ADHD medication titration for children: Preparing for medication

Yes. You can request your child's GP summary from their GP practice now. This is one of the most helpful things you can do while you wait, because GP practices can take up to 4 weeks to provide this information.

Once you receive the GP summary, you can upload it to the patient portal straight away.

Yes. You can upload your child's GP summary as soon as you receive it. You do not need to wait for us to ask for it.

Uploading it early may help avoid delays later, because our clinicians need to review this before medication titration can move forward.

Your child's GP summary gives our clinicians important information about their health.

It should include:

• current medication

• allergies

• medical conditions

• relevant health history

This helps us check whether ADHD medication titration is safe and appropriate for your child.

We cannot safely move forward with medication titration until this information has been reviewed.

No. Please do not upload screenshots or downloaded information from the NHS App.

We need a GP summary provided by your child's GP practice. This helps make sure the relevant information is brought together for our clinicians to review.

You can upload it through the Documents section of your patient portal.

1. Log in to the patient portal.

2. Select Documents from the menu on the left-hand side.

3. Select Upload.

4. Choose GP Summary as the document type.

5. Upload the file.

Once uploaded, your child's GP summary should appear in the Documents section of your portal.

The heart health survey is a short questionnaire about your child's health and family history.

Some questions can be answered by selecting tick boxes. Other questions may ask you to write a short sentence or two about your child's circumstances.

It usually takes around 5 minutes to complete.

Some ADHD medications can affect the heart.

The survey helps our clinicians understand whether medication is safe and appropriate for your child, and whether any additional checks may be needed before treatment begins.

We cannot move forward with medication titration until the survey has been completed and reviewed.

You may find it helpful to have the following information nearby:

• Details of any heart conditions your child has been diagnosed with

• Information about any previous heart-related symptoms or investigations

• Details of any vitamins, supplements or non-prescription medicines your child takes

• Information about any known family history of heart conditions or significant heart-related concerns

• Details of any previous ECGs, if known

You do not need to know every answer. If you are unsure, provide as much information as you can.

That is okay. Please answer as accurately as you can and provide as much information as possible.

We do not expect parents or carers to know every detail of their family's medical history. The important thing is that you answer honestly and provide what information you do have available.

Not every child needs an ECG. Your answers to the heart health survey help our clinicians decide whether any additional checks, such as an ECG, may be needed before medication titration can move forward.

If an ECG or another check is needed, we will explain what you need to do next.

Your child's health measurements help us keep them safe during medication titration.

They give the clinician a clear starting point before medication begins and help monitor how your child's body responds to medication over time.

These measurements are not just administration. They are part of the clinical information the prescriber uses to make safe treatment decisions.

You will need to provide:

• blood pressure

• pulse

• height

• weight

Please wait until we email you to ask for your child's first patient health metrics.

The measurements need to be recent, so arranging them too early may mean they cannot be used.

When we are ready for you to submit them, we will email you with clear instructions.

For the first medication appointment, your child's measurements need to be taken by a healthcare professional.

This could be a:

• GP

• Practice nurse

• Community nurse

• School nurse

• Pharmacist

• Other registered healthcare professional

Please ask them to provide either:

• A printed or signed record of the measurements, or

• Documentation showing their name and professional registration number

In many cases, yes. After the first medication appointment, measurements can often be taken at home using suitable equipment.

Some families also choose to use blood pressure equipment available in GP surgeries or other healthcare settings.

We will let you know what information we need before each appointment.

Your child's clinician needs an up-to-date picture of their health.

Children and young people can grow and change quickly. Medication can also affect people differently.

Recent readings help the clinician understand how your child's body is responding and whether it is safe to continue, adjust or review medication.

Without accurate and recent health measurements, the clinician may not have the information needed to make safe treatment decisions.

This means your child's medication appointment may not be able to go ahead safely and may need to be rearranged.

