5 Questions people ask after ADHD diagnosis - Question 2
Posted on 17th June 2024 at 14:31
How do I get medication?
GPs do not usually prescribe ADHD medication and so you will need to see a specialist prescriber. Most people who have a private ADHD Assessment, will also have private medication assessment. A range of specialist professionals can prescribe ADHD medication including pharmacists, mental health nurses and psychiatrists.
After your ADHD diagnosis, I will give you information about individual professionals and organisations you can contact for a medication assessment. You can self-refer and do not need a referral from another professional. You will need to send a copy of your ADHD Assessment report to the specialist prescriber and they will request additional information about your physical health.
You will have an initial medication assessment appointment with the specialist prescriber and they will build up a picture from your ADHD Assessment report, your questionnaire responses and information gathered during their meeting with you, about your physical and mental health and your family health history. They will then prescribe a medication. They will take into account your physical health history and any other medication you are taking for your physical and mental health.
You will then go through a process of titration. This means finding a medication which will work well for you and determining what dose you need and what time of day you will need to take it for it to be as effective as possible with minimum side effects. Most ADHD medications are stimulants which can cause small but significant increases in blood pressure and heart rate*. The specialist will therefore ask you to monitor your blood pressure and heart rate during the process of titration. If your blood pressure is too high then you will need to be treated for this before you can resume ADHD medication. You will usually be started at a low dose of ADHD medication and the dose will be gradually increased until your ADHD symptoms decrease effectively. During this process, you will meet with the prescriber for some shorter appointments to review how you are finding the medication and to discuss the impact the medication is having on your symptoms.
Once the medication is working well, most people are referred back to the care of their GP for ongoing prescribing. In order for this to happen there will need to be a Shared Care Agreement between the specialist prescriber and your GP. (See Blog on Shared Care Agreements: LINK). The monitoring and review of medication remains with the specialist prescriber. Depending on where you live, your GP may suggest that the monitoring and review of your ADHD medication is moved from the specialist private prescriber to a specialist within the NHS, often within a Specialist NHS ADHD Service. This is obviously a cheaper option than paying a private prescriber when you need a review.
Many prescribers now work online and so you do not need to find prescriber who works in your area.
*Wilens et al, 2005 Blood pressure changes associated with medication treatment of adults with attention-deficit/hyperactivity disorder, J Clin Psychiatry, 66(2):253-9.
ADHD Adult Assessment
If an adult, who thinks they may have ADHD, wants to ask for “reasonable adjustments” to be made by their employer, college or university, then they will need to have gone through an ADHD Assessment and received a formal diagnosis.
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