine to help manage symptoms of ADHD, along with two amphetamine-based medications known as lisdexamfetamine and dexamfetamine. Stimulants Stimulants are the most common treatment for ADHD in adults. These work by increasing activity in parts of the brain that regulate attention and behaviour. They are quick-acting and typically the first option to be considered by GPs. Methylphenidate is more commonly referred to as Ritalin is the most widely prescribed stimulant for adults as well as children. This drug boosts the levels of neurotransmitters in the brain, thereby improving the quality of attention and reducing impulsivity and hyperactivity. It also helps reduce anxiety and depression, which may co-occur with ADHD. Through time, stimulant drugs have been used medicinally as well as recreationally to improve performance, motivation, cognition and mood. These include nicotine and caffeine amphetamines modafinil, methylphenidate, and cocaine. They are also used as appetite suppressants and energy boosters. They can cause significant psychological and physical negative effects when taken in excess. A psychiatrist will take care to adjust the dosages for each patient. They will consider any other medical conditions that the patient might be suffering from, as well as the effects of the medication on their sleep patterns. They will also take into consideration the impact of medication on the patients' lifestyle and diet. A large network meta analysis carried out by NIHR Oxford Health Biomedical Research Centre (NIHR Oxford Health Biomedical Research Centre) and Stichting Eunethydis has found that the drug lisdexamfetamine, also known as Adderall, is more effective than other stimulant at reducing the symptoms of ADHD. It is recommended by NICE and is available in the UK by prescription. Despite positive evidence that support the use of drugs for ADHD is still stigmatized. Falsely framed arguments compare it to child exploitation and controlled substances. This can make people hesitant to seek an assessment or to even consider taking medication for their condition. As the number of patients referred to NHS psychiatry increased during the COVID-19 pandemic also did the number of adults being treated for ADHD. Adult ADHD referrals now surpass those for children. Boys are still more likely to receive referrals, but the number of women who receive treatment for ADHD has quadrupled in the past two years. Unlicensed Medication A range of medicines are approved for treating ADHD in children and adults, with stimulant drugs such as methylphenidate and, sometimes, the newer amphetamine-based drug lisdexamfetamine being prescribed. These drugs are classified as 'controlled medications' because they are addictive and abused. Your psychiatrist will only prescribe these medications if he or believes that they are the most effective solution for your treatment. Then, you will be given an order to go to a local pharmacy and take home. This will be for a month's supply of the medication and your pharmacist should be able explain the procedure to you. In some cases your doctor might decide that the medications they have available are not suitable for you and recommend an unlicensed medicine. This is a decision that is made on an individual basis. Your psychiatrist should only recommend non-licensed medications as a last option. It is important to remember that, while medication is a key part of treatment for ADHD, talking therapy is also vital. The use of medication can help manage your symptoms, but therapy can help change the long-standing negative coping mechanisms and behaviour patterns. Treatment for ADHD for adults must be licensed in the UK with a license known as marketing authorisation (MA) that will define the specific health conditions it's approved for. This will include the ages of the people who are treated and the method by which the medication should be taken. The MHRA will review any IMP prior to its release and the manufacturer is permitted to promote it under their MA, in the event that they do not have a special licence to market paediatric medicines. Off label prescribing happens when a psychiatrist feels it is appropriate to prescribe a drug for an adult even though it was prescribed for use by a child. It is also possible to create”manipulated products” – where the pharmacist makes up an individual formulation for the patient by mixing ingredients, for example if they can't swallow tablets. There's some stigmas associated with using non-licensed medications to treat ADHD in adults, with some psychiatrists expressing concern about the over-prescribing of psychoactive medications for mental health problems. Licensing In the UK there are a range of medications that are authorised to treat ADHD in adults. These include a number of stimulant drugs, such as methylphenidate (Ritalin) and the more recent amphetamine-based medication called lisdexamfetamine (Elvanse). Typically, non prescription adhd medication are offered to patients suffering from the condition after consulting with a psychiatrist. The treatment is prescribed as capsules, and the patient should be closely monitored by their physician in order to find the proper dosage. In addition to these medications however, there are a myriad of other methods by which the disease can be treated and controlled. For instance, behavioural therapies can assist patients in understanding the underlying causes of symptoms and develop strategies to deal with these. In addition, environmental modifications are also helpful in helping people cope with the impact of their symptoms on daily activities. This could include arranging seating arrangements at school or work, providing cards that say 'I Need a Break' and scheduling frequent movement breaks and decreasing noise and distractions. The medications that are licensed to treat ADHD in adults in the UK are not intended to be a cure, but can significantly improve the quality of life of many people who suffer from the condition. However, they are not an instant cure, and should only be used as part of a holistic care plan that includes psychiatric treatment and psychoeducation. Patients who are pregnant should take a pregnancy test prior to taking any medication. They must also inform their GP when they become pregnant or wish to fall pregnant. It is also recommended that patients should visit their GP when they experience serious side-effects or don't feel that they are benefiting from the medication. On 27 September 2023, a national patient safety alert was issued regarding the shortage of extended-release Guanfacine tablets, lisdexamfetamine tablets and methylphenidate tablets. This was replaced by an Medicine Supply Notification (MSN) on May 8, 2024. It lifted the restrictions on prescribing for Elvanse capsules and urged ADHD services to resume initiations. It is a Schedule 2 drug, so it is only prescribed by a registered physician and is subject to the Misuse of Drugs Regulations of 2001. The guidelines recommend that an ADHD patient be evaluated annually by a healthcare professional who is knowledgeable and trained in managing the disorder. This can be performed in primary care or secondary care, based on the local arrangement. This review should include monitoring for blood pressure and heart rate as well as a discussion on the continued need for treatment and ongoing evaluation of symptoms and monitoring improvement. Side Effects ADHD medication is generally safe and well accepted by adults, however it does not cure the condition. It can help to reduce symptoms of behavioural disorders and improve quality of life. It can also enhance working, learning and relationships. Having said that, it's important for anyone starting treatment to be aware of potential adverse effects and to discuss them with their doctor prior to when they start taking the medicine. Side-effects can include a change in appetite, headaches or sleepiness. Some medications can increase heart rate. It is generally harmless and not harmful however, it is worth telling your doctor if there's a history of heart disease or issues. The effects of stimulants increase the levels of norepinephrine and dopamine in the brain. This alters the way the brain sends and receives messages, and increases focus and attention. They are considered to be the first-line treatment for adults with ADHD. Non-stimulant drugs like buproprion and atomoxetine are also available, but they perform more complex effects on the brain and take longer to start working. The latter is a drug that blocks dopamine reuptake in nerve cells and assists with concentration. According to research, about half of the children diagnosed with ADHD will grow out of symptoms in adulthood. It could be because they manage their symptoms or because they become less hyperactive. A large portion of them are still struggling with a world that was not designed to meet their needs. That's why Nice recommends doctors prescribe ADHD drugs only where they are appropriate and to continue to monitor patients regularly. There are a number of other ways to help with ADHD symptoms, such as psychoeducational and lifestyle modifications. These can be used alongside medications to decrease the need for doctors to refer patients suffering from ADHD to specialist services. Many adults are reluctant to inform their families, friends or employers that they are taking ADHD medication due to the stigma that comes with it. There is increasing evidence that revealing the existence of the disorder can help overcome barriers to treatment.