We know arranging measurements can sometimes feel inconvenient, but they are an important part of keeping your child safe during treatment.

There is no perfect way to have this conversation. Many families find it helpful to keep it simple, honest and age appropriate.

You might explain that medication is one of several tools that may help with some of the challenges they experience because of ADHD.

You could say:

• "Medication is not designed to change who you are. It may help some things feel easier, such as focusing, managing big feelings or getting started with tasks. We will keep checking how you feel, and you can tell us if something does not feel right."

Children often take their lead from the adults around them. It is okay if you do not have all the answers. Your child's clinician will be there to support you both throughout the process.

This is one of the most common concerns parents have. The aim of ADHD medication is not to change your child's personality, interests or sense of self.

The goal is to help reduce the impact ADHD symptoms may be having on daily life.

Many parents tell us that their child still feels like themselves, but that certain things feel easier to manage.

If at any point you feel your child is not themselves, or you are concerned about how medication is affecting them, please speak to your clinician.

Possibly. Some children notice improvements in focus, concentration, emotional regulation or day-to-day functioning.

Some children experience side effects, particularly when first starting medication or when their dose changes.

Every child responds differently, which is why medication titration is a gradual process. Your child's clinician will work with you to monitor progress and make adjustments where needed.

Like all medicines, ADHD medication can cause side effects, although many children experience only mild effects or none at all.

The most common side effects include:

• reduced appetite

• changes to sleep patterns

Some children may also experience:

• headaches

• stomach aches

• feeling restless or jittery

• mood changes or irritability

An increase in heart rate or blood pressure

These side effects are often most noticeable when medication is first started or when the dose is increased and may improve as your child's body adjusts.

Your clinician will discuss possible side effects with you before treatment begins and will continue to monitor your child throughout titration.

Please let us know if your child experiences side effects.

Many side effects can be managed by adjusting the dose, changing the timing of medication or reviewing the medication itself.

You do not need to decide on your own whether a side effect is important. If something does not feel right, we would rather you contact us and talk it through.

If your child develops severe symptoms or you are concerned about their immediate wellbeing, please seek urgent medical advice by contacting NHS 111 or calling 999.

Serious side effects are uncommon.

Before medication is prescribed, clinicians review your child's medical history, heart health information and physical measurements to help ensure medication is safe and appropriate.

We continue to monitor your child throughout titration so that any concerns can be identified and addressed early.

It is completely normal to feel uncertain.

Many parents and carers have questions about medication, even when they feel it may help their child.

Starting medication does not mean committing to a permanent decision. Medication titration is a carefully monitored process designed to find out whether medication is helpful and well tolerated.

Your child's clinician will work with you throughout the process, answer your questions and support you in making informed decisions.

You do not need to do everything at once.

Small, manageable steps can help. You may want to:

• Request your child's GP summary

• Read your child's assessment report

• Write down any questions for your clinician

• Think about which ADHD-related challenges are having the biggest impact on daily life

• Focus on one or two recommendations from the assessment report

• Explore practical strategies that may help at home, school or college

• Watch our ADHD video playlist for support and ideas

Progress does not need to happen all at once. Small changes can still make a meaningful difference.

As your child moves through the medication pathway, we will email you when we need information from you.

The information we request helps our clinicians make safe decisions about treatment.

Responding promptly to requests for GP summaries, heart health information and health measurements helps keep your child's pathway moving and can help avoid unnecessary delays when they reach the top of the medication waiting list.

Some information is required before we can safely move forward with medication titration, so completing requested actions as soon as you can will help us prepare for the next stage of treatment.

Try not to feel that you need to get everything right.

It can help to:

• keep a note of any changes you and your child notice

• encourage your child to tell you how they are feeling

• maintain regular routines where possible

• make a note of any questions that come up between appointments

• share any concerns openly with your clinician

Finding the right medication and dose can take time. Titration is a process, not a test, and your clinician will work with you and your child throughout the journey.