How can It help?
Managing ADHD with medication can significantly improve focus, impulse control, and overall daily functioning. Below, we outline how ADHD medication works, the different types available, and what to expect from our follow-up care.
How Does ADHD Medication Work?
ADHD medications primarily work by affecting neurotransmitters in the brain—mainly dopamine and norepinephrine. These chemicals play a key role in attention, motivation, and impulse control.
- Stimulants increase dopamine levels, improving focus and reducing impulsivity.
- Non-stimulants regulate norepinephrine to enhance cognitive function, making them suitable for individuals who do not tolerate stimulants well or have cardiovascular concerns.
Types of Medication
There are two main categories of ADHD medication:1. StimulantsThese are the most commonly prescribed ADHD medications and include:
- Methylphenidate-based (e.g., Ritalin, Concerta, Medikinet) – Available in:
- Short-acting (4-hour)
- Intermediate-acting (8-hour)
- Long-acting (12-hour) formulations.
- Lisdexamfetamine/Dexamphetamine-based (e.g., Elvanse, Amfexa) – Typically long-acting but can be supplemented with short-acting dexamphetamine if needed.
2. Non-StimulantsThese are alternatives for those who experience side effects from stimulants or have cardiovascular concerns:
- Atomoxetine (Strattera) – A norepinephrine reuptake inhibitor, effective for ADHD but takes longer to work.
- Guanfacine (Intuniv) – A non-stimulant that helps with impulsivity and emotional regulation.
Each person responds differently to medication, so finding the right type and dosage may take time.
What is ADHD Medication Titration?
ADHD medication titration is the process of adjusting the type, dose, and schedule of medication to find the most effective and well-tolerated treatment for an individual. Since ADHD medications affect everyone differently, titration helps determine the optimal balance between symptom control and minimal side effects. How Does the Titration Process Work?
- Starting at a Low Dose
- Initially, a clinician prescribes a low dose of the chosen medication to assess how the body responds.
- This helps minimize side effects and allows for gradual adjustments.
- Monitoring Symptoms and Side Effects
- The patient records improvements in focus, impulsivity, and energy levels as well as any side effects like appetite changes, sleep disturbances, or increased heart rate.
- Regular check-ins (weekly or biweekly) with a specialist help track progress.
- Gradual Dose Adjustments
- The clinician increases or adjusts the dosage incrementally based on feedback.
- If side effects become problematic, the dose may be lowered or a different medication may be tried.
- Exploring Different Medications (if needed)
- If the first medication does not provide the desired effect or causes intolerable side effects, a different formulation (e.g., switching from a stimulant to a non-stimulant) may be considered.
- Some patients require short-acting medication alongside a long-acting one for better symptom management.
- Finding the Optimal Dose
- Once the right dosage and medication are found, the patient is considered “stable”, meaning symptoms are well-managed without significant side effects.
- A final review ensures the chosen medication works consistently throughout the day.
How Long Does Titration Take?
- Titration typically takes 4 to 12 weeks, but it varies based on individual response.
- Some people find the right dose quickly, while others may need multiple adjustments over several months.
Why is Titration Important?
- Ensures maximum effectiveness with minimal side effects.
- Helps tailor medication to individual needs.
- Prevents taking too much or too little medication.
- Reduces the risk of adverse effects, such as sleep disturbances or heart rate issues.
What Happens After Titration?
- Once stable on medication, follow-up reviews are scheduled every 6 months (or sooner if needed).
- If symptoms change over time, medication can be adjusted accordingly.
- Some individuals may transition to shared care with their GP, allowing NHS prescriptions (if approved).
Final ThoughtsTitration is an essential part of ADHD treatment, ensuring that medication is safe, effective, and tailored to each individual. With careful monitoring and adjustments, most people find a medication plan that works optimally for them.
What Is the Difference Between a Private Prescription and a Shared Care Prescription?
Private Prescription:
- Issued by a private clinician.
- You pay for both the consultation and the full cost of the medication at a pharmacy.
- The price varies depending on the medication and pharmacy rates.
Shared Care Prescription:
- Your private ADHD specialist works with your NHS GP to transfer prescribing responsibility.
- If your GP agrees, they will prescribe your medication through the NHS, meaning you only pay the standard NHS prescription charge.
