What's The Job Market For ADHD Medication UK Professionals Like?
Adult ADHD Medication in the UK
In the UK, there are guidelines to diagnose ADHD among adults. During the pandemic, referrals to the adult ADHD clinic quadrupled.
Non-stimulants and stimulants are both used to treat ADHD. Methylphenidate, dexamfetamine and Lisdexamfetamine are three amphetamine-based drugs that help manage ADHD symptoms.
adhd stimulant medication are the most common medication used to treat ADHD in adults. They increase the activity of parts of the brain responsible for the behaviour and attention. They are quick-acting and are typically the first option to be to be considered by GPs. Methylphenidate is more commonly referred to as Ritalin is the most commonly prescribed stimulant for adults as well as children.
This medication increases the amount of neurotransmitters in the brain, improving concentration and decreasing hyperactivity and impulsivity. It also helps to reduce anxiety and depression that can be a result of ADHD.
In the past, stimulant drugs were used to boost cognitive function, motivation, and performance. These include nicotine, caffeine amphetamines, cocaine modafinil and methylphenidate. They are also used as appetite suppressants and energy boosters, and can cause significant psychological and physical side effects when taken in excess.
A psychiatrist will be careful to adjust the doses for each patient. They will consider any other medical conditions that patients may have, as well as the impact of the medication on their sleep patterns. They will also consider the effects of medications on the patients' lifestyle and diet.
A large network meta-analysis carried out by the NIHR Oxford Health Biomedical Research Centre and Stichting Eunethydis, has found that the drug lisdexamfetamine (commonly referred to as Adderall) is more effective than other stimulants at decreasing symptoms of ADHD. It is recommended by NICE and is available for prescription in the UK.
Despite evidence-based research, the use of medication for ADHD is still stigmatized. Unhelpful framings compare it to child abuse and controlled substances. This makes many not want to request an assessment, or to consider taking medications to treat their condition.
As the number of patients referred to NHS mental health services increased during the COVID-19 pandemic as did the number of adults being treated for ADHD. In fact adults' ADHD referrals have now surpassed those for children. Boys are still more likely to be referred, however the number of women seeking treatment for ADHD has quadrupled in the past two years.
Unlicensed Medication
There are many medications that are prescribed to treat ADHD in adults and children. These include stimulant drugs such as methylphenidate, and occasionally the more recent amphetamine-based medication Lisdexamfetamine. These drugs are classified as controlled medications because they are addictive and abuse. Your consultant psychiatrist will only prescribe them if they feel they are the most appropriate choice for you as part of your treatment. You will be provided with an approved prescription in writing that you can pick up at the local pharmacy. It will be for a month's supply the medication and your pharmacist will be able to explain the procedure to you.
In some cases your doctor may feel that the medicines available to them are not suitable for you and recommend an unlicensed medication. This is a decision that is made on a case-by-case basis. Your psychiatrist should only recommend non-licensed medications as a last option. Remember that while medication is an essential component of treating ADHD and related disorders, therapy plays a crucial role. Medication can help to manage your symptoms, but therapy can work at changing the long-standing negative coping mechanisms and behaviour patterns.
The medication used to treat ADHD in adults has to be licensed in the UK, with a licence known as marketing authorisation (MA) which will state the health conditions it is approved for. This will include the age of people who can be treated and the method by which the medication should be administered. The MHRA will provide an official assessment of any IMP before it is released, and the manufacturer can only promote it under its MA or if it has a special licence for paediatric medicine.
This is when a medication is approved for children but a psychiatrist believes it's appropriate to prescribe it for an adult, this is also known as off label prescribing. A "manipulated product" is a possibility, where a pharmacist mixes ingredients to make a formula for a patient that is unable to swallow tablets. There's some stigmas associated with using non-licensed medications to treat ADHD in adults, with psychiatrists criticising the over-prescribing of psychoactive medications for mental health problems.
Licensing
In the UK there are a range of medicines that are approved to treat ADHD in adults. There are several stimulant drugs, 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 a psychiatrist. The treatment is usually prescribed in capsules and patients must be monitored carefully by their doctor to ensure that the appropriate dose is found.
There are other options to manage and treat the condition, in addition to medications. For example the use of behavioural therapy can help individuals to understand the causes of their symptoms and come up with strategies to manage these. Additionally, changes to the environment can be beneficial in helping people to cope with the impact of their symptoms on day-to-day activities. This could include arranging seating arrangements at work or school and arranging for frequent movement breaks and providing 'I need a break' cards, as well as cutting down on distractions and noise.
The medications that have been approved by the UK to treat ADHD in adults aren't intended to cure, but can improve the quality of life for many. However, they aren't an all-purpose cure and should only be used as part of a comprehensive care package that includes psychoeducation and psychiatric care.
Patients who are pregnant should have an examination for pregnancy prior to taking any medication. They should also inform their GP in the event that they fall pregnant or want to become pregnant. It is also recommended that patients should consult their GP when they experience significant side effects or do not think they are benefiting from the medication.
A national alert for patient safety concerning the shortage of methylphenidate prolonged-release tablets, guanfacine extended release tablets and lisdexamfetamine capsules was issued on the 27th of September, 2023. On 8 May 2024, a Medicine Supply Notification was issued that lifted the prescribing restrictions on Elvanse capsules.
It is an Schedule 2 drug, so it is only prescribed by a licensed physician and is subject to the Misuse of Drugs Regulations of 2001. The guidelines recommend that an ADHD patient is evaluated annually by a healthcare professional who has the expertise and experience in managing the disorder. This can be performed in primary care or secondary care, based on local arrangements. This review should include a check for heart rate and blood pressure and a discussion of the continued need for treatment, as well as ongoing evaluation of symptoms and monitoring improvement.
Side Effects
ADHD medication is generally well-tolerated and safe for adults. However, it can not cure the condition. It can help to reduce symptoms of behavioural disorder and improve quality of life. It can also help with learning, work and relationships.
It is crucial that those who are beginning treatment be aware of any possible adverse effects. They should discuss these with their doctor prior to beginning the medication. Side-effects can include a change in appetite, headaches and sleeplessness. Some medications can increase heart rate. This is usually mild and harmless but is worth mentioning to your doctor if there is a prior history of heart problems or cardiovascular disease.
Stimulants boost levels of dopamine and norepinephrine in the brain. This alters the way the brain sends and receives messages and improves concentration and attention. They are considered to be the first-line treatment for adult ADHD. Buproprion and Atomoxetine, which are nonstimulant medications have a more intricate action on the brain. They also take longer to begin working. The latter block the reuptake of dopamine by nerve cells and helps with concentration.
Research suggests that around half of children diagnosed with ADHD get rid of their symptoms as they grow older. This may be because they are able to manage their symptoms, or because they become less hyperactive. Many of them continue to struggle with a society that is not designed to meet their needs. Nice recommends that doctors prescribe ADHD medication only when they are needed and continue to monitor their patients frequently.
There are a number of other ways to help with ADHD symptoms, such as psychoeducational therapies and lifestyle changes. These therapies can be utilized in conjunction with medications to decrease the need to refer adults who have ADHD to specialist services.
The stigma that surrounds ADHD can make it difficult to be open about medication and many adults are reluctant to admit that they are taking it to their friends, family or employers. There is growing evidence that talking openly about the disorder can help to break down barriers to treatment.