ADD/ADHD Definition

ADHD, or attention deficit hyperactivity disorder, is an acronym for ‘attention deficit hyperactivity disorder’ or ‘attention deficit disorder’. Scientists now believe that there are hereditary, psychological, and biological factors contributing to the disorder, which is a chemical imbalance in the management systems of the brain.

Our prescription service is not available to clients who have been diagnosed with ADHD elsewhere. In order to continue treatment and medication, we would need to conduct a full assessment with a psychiatrist.

Managing your ADHD diagnosis

ADHD is classified into three types. A person of the ‘combined type’ is both inattentive and hyperactive, whereas someone of the ‘predominately hyperactive’ type is much more hyperactive and impulsive. Lastly, there is ‘predominantly inattentive’, which has the greatest impact on distraction.

ADHD symptoms and signs

Adults can experience less obvious symptoms of attention deficit hyperactivity disorder, despite its effects. Symptoms of ADHD in adults can be divided into five broad categories:

• Hyper focus. The more focused you are on one task, the more likely it is that you will overlook other more important tasks, especially if it is consuming and enjoyable for you.
• Impulsivity. It is possible to engage in impulsive behavior, such as spending money.
• Emotional difficulty. You might lose your temper easily if you’re having a hard time handling stress.
• Hyperactivity. You may feel restless or fidgety constantly, and you may need less sleep as a result.
• Disorganization. Adults with ADHD are more likely to lose things or forget important tasks.

It can be very challenging to deal with attention deficit hyperactivity disorder when these symptoms combine. It can lead to a variety of problems if left unchecked. Among these are financial difficulties, work-related problems, relationship problems, and physical or mental health problems.

Is it time to thrive despite adult ADHD?

You can learn tools that can really make a difference in your career, relationships, and life in general from our highly qualified and experienced ADHD psychiatrists, ADHD therapists, and ADHD coaches.

Contact us today or complete our online form to schedule a confidential first session in Expert Therapy clinic or online. Please let us know how we can help.

ADHD Specialist Clinic

Our ADHD clinic with renowned ADHD experts, ADHD consultant psychiatrists, and ADHD with co-occurring issues specialists includes the following.

• Multiple specialized screening questionnaires will be used as part of a comprehensive psychiatric assessment.
• In addition to DSM4, Wender Utah, ASRS, DIVA 5, and Conners 66 item long scale questionnaires, our ADHD specialists use six separate indices to measure the severity and symptoms of ADHD, as well as a graphic profile that illustrates both symptoms and severity.
• Examples of typical brain scans will be shown along with an explanation of the condition.
• Upon receiving your diagnosis, profile, and assessment report, your GP should receive a copy.
• The diagnosis can then be confirmed and treatment offered, which can relieve symptoms rapidly through its effect on dopamine and noradrenaline levels.
• Depending on the assessment, prescription services are available. Imported medications are not included in this list.
• As appropriate, referral to CBT (cognitive behavioral therapy) for ADHD.
• The dosage and type of medication should be adjusted according to clinical indications on an ongoing basis.

ADHD treatment

ADHD cannot be cured. This disorder is treated by managing its symptoms and minimizing the difficulties it can cause. Drugs, therapy, or a combination of the two can be used to treat attention deficit hyperactivity disorder.

Self-management skills are also an important part of dealing with adult ADHD. A few examples of these include eating healthily, exercising regularly, and creating coping strategies (such as color coding or making lists).

Different forms of therapy are available as treatments. The types of therapy include general talk therapy and marriage or couples counseling (if indicated). Or, commonly, cognitive behavioral therapy (CBT), where the goal is to identify and change problematic behavior.

The use of drugs as a treatment is common. It is important to note, however, that these are usually part of a long-term treatment program that includes therapy.

Results of ADHD treatment

Patient feedback about the positive effects of treatment for attention deficit hyperactivity disorder:

• Felt much calmer in my head, much more serene. I was less fidgety, less anxious.
• I am able to deal with my son calmly without anger outbursts.
• My day was filled with boring tasks!
• “I’m on my way to regaining my mojo.
• After I began treatment, my life has changed drastically. Instead of existing, I feel like a man again, confident, calm, able, and motivated.

 

The typical treatment plan for ADHD is as follows:

ADHD assessments take about 90 minutes on average. It can sometimes take an hour to complete this task.

On average, we allocate 90 minutes per day. When ADHD is assessed early on, it may be obvious that it is not the main issue, or that other symptoms may be present that are unrelated to ADHD.

As a result, a full ADHD assessment will not be required, and the fee can be adjusted accordingly and fairly in agreement with the patient in such situations.

The following is a typical treatment plan for a situation where treatment is effective and stable (more complex situations may require more attendances):

90-minute initial assessment – £2240 (1-month prescription included, plus follow-up appointment of 20 minutes).

An appointment fee of £230-£300 is charged after 28 days (prescription included if needed).

If stable review in 1-2 months £230-£300 (1-2 months prescription included in appointment fee where appropriate).

After that, you will receive a prescription for two months without an appointment for £150.

Then every 4-6 months, either over ZOOM/SKYPE or in person (two-month prescriptions will be provided at each visit). £230-£300 per consultation.

Every two months (where appropriate) and as needed, prescriptions are ordered, sent by post or collected for £150.

