ADHD medication in the UK: what are your options?

Introduction

ADHD (Attention Deficit & hyperactivity disorder) is a neurodevelopmental disorder affecting individuals’ ability to manage their energy levels, effectively impacting nearly 6.8% (366.3 million) adults worldwide.

This condition transcends age, impacting both children and adults and can significantly influence various aspects of life. In the United Kingdom, as in many parts of the world, several adults with long-term anxiety and depression may have undiagnosed ADHD.

Although it is normal for humans to have trouble focusing, let’s understand how ADHD affects this through a microscopic lens and affects life.

What is ADHD?

ADHD is a biological, neurological condition affecting individuals’ ability to concentrate and control impulses, leading to forgetting or losing things a lot, fidgeting, and difficulty getting along.

ADHD patients have low dopamine (brain chemical) levels, compromising their ability to control attention, social judgment, and movement. It’s a complex condition that can manifest differently in each person, requiring tailored strategies for management and support.

Recognised types of ADHD

Evidence suggests that ADHD is genetic. In the UK alone, childhood incidence rates are 5% and adult incidence rates of 3-4% when it comes to ADHD. That’s an estimated 2.6 million people in the UK with ADHD (694,000 children, 1.9 million).

The leap of faith here would be that these are diagnosed cases, which means that help would reach them in some way. Broadly, ADHD symptoms can be categorised into three types:

Inattentive Symptoms: Here, the ability to maintain focus, follow through on tasks, and organise activities is compromised. Patients may often need to be more mindful, have difficulty sustaining attention, and need help with details.

Hyperactive Symptoms: Hyperactivity is characterised by excessive restlessness, fidgeting, and difficulty remaining still. People with hyperactive symptoms may talk excessively, interrupt others, and have trouble engaging in quiet activities.

Impulsive Symptoms: Impulsivity involves making hasty decisions without considering potential consequences. Individuals with impulsivity may have trouble waiting their turn, blurting out answers, and engaging in risky behaviours.

As an adult, you must know these symptoms for children around you and yourself to gauge your mental well-being. Undiagnosed ADHD can lead to long-term detrimental effects.

ADHD treatment in the UK

If you’re experiencing any of the sentiments mentioned above, the first thing that you want to do is visit your GP. While they can’t diagnose ADHD immediately, they will gather as much information as possible to steer you toward seeking help. In most cases, your GP will ask you to return to make a referral.

ADHD treatment strategies encompass medication, therapy, or a combination of both, often yielding favourable results for the patient as per their need. Typically, a specialist, such as a paediatrician or psychiatrist, oversees the treatment plan, although ongoing monitoring by a GP might be involved.

Currently, medication options comprise five licensed types for ADHD treatment:

Methylphenidate: Primarily used for elevating brain activity in regions crucial for attention and behaviour control.
- Available: Tablets (2 to 3 times daily) or modified-release tablets (once daily, gradual dose release).
- Known side-effects: Slight elevation in blood pressure & heart rate, decreased appetite potentially leading to weight loss or inadequate weight gain, sleep disturbances, and headaches. Stomach discomfort.
Lisdexamfetamine: Primarily used for focus attention, reduces impulsive behaviour, and enhances concentration.
- Available: Capsule, to be taken once a day
- Known side-effects: dizziness, headaches, diarrhoea, nausea or vomiting.

Dexamfetamine: This drug is similar to lisdexamfetamine and works similarly.
- Available: Tablet, taken 2-4 times a day
- Known side effects: Decreased appetite, agitation, aggression, headaches, nausea or vomiting.
Atomoxetine: Slightly different in consumption and results when compared to other ADHD medicines, atomoxetine is a selective noradrenaline reuptake inhibitor (SNRI) used to control impulses and aid concentration.
- Available: Capsule, taken once or twice a day.
- Known side effects: Irritability, headaches, dizziness, trouble sleeping, and stomach aches.

Guanfacine: This is primarily used to calm the brain and improve attention. Another commonly known use of Guanfacine is reducing blood pressure.
- Available: Tablet, taken once a day
- Known side effects: Fatigue, tiredness, headache, and dry mouth.

Each medicine comes with its unique set of dosages. Some are daily intake, and others might only be required for specific events. We highly recommend going under periodic breaks under your GP’s supervision to check the ongoing necessity.

While these medications do not offer a definitive cure for ADHD, they can enhance concentration, reduce impulsiveness, promote a sense of calmness, and facilitate skill acquisition and refinement.

Open communication with the GP about any encountered side effects is vital. If treatment adjustments or cessation are desired, discussing such concerns with the GP is recommended.

Understanding your medication

Stimulants VS non-stimulants

ADHD medicines across the UK can be broadly categorised as stimulants vs. non-stimulants. Stimulant medications are available in two groups – Methylphenidate and Amphetamine, the usage and dosage we’ve already discussed.

