ADHD - Adults

[PlywoodPascal]

I am still really struggling on dexamfetamine, it’s grim.

[hepy]

Had my assessment on Monday and I am going to be prescribed Concerta.

Doctor said there are no shortages of this?

Anyone any experience with it? Hints and tips? I’ve never taken any ADHD medication before and get wired from just two cups of filter coffee.

[KAgantua]

Anyone had any luck with private diagnosis? Have found a clinic just outside London that has great reviews but is expensive for the initial consultation.

Its for my girlfirend who has all the signs/ anxiety/ tics/ active mind/ procrastination/ fits of energy and crashing/

[Woodrow Wilson]

hepy said:

Had my assessment on Monday and I am going to be prescribed Concerta.

Doctor said there are no shortages of this?

Anyone any experience with it? Hints and tips? I’ve never taken any ADHD medication before and get wired from just two cups of filter coffee.

I don't get wired from coffee, but when I first started taking Concerta it did seem to make me a bit buzzy with coffee (it doesn't appear to now)

If you are affected by coffee, then Concerta might have an effect.

[Kermit power]

KAgantua said:

Anyone had any luck with private diagnosis? Have found a clinic just outside London that has great reviews but is expensive for the initial consultation.

Its for my girlfirend who has all the signs/ anxiety/ tics/ active mind/ procrastination/ fits of energy and crashing/

Does she have private medical insurance with work?

Mine wouldn't pay for anything beyond diagnosis as it then counts as a preexisting condition, but at least I got the diagnosis paid for!

For what it's worth, mine was done with www.psychiatry-uk.com. I'm not sure what the cost was, but the NHS Adult Mental Health team were very complimentary about the quality of the report - apparently they see quite a lot of pretty sketchy private ones! - and it significantly bumped me up the waiting list to get onto NHS prescriptions through a shared-services agreement with my GP as the AMH team were happy to take me on with a validation check rather than a full diagnosis from scratch.

[KAgantua]

Kermit power said:

KAgantua said:

Anyone had any luck with private diagnosis? Have found a clinic just outside London that has great reviews but is expensive for the initial consultation.

Its for my girlfirend who has all the signs/ anxiety/ tics/ active mind/ procrastination/ fits of energy and crashing/

Does she have private medical insurance with work?

Mine wouldn't pay for anything beyond diagnosis as it then counts as a preexisting condition, but at least I got the diagnosis paid for!

For what it's worth, mine was done with www.psychiatry-uk.com. I'm not sure what the cost was, but the NHS Adult Mental Health team were very complimentary about the quality of the report - apparently they see quite a lot of pretty sketchy private ones! - and it significantly bumped me up the waiting list to get onto NHS prescriptions through a shared-services agreement with my GP as the AMH team were happy to take me on with a validation check rather than a full diagnosis from scratch.

Thanks sir, looks interesting, ill digest fully later/ tomorrow.

[pherlopolus]

I managed to get some 60 (normal 30) so got 2 months for my £105.

The boots pharmacy stock website seems to work well. https://pharmacystockchecker.com/

[Kermit power]

pherlopolus said:

I managed to get some 60 (normal 30) so got 2 months for my £105.

The boots pharmacy stock website seems to work well. https://pharmacystockchecker.com/

Can you not get an NHS prescription, or are you just still in the queue?

[pavarotti1980]

CinnamonFan said:

Its unlikely the GPs first choice would be Elvanse. Usually first line treatment is some sort of Methylphenidate which to my knowledge has no shortage. Its worth you asking the question for sure.

NICE guidance for ADHD in adults is methylphenidate or lisdexamfetamine as first line. Have a look at NG87 (1.7.11)

Given the current issues with methylphenidate it would seem prudent of a prescriber to explore commencement of lisdex instead if that stock is available and supply is likely to be more consistent.

[sparkyhx]

Kermit power said:

Hallelujah!



Not my usual 70mg dose, but they're expecting a 20mg prescription to keep it company tomorrow!

50mg are largely back on stream now, other doses are low/non existant - I think 20's are in the non existant list at the moment

[pherlopolus]

Kermit power said:

Can you not get an NHS prescription, or are you just still in the queue?

Shared care request has gone over with no guarentee of success.

If I need both meds each month it's about £250 inc consultation and precription charges. Still better than not having them, and we can afford it.

[CinnamonFan]

pavarotti1980 said:

NICE guidance for ADHD in adults is methylphenidate or lisdexamfetamine as first line. Have a look at NG87 (1.7.11)

Given the current issues with methylphenidate it would seem prudent of a prescriber to explore commencement of lisdex instead if that stock is available and supply is likely to be more consistent.

My comment was based from my work with children.