- GPs are not obligated to accept shared care agreements with private providers.
How Do Private Prescriptions Work?
If you receive a private prescription, the process is as follows:
- Pay for a consultation with your ADHD specialist.
- Receive a private prescription, which you can take to a pharmacy.
- Pay the full cost of the medication (prices vary between pharmacies).
Some patients continue on private prescriptions indefinitely if their GP does not agree to shared care.
Specialist Follow-Up and Our Services
Once you start ADHD medication, ongoing monitoring is essential to ensure its effectiveness and manage any side effects.
- We offer four types of follow-up appointments, ranging from £35 to £145, depending on the consultation length.
- Once stable on medication, we provide a free review every six months to ensure continued effectiveness.
- We always request shared care from your GP once you are stable, but NHS GPs are not required to accept this arrangement.
ADHD Medication FAQ
How do I get my ADHD medication?
Whether we are going down the ‘shared care’ route to prescribing or prescribing purely on a private basis, we always follow what’s in the national guidelines for ADHD and in the UK, we follow the NICE Guidelines, which states that, ‘All medication for ADHD should only be initiated by a healthcare professional with training and expertise in diagnosing and managing ADHD’, which would NOT be your GP. Our Clinical Specialists with Prescribing Qualifications will always write your prescriptions until your treatment is stable.
How much do the private prescriptions for ADHD Medication cost?
Let’s break the costs down for you. There are 2 options for a private prescription.
Option 1: You receive your private script from ADHD Direct in the way of a paper prescription posted to you or we can post the prescription to your pharmacy of choice. This option costs you £20 for the prescription. This covers the prescription cost and postage, which is sent via royal mail recorded delivery. You then will purchase the medication at your pharmacy. This will include the price of the medication and the pharmacy’s private dispensing charge.
Option 2: This involves ADHD Direct electronically requesting your prescription to Private Pharmacy Group and they will deliver your medication directly to your home address via DPD. This eliminates the need to bring your prescription to the pharmacy, simplifying the process for you. This option costs you £20 for the prescription.
I have received notification that my prescription is being processed in London using PPG?
Please don’t worry, PPG are UK wide and will process your prescription through their own processes, rest assured this will still be delivered to you.
Why do I need an ADHD medication review appointment?
The national guidance and local shared care agreements stipulate that the private service (that’s us) must regularly review your medication to ensure it’s effective, safe and make any adjustments as required.
What happens once I’m stable on my ADHD medication?
Good news is that we will only see you when we have to and if you’re stable on your treatment, this means we’ll see you for review either 6 monthly for a child and 6 monthly or 12 monthly for an adult. More good news, these appointments could be free of charge. If you’re stable on your treatment at your medication review appointment and you and your clinician don’t anticipate any changes to your treatment in the next 6 to 12 months, then you may be advised to book your next review with one of our Clinical Assistants and these appointments are FREE.
However, if you develop any side-effects or any other complications, then you will need to have a review appointment with one of our Specialists.
At ADHD Direct, we are committed to your well-being. We understand that once you have achieved stability with your medication, the ongoing costs of medication review appointments can be challenging. That’s why we offer these appointments to you free of charge. We recognise that the NHS may not always have the capacity to fully take over your care, and our aim is to make this aspect of your healthcare as accessible as possible for you.
Do I need an ECG before starting treatment?
The guidelines state that an ECG should not be carried out routinely before starting ADHD medications unless
you have a significant family history suggesting a Potential underlying cardiac condition, this would be:
- history of congenital heart disease or previous cardiac surgery
- history of sudden death in a first-degree relative under 40 years suggesting a
- cardiac disease
- shortness of breath on exertion compared with peers
- fainting on exertion or in response to fright or noise
- palpitations that are rapid, regular and start and stop suddenly (fleeting
- occasional bumps are usually ectopic and do not need investigation)
- chest pain suggesting cardiac origin
- signs of heart failure
- a murmur heard on cardiac examination
We will always carry out a systematic enquiry of your cardiac history and we will also take baseline measurements of your blood pressure, pulse, weight and height for children. These measurements are recorded at agreed intervals for the duration that you take your ADHD medication.
If we think that you do require further cardiac assessment, then in the first instance, we will ask you to consult your GP.