Stimulants are usually recommended for beginners, so they’re not harsh on the body and are a preferred choice for children and young people. Non-stimulants are used when stimulant drugs do not work or are suitable for the patient.

Branded vs. generic medication

To understand branded vs. generic medication in the UK, let’s first see how patients across the UK access healthcare. On a broad, the UK has NHS care (government-funded) and private care. NHS usually is the first choice for anyone because of subsidised medication costs by the government, however, there is typically a longer waiting time which is why patients turn to private medication.

When someone visits a private prescriber, they need to cover a private fee for the prescriber. They also need to cover a private prescription fee which includes the medication and dispensing fees if they go to a local or online pharmacy. Signature Pharmacy offers competitive pricing for these services with a free delivery service.

After using a private prescription for some time, individuals might transition to a shared care agreement. This allows them to switch back to their NHS GP, who can continue providing the prescription. This step is taken after making sure the medication is effective and the patient’s condition is stable. Your well-being matters!

At significant, generic medications offer cost-effective alternatives to name-brand drugs, potentially saving substantial amounts for lifelong treatment plans.

The only challenge is that while they’re replaceable, they’re not interchangeable. Generic medications ensure “bioequivalence” to name-brand counterparts, encompassing dosage form, safety, strength, route, quality, and performance. Despite active ingredient similarity, variations arise in binding chemicals, fillers, and colours allowed in generic compounds.

While MHRA-permissible, differences in release rates between generic and name-brand drugs might influence patient responses. Since most ADHD patients have behavioural, neurological, or mental health conditions, it can be challenging without the GP’s consent. While transitioning to generic ADHD drugs, one must remain mindful and vigilant over behavioural changes, with external observers’ insights aiding assessment.

Cost disparities between brand vs. generic

When taking ADHD medicines, know that generic drugs can be 85% cheaper than those of name brands. They go through the same testing processes and have the same approval processes.

To think of it, there are numerous reasons why these costs can be so different and far from each other, from dosage to the brand name, from immediate versus extended use. Either way, ensuring the difference and transparency in the structure is tricky. Let’s take the example of Adderall, a popular combination drug of amphetamine and dextroamphetamine.

If you want to save some cost, try SignaturePharmacy, an online chemist delivery platform that helps patients with NHS and private prescriptions direct to your door for free.

Another way to be easy on your wallet is to discuss the medicine upfront with your private prescriber and understand if a cheaper generic alternative is available in the market. With the specialist’s consent, you can easily switch to drugs that do not cast a hole in your pocket.

How much does a private ADHD assessment cost in the UK?

The expense of private ADHD assessments in the UK can fluctuate based on the clinic, geographical area, and the specific evaluation needed. Adults usually expect to pay approximately £1,200, while children’s assessments could amount to around £1,600. Recognising that these figures are approximate and subject to variability is vital.

The primary reason why patients turn to private assessment and medication in the UK is that it can provide a quicker path to diagnosis and treatment. Longer queues and wait times can be avoided. Be sure to research reputable clinics, compare prices, and discuss payment before booking.

Coverage by insurance for ADHD patients

This is money-conducted research across the UK’s top insurance providers like Axa PPP, Bupa, Aviva, and Vitality Health to understand how it pans out for ADHD patients. Unfortunately, you must read through the fine print to understand whether your agency covers you.

Most big insurance agencies allow coverage for acute mental health conditions that can lead to full recovery. However, ADHD is a lifetime illness. This rationale is bolstered by their policy documentation, which explicitly excludes coverage for “treatment, including diagnostic tests to treat or assess learning difficulties or developmental or behavioural problems falling under ADHD.

During this research, the team discovered that Bupa covers many mental conditions, even if they arise from ADHD.

Based on This is Money’s research, only one out of four major private healthcare insurers will pay for an ADHD assessment. So while having insurance is excellent, as a patient, you must also understand the areas it covers.

Consider this before deciding on your medication in the UK

Are you aware of your triggers and low points? Like do you perform better with coffee or when you’re relaxed?
Are you aware of what brings you peace? Meditation? Music? A walk? Elements that help you navigate
Do you have any preferences in taking medicine? Cost? Number of times in a day? Capsule over tablet?
Are there any other medical conditions that may come in the way of your treatment?
Do you need the medication every day on special occasions?

These are not all, but some of the questions to get you started with your conversation with the GP. It’s essential to have clarity around when you seek help.

Conclusion

ADHD remains the most common undiagnosed challenge in children, according to the Centers for Disease Control and Prevention. With rising cases and more significant demand for assessment and medication, patients are constantly at the mercy of time.

In many cases, it could be months before patients get their first appointment through NHS, and even private clinics are challenging. If you know someone suffering, do not hesitate to book your appointment with your GP, who can nudge you in the right direction.

Amid this hubbub, online pharmacies that help with private prescription delivery are super helpful to get your medication to you in time at a much cheaper rate. Simple steps like uploading your prescription and making hassle-free online payments can save you hours of labour and get your doses at your doorstep.

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