When the patient is stable, prescriptions can be provided through Primary Care with 3 or 4 months of private review of £230-£300 (which can also include ZOOM/SKYPE or telephone consultations).

Private medication costs to the pharmacist are not included in any of the above. They typically are as follows:

Medication for ADHD

Adults with ADHD can be diagnosed by our experts

The following US medications are available on prescription in the UK: Elvanse (Vyvanse), Ritalin (Methylphenidate), ConcertaXL (Equasym XL, Medikinet SR), Dexamfetamine (Dexedrine) and Adderall. There is no XR form of Adderall available in the UK, so the cost of the drug is disproportionately high (£350-450 for 28 days). The cost of Elvanse is approximately £90 – £130 per month. At a monthly cost of £70-120, other medications are more affordable.

It is not possible to use a UK prescription in the USA. If there is a reason for a large amount (i.e. travel), up to three months can be dispensed in one dose at most UK pharmacies (usually 28 days at a time). International borders do not restrict the importation of three months’ supply.

Administration of Elvanse

The following tips will help you administer Elvanse:

For many people, Elvanse offers certain advantages over Ritalin, Concerta, or Dexamfetamine due to its active ingredient ‘lis-dexamfetamine’. Since it is a pro drug, it is inactive when swallowed and is absorbed quickly through the stomach and small intestine. The active ingredient, Dexamfetamine, is broken down in the bloodstream.

Due to the slow release of the compound, it can last up to 16 hours after ingestion; however, most people experience 10 to 12 hours of action after ingestion. Due to individual metabolisms, some people experience much shorter effect times, so dose adjustments are often necessary. There is a fairly smooth release curve that peaks around lunchtime and tails off gradually in the evening.

Taking Elvanse in the morning after a light breakfast is the best time to take it. It is absorbed too quickly on an empty stomach, resulting in a shorter, less smooth effect. It is less effective after a heavy fatty breakfast because it is absorbed slowly. It is ideal to eat cereal or toast for breakfast.

There is a great deal of variation in the effects on the first few days between individuals. When the first 30mg dose does not produce an effect, our administrators will contact our psychiatrist for advice. To establish an effect, a dosage increase is usually required. If Elvanse works well for several days, then stops, this is usually due to downregulation of dopamine receptors. This is very common and simply means that the brain cells are becoming more sensitive. A dose adjustment should be made once again after seeking advice.

On 30mg, some people feel “wired” or agitated early on. A dose adjustment downward can be made with advice if this doesn’t settle in a day or so. First month doses may not need to be adjusted, but at the first follow-up appointment they may need to be adjusted.

The interaction between Elvanse and caffeine can sometimes cause tremors. To avoid this, we recommend reducing caffeine intake. Elvanse can be taken with antidepressants, especially SSRIs (e.g. Prozac, Citalopram Seroxat and others), as well as Buproprion. Excess noradrenaline release may result in over-stimulation with SNRIs (cymbalta, effexor).

In the UK, Adderall, which is expensive, is not widely used because of its side effects. Elvanse can be combined with short acting Dexamfetamine to produce similar results.

Dosages of Elvanse

To take 15mg of Elvanse, break a capsule of 30mg and place it on a clean, dry surface. Separate the powder into two equal piles. Mix half of the tablet with a small amount of water in a glass and drink the mixture. The remaining powder can be saved for the next day.

Take half a capsule along with one full capsule of Elvanse at 45mg.

Take both 30mg capsules of Elvanse together for a 60mg dose.

A combination of 25mg and 35mg can also be achieved using larger capsules, 50mg and 70mg.

A quote from ‘Mentally Healthy’ magazine’s November 2011 issue:

According to a doctor and psychiatrist, the UK is slowly catching up with the US in acknowledging that ADHD brain changes do persist well into adulthood. A general psychiatrist at London, who has witnessed the increase in adult sufferers seeking treatment, said:

“I started seeing a lot of people asking for treatment, especially Americans who are more aware of the condition than we are in the UK at the moment. According to a recent audit, approximately 80% of adults with ADHD diagnoses have experienced a positive or extremely positive response to treatment methods currently available. Childhood is often the time when people learn how to manage their symptoms. The symptoms overwhelm them when they are stretched in higher education or highly skilled jobs. Even though the condition may have been present since childhood, some people seek treatment for the first time at this point.”

Our psychiatrist has worked with adult ADHD sufferers for several years, and believes there are many cases proving that a combination of therapy and medication can significantly alleviate symptoms.

Treatment and diagnosis

Doctors and psychiatrists who diagnose the disorder in adults use the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Criteria checklist, published by the American Psychiatric Association. According to our psychiatrist:

After identifying childhood symptoms, I use the Wender Utah Rating Scale to gain a better understanding of how ADHD affects adults in adulthood.

After completing the questionnaire, I conduct a detailed psychiatric assessment in person. A month’s therapeutic trial is offered after a possible diagnosis. Medication is the primary method I use to treat people, which increases brain dopamine levels, which alleviates the core symptoms. Combined with cognitive behavioral therapy, diet and exercise, this treatment can be extremely effective.

Many people have described the changes they’ve seen in themselves as “miraculous,” psychiatrist says. Treatment improves their concentration levels, reduces their procrastination, and in some cases has completely transformed their lives.

 

Related topics

• Adult ADHD – Are you suffering from it?
• ADHD – A Help Guide