To my knowledge Methylphenidate stock issues are clearing up. Lisdexamfetamine stock issues persist, higher doses appear to be restocked quicker than lower.

NG87 also says (below the bit you pasted)

"March 2018 – this is an off-label use of lisdexamfetamine for adults with no ADHD symptoms in childhood. See NICE's information on prescribing medicines. Not all preparations of methylphenidate are licensed for treating symptoms of ADHD in adults"

From a lot of the posts in this thread id think adult diagnosis is more common rather than childgoodfor PHers.

Off label Lisdex can be done, but prescribers need to be able to justify it hence my comment about prefering Methylphenidate.

I think the stock supply wherever you are is different to my local services, hence us thinking opposite views. Thanks for the thought provoking comment, enables me to think about other perspectives.

[pavarotti1980]

CinnamonFan said:

My comment was based from my work with children.

To my knowledge Methylphenidate stock issues are clearing up. Lisdexamfetamine stock issues persist, higher doses appear to be restocked quicker than lower.

NG87 also says (below the bit you pasted)

"March 2018 – this is an off-label use of lisdexamfetamine for adults with no ADHD symptoms in childhood. See NICE's information on prescribing medicines. Not all preparations of methylphenidate are licensed for treating symptoms of ADHD in adults"

From a lot of the posts in this thread id think adult diagnosis is more common rather than childgoodfor PHers.

Off label Lisdex can be done, but prescribers need to be able to justify it hence my comment about prefering Methylphenidate.

I think the stock supply wherever you are is different to my local services, hence us thinking opposite views. Thanks for the thought provoking comment, enables me to think about other perspectives.

Given the subject is ADHD in adults it would be a bit confusing for people if your advice is based on children and adolescents.

Off-label prescribing is routine and is backed by a SCG guideline for secondary care to stabilise before dropping back into primary care. Also bear in mind that the off-label only relates to adults who had no ADHD symptoms in childhood. I am guidelines group that produces SCG's for the local APC and had these discussions at length when the ADHD one was produced.

Edited by pavarotti1980 on Wednesday 15th November 16:11

[CinnamonFan]

pavarotti1980 said:

Given the subject is ADHD in adults it would be a bit confusing for people if your advice is based on children and adolescents.

Off-label prescribing is routine and is backed by a SCG guideline for secondary care to stabilise before dropping back into primary care. Also bear in mind that the off-label only relates to adults who had no ADHD symptoms in childhood. I am guidelines group that produces SCG's for the local APC and had these discussions at length when the ADHD one was produced.

Edited by pavarotti1980 on Wednesday 15th November 16:11

I dont pretend to understand any of the acronyms in your last sentence, but did you see where I left my coat?

[Kermit power]

pherlopolus said:

Kermit power said:

Can you not get an NHS prescription, or are you just still in the queue?

Shared care request has gone over with no guarentee of success.

If I need both meds each month it's about £250 inc consultation and precription charges. Still better than not having them, and we can afford it.

Yeah, it took me about 2 years to get to the front of that queue, for a 10 minute conversation in which the psychiatrist did little more than ask if my teport was accurate before signing off on it!

[pherlopolus]

Kermit power said:

Yeah, it took me about 2 years to get to the front of that queue, for a 10 minute conversation in which the psychiatrist did little more than ask if my teport was accurate before signing off on it!

I was in there for 2 hours with an underling, then 10 mins with psychologist. On the bright side my consultation is by email every month and only £45

[Kermit power]

pherlopolus said:

Kermit power said:

Yeah, it took me about 2 years to get to the front of that queue, for a 10 minute conversation in which the psychiatrist did little more than ask if my teport was accurate before signing off on it!

I was in there for 2 hours with an underling, then 10 mins with psychologist. On the bright side my consultation is by email every month and only £45

Mine are all free on the NHS though!

[Job38]

My psychiatrist has suggested switching to Adderall owing to Elvanse shortages.
'It is a bit more expensive I'm afraid' (I was lead to believe Elvanse was the most expensive?)

1 month prescription - £450 !!!

[pavarotti1980]

Job38 said:

My psychiatrist has suggested switching to Adderall owing to Elvanse shortages.
'It is a bit more expensive I'm afraid' (I was lead to believe Elvanse was the most expensive?)

1 month prescription - £450 !!!

That is because they will be importing it (from the US I think) and it doesn't have a UK license so it is effectively a blank cheque

[toohuge]

Does anyone have any book recommendations they could make to help me educate myself a little more about ADHD and how it impacts on someone's life? A friend of mine (female) is diagnosed with ADHD and I realised I'm none the wiser as to the struggles and perspective it must bring and I'd like to be better informed.

Thanks
Chris