When it comes to private assessment and treatment of ADHD, our approach is the same as in the NHS. We follow the NICE guidelines and work with you collaboratively to consider pros and cons of the various ADHD medication options licensed in the UK. Below we present to you in a tabular form an easy comparison guide for your consideration. We usually also send additional reading information before appointments as relevant, but below you will also find a FAQ.
|Stimulants typically these dopamine enhancing drugs are the first line treatment for majority patients.||Non-stimulant Tends to be second line treatment and work through Nor-Epinephrine pathway||Non-stimulant|
second/third line treatment & work through Nor-Epinephrine pathway
|Common names – Ritalin /Concerta (Methylphenidate), Elvanse (Lisdexamfetamine)||Strattera||Intuniv|
|Tablets / Capsules or some options in Liquid forms||Capsule and Liquid||Tablet only, cannot be crushed.|
|Fast acting and works in an hour from taking medication at optimal dose||2-8 weeks to provide benefits||2-8 weeks to provide benefits|
|Works 8-12 hours only||24 hours||24 hours|
|Morning only treatment||Morning only treatment||Usually an evening dose|
|It is possible to stop-start the treatment, usually taken weekdays, term time only to minimise side-effects.||Has to be taken daily, avoid abrupt stopage||Has to be taken daily, avoid abrupt stopage|
|Effects noted in an hour, wear off by 4-6pm. Produces a 20 point improvement on rating scales.||12 point improvement on average||12 point improvement on average|
|Appetite suppression and weight loss is the biggest concern +++||Appetite & Weight loss +||Likely gain in appetite and weight|
|Possible insomnia ++||Insomnia +||Improves sleep|
|Possible increase in pulse & BP||Possible increase in pulse & BP||May reduce pulse and BP|
|May affect mood and anxiety but usually has a stabilising effect.||Similar||Similar|
|May cause/worsen tics||Rarely +||Used to treat tics.|
|Growth Hormone suppression & loss of 2cm average adult height if medication is used withour medication holidays.||Unlikely||No such known concerns|
|ECG advised if family history of cardiac arrhythmia, fainting episodes, anyone dying very young or other ailments.||Similar||Similar|
|NICE allows used age 5 +||Similar||Similar|
When considering the ADHD medication options and starting the treatment privately, a number of questions are commonly posed to us, below find a FAQ and usual solutions.
Will the NHS/GP provide the prescription? Typically the expectation is for the treatment to be initiated by the specialist, be it private or NHS. This thus is offered as a private prescription. Once settled on the optimal dose, you can request the GP to provide repeat prescriptions (this is at their discretion).
What are the costs of the private prescription? These are separate to our fees and paid direct to pharmacy, the pricing varies from £30 to £100 per month. Once the GP provides the support after the initial 2-3 months, this would be free.
Can treatments be combined? All the above medications have been licensed in UK as mono-therapy. In some situations drugs may be combined with caution, but this will be off-label prescribing.
Can other conditions be treated alongside? Yes, any co-morbid anxiety, depression may be treated with anti-depressants concurrently.
What about Adderall? Adderall short acting is not available in the UK. The long-acting Adderall XR is imported and not licensed or provided within NHS or via GP. Privately, the cost of the monthly prescription is likely to be approximately £400.
Are there other treatment options aside from those listed above? In rare situations, options like certain anti-depressants may be used to augment the effects of medication. We recommend caution and an ECG before combining certain agents, e.g. Imipramine or Bupropion.
It is vital to highlight that NICE strongly supports use of medication with non-pharmacological approaches of treatment of ADHD. Please browse our other page/s for more information or subscribe to receive updates.