MEDICATION
ADHD Medication in the UK
Medication can be an effective part of managing Attention Deficit Hyperactivity Disorder (ADHD) for both children and adults. In the UK, ADHD medications are prescribed following a diagnosis by a specialist, in line with National Institute for Health and Care Excellence (NICE) guidelines. This page explains the types of medications available, the prescription process, and what to expect.
Types of ADHD Medications
ADHD medications in the UK are primarily stimulants and non-stimulants, each targeting symptoms like inattention, impulsivity, or hyperactivity. Common options include:
- Stimulants:
These are the most commonly prescribed and work by increasing dopamine and norepinephrine in the brain.
- Methylphenidate (e.g., Ritalin, Concerta, Equasym): Available in short-acting (4–6 hours) or long-acting (8–12 hours) forms.
- Lisdexamfetamine (e.g., Elvanse): A long-acting option, often prescribed for children and adults.
- Dexamfetamine (e.g., Amfexa): Less common, used for specific cases.
- Non-Stimulants:
These are typically prescribed if stimulants are ineffective or cause side effects.
- Atomoxetine (e.g., Strattera): A selective norepinephrine reuptake inhibitor, often used for adults or those with anxiety.
- Guanfacine (e.g., Intuniv): Primarily for children, it helps with hyperactivity and impulsivity.
The Prescription Process
1. Diagnosis:
Medication is only prescribed after a confirmed ADHD diagnosis by a specialist (e.g., psychiatrist or paediatrician). Your GP cannot initiate ADHD medication but can refer you.
2. Initial Assessment:
The specialist assesses your symptoms, medical history, and lifestyle to recommend a suitable medication. They’ll discuss benefits, side effects, and any contraindications (e.g., heart conditions).
3. Titration Period:
Medication starts at a low dose, with adjustments over weeks to find the optimal dose. This involves regular follow-ups, often monthly at first, to monitor effects and side effects.
4. Ongoing Monitoring:
Once stable, prescriptions may be managed via a shared care agreement, where your GP takes over prescribing under specialist guidance. Regular reviews (every 6–12 months) ensure the medication remains effective.
Medication for Children vs. Adults
- Children:
Medications like methylphenidate or lisdexamfetamine are commonly prescribed. Guanfacine may be used for younger patients. Parents are involved in monitoring effects, and school feedback may be considered. NICE recommends combining medication with behavioural therapies for children under 5 or with milder symptoms.
- Adults:
Methylphenidate or lisdexamfetamine are first-line treatments, with atomoxetine as an alternative. Adults may need to balance medication timing with work or lifestyle. Psychoeducation or coaching is often recommended alongside medication.
Accessing Medication: NHS vs. Private
- NHS:
Medications are prescribed free for children under 16 or adults with certain exemptions (e.g., low income). Waiting times for specialist appointments can delay starting treatment. Shared care agreements streamline GP prescribing after titration.
- Private:
Private specialists can prescribe faster, but costs for consultations and medication (if not covered by shared care) can range from £100–£500 monthly. Ensure the provider is registered with the Care Quality Commission (CQC).
Benefits and Side Effects
- Benefits:
Medications can improve focus, reduce impulsivity, and enhance quality of life. Many report better academic, work, or social outcomes.
- Side Effects:
Common side effects include appetite loss, sleep issues, headaches, or mood changes. These often lessen over time. Serious side effects (e.g., heart issues) are rare but monitored during titration. Specialists will adjust doses or switch medications if needed.
Key Considerations
- Not a Cure: Medication manages symptoms but doesn’t cure ADHD. Combining it with therapy or lifestyle changes often yields the best results.
- Controlled Drugs: Stimulants are classified as controlled substances, requiring strict prescription protocols (e.g., no repeat prescriptions without review).
- Personal Choice: Some choose not to use medication, opting for behavioural strategies or coaching. Discuss all options with your specialist.