Sometimes it seems I know more about the US medical system than I do about the UK one. I do know that there are only 3 medications licensed for use for ADHD in the UK; methlyphenidate (Ritalin), dextroamphetamine and atomoxetine (Strattera).

I was talking to a friend today about off-license prescribing in the UK, and while it seems a very common practice in the US, she said that there was a lot of red tape and a stricter legal-medical framework in the UK which restricts off-license prescribing. She also said that the UK is slow to take up new medications, and that she'd been unable to get modern alternatives to old drugs with very poor side-effect profiles to treat her Reynauld's syndrome.

Also, is it now standard practice in the UK for patients to be put on atomoxetine as a first-line medication for ADHD? Is there anyone who was diagnosed recently who was put onto something else first?

How much difficulty do people have in getting a diagnosis in the UK? What was your diagnostic and treatment process like?

For me, I'd been previously diagnosed with Asperger's syndrome, and then a psychologist had identified ADHD as a potential problem while testing me for dyslexic-spectrum stuff, since I'd been diagnosed with developmental dyspraxia years earlier at school, so I made an appointment with my GP, asked for a referral and told him about the psychologist's report, then waited 5 months for the appointment with the psychiatrist, talked to the psychiatrist for an hour about the problems I had, got diagnosed with ADHD, went to my GP the next day to pick up the prescription he'd written based on the recommendation from the psychiatrist (since the psychiatrists don't seem to be allowed to prescribe things here; just to make recommendations for prescriptions to GP's), took it to the pharmacy and began a long month of feeling terrible from the side-effects while having no benefits from it, before phoning the psychiatrist to see if I could get my next appointment moved forwards, since it was still 5 weeks away (with absolutely no followup in-between to see how I was doing on the new meds), got it moved forward by about 4 weeks, and now I'm going there on Thursday.

Please, share your own experiences with ADHD and the UK medical system, or even just of the UK medical system in general.

I was diagnosed through school at 15. I was reffered to a pediatrician and after 2 long appoinments I was diagnosed with ADHD and given a pescription for Concerta.

So I was given methylphenidate as a first medication for my ADHD and I havent met anyone yet that I know takes Strattera.

I just got back from a second appointment with the psychiatrist. I told her the atomoxetine wasn't working, and gave her a list of the side-effects. She said she wasn't surprised it didn't work, since because I wasn't hyperactive, I didn't have 'the full range of symptoms'. I explained to her that ADHD is split into inattentive, hyperactive and combined type, and she said that only combined type was 'proper' ADHD.

I then told her that I wanted to try a different medication, and she said that since the atomoxetine didn't work, other medications wouldn't work either, since it meant I didn't have full ADHD. Eventually I convinced her that I wasn't going to give up until I got something, so she tried to give me Ritalin XR, while saying that the GP might not prescribe it since it's usually only used with children. I told her that the D-isomer of methyphenidate, the one most commonly used in meds, has a greater effect on epinephrine than dopamine, and that since atomoxetine hadn't worked for me, methylphenidate was the less likely to work out of methyphenidate and dextroamphetamine.

She said that she wanted to give me methylphenidate because she had experience of it, but no experience with dextroamphetamine, but I persisted. She then said that she didn't think dextroamphetamine was licensed for adults, and that she couldn't prescribe things off-licence. Still I persisted. She then made a comment about me being like a walking encyclopedia as I demonstrated more knowledge of the condition than she did, and decided that actually she could prescribe things off-license if the GP approved, told me there probably wouldn't be any problem and gave me a letter to hand in to the GP's surgery.

I don't have a prescription yet; that has to wait until tomorrow when I'll find out if it's gotten the GP's stamp of approval or not. The GP thinks all I need to do is get a job and I'll be better though, so things are still uncertain. I've been seeing a different doc for the past year; one with a better bedside manner, but I must still be officially a patient of the old doc.

"has a greater effect on epinephrine than dopamine" should read "has a greater effect on norepinephrine than dopamine".

I haven't slept today.

Damn PeterMac, I wouldn't have the balls to stick up for myself to the doc. Way to go!

It's bizarre to me that a country so much more liberal than the very conservative US is so reluctant to see ADHD as a real thing.

Are meds free for everyone out there? maybe it's just a cost thing.

Usually people pay a presciption fee each month for each med they get, which is about £6 ($12). Doctors here can only prescribe enough medication for 28 days, and then the person has to get another prescription, go back to the pharmacy and pay the £6 or so again. I get it free though, since I'm on benefits.

It seems the attitude here is that stimulants are only for children, and that adults should only take Strattera.

Yeah. The field is so new (especially for adults) and the social misconceptions are so great that it feels like we're just a bunch of salmons going against the current.

My spouse sent me this becuase it has the word ADD in it, when I read it yesterday I thought of you all in the UK. . . which is why I saved it {sounds better than I forgot to delete it} any way maybe forgetfullness serves a perpose after all. . . an article from the UK.



Lack of ADHD support could be "catastrophic" (http://www.inthenews.co.uk/news/politics/politics/lack-adhd-support-could-be-catastrophic-$1108650.htm)


Leading psychiatrists have called for more support to help adults with attention deficit hyperactivity disorders (ADHD).

The call comes after research reported by the BBC suggested that up to four per cent of adults in the UK could suffer from ADHD

Professor Anthony Hale, a professor of psychiatry at the University of Kent, criticised the lack of help for adults with the disorders.

Speaking on the Today programme, Professor Hale said there were "huge numbers of people" across the country waiting to see adult psychiatrists who "don't have the expertise to deal with them".

He said there were only a very small number of clinics that were equipped to treat adults with ADHD and that patients were frequently given inadequate care.

"There are only a handful of clinics and specialists across the country at the moment who are doing it, and the rest of them are getting random allocation of care to all the different existing bits of the service that aren't really suitable."

***End Quote

There is more to the article for any interested.

I feel bad for you Peter and I hope the Dex works out for you!

Maybe some day you can come over here to the states and get the treatment you need and deserve.