This is a starter guide to the ADHD treatment journey.
Remember, treatment is for management of the condition and not a cure. Be prepared to look at a holistic treatment program that involves medication, self-awareness, support, therapy and ultimately, lifestyle changes. There is no one treatment that will work for every individual. The journey towards finding what works for you can be frustrating and long, but it can also offer the reward of a happier life.
Recommendations suggested in this website come from ‘NICE Guidelines’. The National Institute for Health and Care Excellence (NICE) is an executive non-departmental public body of the Department of Health in the United Kingdom. It serves both the English NHS and the Welsh NHS and provides clinical guidance on treatments and their effectiveness.
You may have heard of NICE before; we will occasionally refer to it throughout this website and you may hear of it through your treatment. It is well worth reading these guidelines:
Full NICE guidelines: https://www.nice.org.uk/guidance/cg142/evidence/full-guideline-186587677
ADHD guidance: https://www.nice.org.uk/guidance/cg72
The first step is to go to your GP, describe your symptoms and ask for a referral to the ADHD specialist clinic. For information, both East Sussex and West Sussex have a specialist clinic to diagnose adults for ADHD, Autism, Tourettes and other neuro-diversity. If you are referred by your GP, you will see a specialist and begin to look at the options for treatment. This specialist will consider your symptoms and medical history to see what medication, if any, is appropriate. If you have a history of other diagnosis (co-morbidity), mental disorders, self-harm, alcohol or substance misuse issues, then this will be taken into account.
Your specialist will use the NICE Guidelines and move through the recognised stages. These are the named medications with a brief outline of their type and effect.
Please note: for detail about any part of this process and about each medication please consult the NICE guidance.
NICE guidelines: “Drug treatment for adults with ADHD should always form part of a comprehensive treatment programme that addresses psychological, behavioural and educational or occupational needs. Following a decision to start drug treatment in adults with ADHD, methylphenidate should normally be tried first.”
Short Release: Ritalin
Effect: Lasts about 2 to 3 hours, 30 mins after being taken
Long Release: Concerta, Matoride
Effect: Lasts several hours, taken once daily
Type: Non stimulant
Constant Release: Strattera
Effect: This is similar to an antidepressant and will likely be given if there is a history of substance abuse or problematic behaviours. Takes time to build into the system
Name: Dexamphetamine or Dexamphetamine
Short Release: Dexamphetamine
Effect: Similar to Methylphenidate. It can be addictive and so not given to those with substance abuse issues or potential characteristics
Constant Release: Elvanse
Effect: Non-active chemical breaks down into liver and becomes dexamfetamine which has the brand name ‘elvanse’. Is not addictive.
It is important to remember that medication does not work alone and as with all treatments, an individual has to take ultimate responsibility for the downsides, as well as the benefits.
Facts about medication it is useful to consider:
- ADHD medication is effective – it has an 80% success rate.
- Medication does not have to be taken forever. It can be used to gauge how much it changes your daily life and how you wish to incorporate it.
- An individual can decide to take the medication as and when they need it.
- It is not a ‘miracle cure’.
Co-morbidity and neurodiversity
An individual may have a dual diagnosis or co-morbidity alongside their ADHD diagnosis; such as Aspergers or Autism, PTSD, Personality Disorder, Sensory Processing Disorder, Depression or Anxiety.
Your consultant and GP will consult with you about the right medications that help to treat these conditions
Psychotic Mental Health Conditions
If an individual is going through a serious mental health crisis or an ongoing condition then they will not be prescribed ADHD medication in conjunction with antipsychotics. This is underlined in the NICE Guidelines.
HIV and HIV prevention medication
There are no known side effects that impact on the workings of HIV medication. This includes PrEP and PEP.