Two types of medications are used to treat adult ADHD: stimulant and non-stimulant. While NICE guidelines state treatment must start with stimulant medication, lack of response to it should be considered in light of the diagnostic subtypes: Hyperactivity/Impulsivity might respond better to a non-stimulant and Attention deficit to stimulant medication. However, this is not a rule, and treatment should be individually tailored to the patient’s presentation and needs.
How do stimulants work?
Stimulants help the symptoms of ADHD in several ways. First, they increase dopamine levels in the brain. Dopamine is a neurotransmitter associated with pleasure, attention span and motivation. Stimulants can help people with ADHD with concentration and focus and decrease irritability and hyperactivity. Stimulants are legally ‘controlled’ drugs because they can be open to abuse and can be addictive. People will react differently to the different types, and it's important to be closely monitored by your consultant psychiatrist to ensure you're taking the right drug and dose for your condition.
Side effects can range from decreased appetite and weight loss to mood swings and sleep problems, so it's important to communicate with your consultant psychiatrist and inform us if you regularly experience any significant adverse side effects.
I noticed a difference within a few days really, and once I was on a stable dose it was like I was a new person. They have been really effective, I can’t believe I waited so long.
Non-stimulant ADHD medications are longer lasting, which means they only need to be taken once a day and can be useful for people who also experience depression as they have anti-depressive qualities.
One of the most commonly used non-stimulants is Atomoxetine (sometimes called Strattera). This can help people with ADHD by increasing noradrenaline levels. This increases the number of messages passed in the brain which in turn increases concentration and helps control impulses. Atomoxetine is generally used when stimulants have been ruled out or aren't effective.
Side effects of non-stimulant ADHD medication can range from decreased appetite and weight loss to sleep disturbances. Again, we recommend contacting us if you regularly experience any significant adverse side effects from your medication.
If you think you might have ADHD, a diagnosis could help you make sense of behaviours and past decisions. Various treatments, including medication and therapy, can help manage all kinds of challenges, but the first step is to get an assessment.
Once you have a diagnosis of ADHD, there are several options as to how you can receive treatment. This will depend on the services offered by your local NHS team. We always advise that you speak to your GP when deciding whether this assessment is right for you to ensure you understand where you might be able to access ongoing treatment.
- Continue privately
You may wish to continue with private treatment. This will involve several follow-up appointments with a consultant psychiatrist to start you on medication and monitor your progress and dosage levels. Normally four or five appointments are needed to get the ADHD medication levels stable and to check for side effects. The psychiatrist will need to see you fortnightly, moving to monthly, to ensure the medication has the desired effect.
- NHS care
Alternatively, you may return to NHS care, where your report will be shared with your GP, who can prescribe the ADHD medication you have been prescribed and carry out the monitoring process. Not all GPs can do this, so we recommend you talk to them beforehand to clarify what is available in your area.
You may wish, or need, to pay privately for your medication prescriptions – again this is based on your personal preferences and what services are available to you via the NHS. Your GP should be able to advise. We cannot guarantee that your GP will be happy to prescribe our recommendations, but we are happy to discuss this option with you.