ADHD Medication in the UK
Medications for ADHD aid in reducing symptoms by increasing activity in certain areas of the brain. They also increase the production of neurotransmitters that are deficient in people with ADHD.
In the UK the UK, stimulant drugs are the most frequently prescribed treatment for adults with ADHD. They increase activity in the parts of the brain involved in attention and impulse control.
Stimulants
There are two types of medication licensed for use in the UK to treat adult ADHD stimulants and non-stimulant medications. The stimulants are typically offered as the first option due to their ability to increase activity in the areas of the brain that help to regulate attention and behaviour. These include methylphenidate, also known as Ritalin, and Lisdexamfetamine. These tablets can be taken several times a day as a short-acting tablet or once a week in the form of an extended-acting pill that is released into the bloodstream throughout the day. At first the dosage of the medication could need to be adjusted and monitored (titrated) to determine the dose that is effective for you.
Stimulants have a long history of use both medicinally and as recreational drugs. In the 1930s, truck drivers, students, and athletes took amphetamines to increase their energy levels. Amphetamines pose a risk and can be abused. They are abused as they can make people feel good and can stimulate the mind in ways that can lead them to addiction.
The loss of appetite, the difficulties sleeping and issues with digestion or stomach are among the most frequent negative effects of stimulants. These issues can be addressed by adjusting the dose or timing. The majority of adults are tolerant. Children may experience more serious adverse effects, including weight gain, tics and crankiness.
Non-stimulant ADHD medication functions differently in comparison to stimulants and can take some time to begin working. Clonidine and Guanfacine are known as Catapres and Intuniv, are alpha agonists. They stimulate receptors in the brain to increase concentration and decrease the impulsivity, hyperactivity and behavioral issues such as aggression and tics. They can be used as a complement to ADHD stimulant medications or taken on their own by children aged 6-17.
Atomoxetine (brand name Strattera) is a different non-stimulant medication for ADHD that boosts levels of the neurotransmitter noradrenaline to improve impulse control and improve concentration. It is a medication that can be prescribed on its own, but is typically combined with guanfacine in children. These drugs are less likely to have the same side-effects as stimulants, however they can still cause a range of them such as headaches and difficulty sleeping.
Atomoxetine
Some children are not responsive to stimulant medications like Adderall and Ritalin. There are adult add medications to stimulants for children who aren't. They increase the signaling between brain regions, nerves and brain regions. This helps kids control their impulsivity and improve their concentration. Nonstimulant ADHD medicines contain different active ingredients to stimulants and don't have the potential for abuse as they aren't controlled substances.
Atomoxetine (Strattera) is one of the newer non-stimulant medications that treat ADHD in children, adults and teens. It is an antidepressant, and has been shown to reduce ADHD symptoms by increasing the amount a chemical called noradrenaline within the brain. Noradrenaline is a chemical that sends messages between brain cells. It also plays a role in impulsivity, motivation, and attention.
Because of its unique mechanism of action, atomoxetine does not suffer from the same adverse effects as other antidepressants like Wellbutrin and Effexor. It can be prescribed for children as young as five and is taken orally at least once or twice per day in tablet form. Atomoxetine provides stable, 24-hour control of ADHD symptoms, so it could help to reduce the symptoms in the evening when the effects of certain stimulants wear off.
The FDA has also approved guanfacine XR and Clonidine XR both of which are available as non-stimulant ADHD medication. These are usually given to children who haven't reacted to stimulant medications or have trouble with their side effects. They can be used by themselves or in combination with stimulants like Adderall XR (amphetamine salts) to offer an effective treatment for ADHD.
Follow your doctor's instructions if you or your child is taking an non-stimulant ADHD medication. They may suggest starting with lower doses, and then gradually increasing the dosage. They will also ask about any other medications that you or your child is taking to ensure that there aren't any interactions. You'll need to attend regular appointments and let your GP be aware of any concerns or adverse reactions from the medication. They may change the dosage, or suggest alternative treatments, such as talk therapy.
Unlicensed Medication
Adult ADHD is treated using different stimulant and anti-stimulant medicines. Psychiatrists can also prescribe medicines that are off label (these are substances that are approved for a different condition, but are being evaluated for their effectiveness in adults with ADHD). These medications are typically antidepressants, such as bupropion and venflaxine, both of which have been proven to have some positive effects on the condition and are well tolerated at lower doses than those used in the licensed treatments.
Unlicensed medications can be prescribed to patients if there is a real clinical need that can't be met by a licensed medicine. Patients whose usual medication has been temporarily stopped due to a disruption of supply, or patients who require a liquid version of a licensed tablet or capsule for reasons like allergies or intolerances could all be affected.
Unlicensed medications are often described as "specials". This term is also used to describe medicines that are "off-label" or have been prepared or provided in a way that is not covered by the licence. These might include crushing tablets to make them easier to swallow or adding liquid to an approved capsule or tablet to create a mix for administration by injection, or using a syringe pump in order to administer medication subcutaneously (under the skin).
In general healthcare professionals will only employ unlicensed drugs as a last resort and when it is felt that there is no licensed alternative available. They will carefully consider a wide selection of options to meet the needs of each patient. They will also periodically review treatment and results taking into account both clinical experience and the latest approved treatments.
It is essential that any medicine not licensed to treat a patient is safe and effective and the reason for prescribing it is documented in the patient's medical record. Report any side effects that a patient might experience from an off-label medication using the MHRA Yellow Card Scheme. This information is used by the MHRA to update the marketing authorisation of the medicine and ensure future prescriptions are safe and effective.
Talk Therapy
A talk therapist works with you to help you identify your issues and find ways to manage. They can also offer you guidance and assistance on how to change your ways of thinking and acting in order to feel more positive. It is crucial that you complete the recommended amount of sessions in order to make you feel better.
The amount of neurotransmitters within your brain can help reduce ADHD symptoms. These chemicals help your neurons pass on messages, helping you to concentrate your thoughts and avoid distractions. There are two main types of medication used to treat ADHD which are stimulants and non-stimulants. All of them improve the quantity of neurotransmitters that are available in your brain.
In the UK there are many drugs that can be used to treat ADHD. The most common medication is methylphenidate. It is available as immediate-release tablets that are taken in small doses 2 to 3 times daily. Also, as modified-release tablets, which are taken weekly, but released over the duration of the day. These medications are not a cure but can help you control your an impulsive behaviour and help you focus. They are generally well-tolerated, but your specialist will closely monitor your progress to ensure that you receive the correct dose and don't experience any adverse side consequences. It could take a few weeks for the medication to reach its ideal level. You may also have to titrate (change your dose on a regular basis) to determine the best dosage.
Non-stimulant medicines like atomoxetine (available only with a prescription) are more effective and have less of a potential for addiction than stimulants. They have a stronger evidence base, but they aren't as well-tolerated and some people experience problems with their memory, appetite or sleep. Your doctor will track your progress and decide whether to continue with atomoxetine, or switch to another treatment.
People with ADHD are unable to find permanent solutions with medication or therapy. However, they can improve your ability to manage your symptoms and live a fulfilling life. Combining therapy with medication sessions will help you gain the most benefit from your treatment. You'll learn strategies for coping and identify unhelpful patterns of behavior and thinking. For some, their increased confidence and mood can last well beyond the duration of their treatment.