Partner can't get ADHD meds

[sicklycolleague]

Posting on here for traffic and advice please.

Partner was diagnosed with ADHD by a private doctor when he was at uni. Ever since he has struggled to get medication (methylphenidate) and it's really affecting his performance at work as he today admitted he'd been without medication for months.

In the past he was a patient at his childhood GP but having moved to London and move every few years between flatshares he has really struggled. The best he did was a temporary (v reluctant) prescription at a previous GP but now he has changed to the GP at Hand app (I've no idea why as I seem to remember they don't recommend it if you're someone who regularly needs to see a GP, I was put off for this reason) and they simply won't prescribe it and don't believe he needs it. He has a relatively high pressure job he is really struggling with, plus is currently doing applications that are taking forever as he simply can't focus, which is further putting strain on him. Added to that, the mental load of pursuing this through doctors means getting info from him is quite difficult and he doesn't really have the energy to follow this all up.

So, whilst I don't want to do this for him, does anyone have any experience of how the process works and how I could help him speed this up? I have recommended he change to his local physical GP (who I'm registered with and they are great) though he's currently waiting for a referral for something else and understandably doesn't want to change just yet. And is there any reason the private diagnosis isn't recognised?

I'm a pharmacist, and have no easy way of getting his GP to prescribe methylphenidate, although a physical GP seems a better option than an app GP. Alternatively I have seen a lot of private scripts written by Psychiatry UK doctors, particularly during lock down. This means paying privately for the medication they prescribe, but methylphenidate is one of the cheaper drugs at around £50/month, but I don't know how much they charge for consultations or prescription writing services. Also not an endorsement of them, just that I have seen quite a few scripts written by them

Absolutely no chance with the NHS in the near future. The NHS route will take months, unless you have an amazing GP who will prescribe. A friend had a similar problem recently. Their only option was a private Psych telephone consultation costing over £200 which got him a private prescription which was roughly a further £90. The Psych agreed a referral to the GP for ongoing NHS prescriptions. There is no guarantee that the referral will be looked at before more meds are needed so its possible that another private prescription is the only option.

Go to gp and get gp to refer him so at least he is on the nhs waiting list (though could be years). Get him back to private gp asap or clinical psychiatrist. Does he still have diagnosis paperwork? That would be a huge help. He is probably going to have to get private script for the foreseeable future

adhdaware.org.uk/what-is-adhd/getting-nhs-diagnosis/

www.ukaan.org

www.adders.org.uk

Methylphenidate is a controlled drug so in my experience gp will only prescribe o the back of consultants diagnosis or clinical psychologist.

Hi, I work in mental health and have some experience of the ADHD services in our area. GPs won't prescribe. He needs to go to his GP and either ask to be referred to the local mental health assessment team (often called a Single Point if Access team, but varies from area to area!) or in our area GPs can refer djrect to the ADHD service. There are long waiting lists, we are advised a year. However I recently knew a patient to be seen and prescribed medication within a month so you never know. If he is really struggling then honestly his best bet is to go private, sorry :( however definitely best to get at least on the NHS waiting list as once he's seen them his GP should continue to prescribe off the back of that and would then refer him back to the ADHD service if he needs a medication review etc in the future. Hope that helps!

He can ask to be referred to psychiatry uk by his gp via right to choose. I've just been diagnosed this way, and though it's a private clinic it was paid for by the NHS, as will my medication be (apart from standard prescription charge.)

I think (certainly in children) that methylphenidate falls into specialist only initiation and require monitoring. This is sometimes done under a “shared care” agreement between GP and psychiatrist- GP agrees to do physical monitoring (weight, pulse, blood pressure, any bloods if required and so on- exactly what is needed varies between drugs/condition being monitored).

Without that specialist review and monitoring, it may not be that GP disagrees with diagnosis or is ignoring because it was obtained privately but because there is not the appropriate review and monitoring in place for them to continue to prescribe safely.This should have been explained to your partner though. I think he might need to ask to be referred to an appropriate specialist either via NHS or privately.

He should go back private if it’s affecting his work as even if he manages to get an NHS diagnosis leading to a prescription, the process will take at least months- even years sometimes (depending on your area). And that was pre-COVID.

Sounds as though not only does he need a physical GP but one who accepts shared care. I suspect most GPs would prefer him to have been reviewed by a psychiatrist (ADHD specialist) before agreeing to shared care.

My dd’s GP accepted shared care on the proviso she was on a stabilised dose & is reviewed by consultant at least annually.

First step I’d make is getting an appointment with an ADHD psychiatrist for review. Explain he WAS diagnosed as an adult so he doesn’t need rediagnosis but that he needs review & continuing consultant supervision of care.

Thanks all - this is very helpful. I will try to get him to arrange an appointment privately for the time being and then sort the GP issue too.

Just wanted to share my experience of using ‘psychiatry UK’ about 2 months ago. I notice that someone mentioned them in this thread. I chose a psychiatrist from a long list of options and then arranged an appointment where you had to pay upfront. This cost about £360. The wait for the appointment was only about a week. In the meantime I had to fill in about 4 forms. Two were simple checklists concerning symptoms and heart health. Two were more involved requiring more detail about ADHD symptoms from myself and a friend or relative who had known me for years. The last one wasn’t essential from what I can remember. At the end of the appointment the psychiatrist told me he believed I had ADHD.
I was then prescribed methylphenidate ( Xaggitin -xl) I believe this is the cheapest option which is why they try it initially.
I was then passed over to a nurse who I could contact online with any questions. He sent out my prescription a few days after I had paid the titration fee of £150. I was advised to buy a blood pressure machine to check bp and pulse after each increase in dose. ( this cost £20 ) The fee for arranging the prescription each month is £25 and the prescription itself is about £43.
I am still in the titration period so they are trying to get the dose right. After this month ( 2 months on the meds) they say they will attempt to pass over to GP, so my prescriptions will be on NHS. Hopefully this will be successful, but of course not guaranteed.
I appreciate that your husband may not need re-diagnosing, but I imagine to get the meds prescribed he would probably need to pay the £360 fee.
So far the outlay has been £650 all in, but if going private is an option for you I think it’s worth it. I have been on a final warning from work and have been able to turn it around with the meds. I have been to 2 separate GP’s in the past about it and both were initially quite dismissive. Good luck with it all!

Sorry partner not husband!

The final cost ( if NHS agrees to fund ) will probably be a half hour appointment in a month ( about £180 ) where they will agree to contact the GP about switching my prescription to them.

Yes it was me who mentioned them. I've recently been diagnosed by psychiatry UK, but as I was referred by my gp through right to choose, I didn't have to pay anything. The process was exactly the same as the poster above, I'm currently waiting for an ecg before I start medication but when I do it will be paid for by the NHS and I will only have to pay normal prescription charges. If you Google psychiatry UK right to choose you should find the page on their website which explains the process.