An ADHD diagnosis is often the start of a new chapter. Once you have your assessment outcome, it’s natural to have questions about what happens next, especially if you’re considering medication.
Understanding how ADHD medication is prescribed, what titration involves and how shared care works with your GP can help you feel more prepared to make informed decisions.
In this guide, Lynsey McLatchie, Lead Non-Medical Prescriber at Melios, explains what to expect after an ADHD diagnosis, from prescribing and titration through to ongoing medication reviews and shared care.
Does everyone with ADHD need medication?
Medication can be a very effective treatment for many people with ADHD, but it isn’t the right option for everyone.
After your assessment, your clinician will discuss your results and make personalised recommendations based on your symptoms, medical history and circumstances. These may include medication, or they may focus on other ways to help you manage your ADHD, along with signposting to further information and support.
Who can prescribe ADHD medication?
If medication is recommended following your assessment, it will usually be started by a specialist ADHD clinician, such as a psychiatrist or a qualified non-medical prescriber working within a specialist service.
GPs do not usually start ADHD medication. However, once the medication has been reviewed and you’re on a stable dose, your GP may be able to take over prescribing through a shared care agreement. Whether this happens depends on your GP practice and local prescribing arrangements, which we’ll explain in more detail later in this guide.
“As a specialist prescribing team, our role is to make sure any medication is prescribed safely and appropriately. We’ll work with you throughout the process, answer your questions and monitor how you’re getting on before discussing whether shared care is an option.”
Lynsey McLatchie, Lead Non-Medical Prescriber, Melios
What is titration, and what does it involve?
Titration is the process of finding the medication and dose that’s right for you. Everyone responds differently to ADHD medication, so it’s important to take the time to find the approach that works best while monitoring how you’re feeling.
During titration, your prescribing clinician will work with you to:
- Start medication at an appropriate dose.
- Monitor how well it’s working and whether you’re experiencing any side effects.
- Adjust the dose if needed.
- Continue reviewing your progress until your medication is working well and is well tolerated.
How long titration takes varies from person to person. Some people reach a stable dose within a few weeks, while others need longer. Throughout the process, your clinician will ask how you’re getting on so that any changes can be made safely and with your agreement.
“Titration is a gradual process, and everyone’s experience is different. We’ll work with you to understand how the medication is affecting you and make any changes based on your individual response, rather than following a fixed timetable.”
Lynsey McLatchie, Lead Non-Medical Prescriber, Melios
What is shared care?
Once your medication has been stabilised, your GP may be able to take over prescribing through a shared care agreement.
If a shared care arrangement is in place, your GP is responsible for issuing your repeat prescriptions, while Melios continues to provide specialist oversight. This includes annual reviews and support if your treatment needs to change.
Shared care allows your day-to-day prescribing to be managed by your GP while your specialist team remains involved in your ongoing care.
Will GPs accept shared care?
Whether your GP accepts a shared care agreement will depend on your GP practice and local prescribing arrangements. Whether a GP accepts shared care varies between practices and local prescribing arrangements. Some practices are able to take on prescribing once medication has been stabilised by a specialist, while others may decide not to.
If your GP does not accept shared care, your clinician will explain the options available and discuss the next steps with you. Your clinician will explain your options and discuss the next steps with you.
As part of the process, we’ll provide your GP with a shared care letter and any supporting clinical information they need. If there are any questions about your treatment, our team is available to provide further information where appropriate.
“Every GP practice has its own approach to shared care, so it’s not something we can guarantee. Our role is to provide clear clinical information and support you through the process, whatever the outcome.”
Lynsey McLatchie, Lead Non-Medical Prescriber, Melios
What if my GP doesn’t accept shared care?
If your GP decides not to enter into a shared care agreement, your clinician will talk you through the options available.
In some cases, Melios can continue prescribing your medication. This is a private service and there is an ongoing cost, which your clinician will explain before you make any decisions.
If you have any concerns about shared care, it’s worth discussing them with your GP early on. Your clinician can also provide supporting information where needed to help you understand the process.
Will I need to take ADHD medication forever?
Not necessarily. Some people choose to take ADHD medication long term because they find it beneficial, while others decide to stop or review their treatment over time.
If you’re taking ADHD medication, you’ll have regular reviews with your prescribing clinician to discuss how you’re getting on. Any decisions about starting, continuing or stopping medication will be made together, based on your individual needs and circumstances.
“Medication isn’t a lifelong commitment for everyone. Regular reviews give us the opportunity to make sure your treatment continues to meet your needs and to discuss any changes if they’re appropriate.”
Lynsey McLatchie, Lead Non-Medical Prescriber, Melios
What are the possible side effects of ADHD medication?
Like all medications, ADHD medication can cause side effects, although not everyone experiences them. Common side effects can include reduced appetite, difficulty sleeping and an increased heart rate.
Your prescribing clinician will explain the possible side effects before you start medication and discuss any concerns with you throughout titration. If needed, your medication or dose can be adjusted to help manage side effects.
For some people, a non-stimulant medication may be more appropriate. Your clinician will discuss the options available based on your individual needs.
What does the process look like from start to finish?
If medication is recommended, the process typically looks like this:
- ADHD assessment and clinical recommendations.
- Pre-medication screening to check whether medication is appropriate.
- Medication started by a Melios specialist prescriber.
- Titration, with regular reviews to find the right medication and dose.
- Once your medication is stable, a shared care agreement may be discussed with your GP.
- If shared care is agreed, your GP takes over repeat prescribing while Melios continues to provide specialist oversight.
- Annual medication reviews with Melios.
Every step is discussed with you, so you’ll always understand what’s happening and have the opportunity to ask questions.
Please note: The exact pathway may vary depending on your individual circumstances and whether shared care is available through your GP.
Have questions about ADHD medication?
If you’ve had an ADHD assessment with Melios or Healios and would like to find out more about medication or shared care, our team is here to help.
If you’re considering an ADHD assessment and would like to understand what treatment options may be available afterwards, we can talk you through the process during your initial consultation.
If you’re an employer looking to support your workforce, our team can also advise on the services available for organisations.
Please note: We currently provide medication management for people who have received their ADHD diagnosis through Melios or Healios.
We are here whenever you are ready.
Sources
British National Formulary (BNF). ADHD prescribing information.
