to want to medicate DD’s ADHD but don’t know how to?

[MigraineMarnie]

Long and short of it is that DD is massively struggling in secondary school and we have finally decided medication may be the best route to go down.

How do you find a private GP to prescribe?

She had her assessment in another country ( my home country ) as the NHS lists were approx 3 years but now I’m going to really struggle getting my hands on the so needed medication.

Can anyone help?

@Namechangeforadvicepleaseandthankyou
Seratonin pooling has been noted.
Depression in mid twenties, it is worth looking around ( at legitimate, peer reviewed) on Google Scholar before making a decision.

What @HairyKitty said. You have to find the money to have a psychiatrist diagnose and oversee all care. A GP cannot do this and the waiting list for cahms is outrageous. This is another thing that needs addressing by a health and education secretary when we get a new government.

Also, medication is fantastic when you do finally get it. Life changing.

Rates of depression anxiety and substance abuse are very high in non medicated population with adhd.

But specifically Ritalin? That's a brand name, not a drug.

@Gilead could you please point me to some of that research please as my ds was on Equasim (methylphenidate) for years before we had to move on to a tear 2 medication and I've never seen any reliable information on long-term side effects.

perhaps they will prescribe with camhs and the wait for prescription wont be long?
i dont think adults take the medication?
at least as far as i understood

OP I had to go private in the UK for my ADHD DD14 3 years ago.

Initial costs were 900 and then a couple of follow ups. We did it through the priory clinic and see a really good consultant in their Oxford branch.

My DD is on Elvanse. The good thing is that this is a daily meditation. She doesn't take it at the weekends or on holidays. It can be split and sprinkled on a spoon of cereal if your DD struggles to swallow pills.

It's made a huge difference to her experiences at school.

ask the gp for their suggestion

You have been lied too. They may have thought medication wasn’t suitable in your daughters case for whatever reason but children can be medicated.

ds has been on a combination of meds since he was 9 and they have been a game changer.

That's not what the GMC says about giving advice online

Medication for ADHD will always be initiated by a psychiatrist. In the majority of cases, shared care guidelines facilitate a GP to continue prescribing once the individual is stable.

As you can see from PP, all GPs have their own guidelines on whether they will accept a private assessment and initiation to continue prescribe. None will initiate medication in someone who has not had it before though.

Get in touch with private psychiatrists and explain you have an assessment from abroad. Ask them if they will accept it and be able to initiate medication. Get on the NHS waiting list asap regardless as you want ongoing care via NHS no matter how long the wait is

@prescribingmum that is not true ds has had all of his medication prescribed and adjusted by his pediatrician and has never seen a psychiatrists in his life and he started his meds at age 6. We are in Scotland btw

@Hoardasurass yes it depends on the local setup - in some places all the ADHD assessments are done by CAMHS in others it's Community Paeds or a mixture of the two

I think @prescribingmum main point is that ADHD medication is always initiated by secondary care services [Paeds/CAMHS} and not by GPs in primary care

I understand that however that's not what was said and it needed correcting

Then what would you say is the best alternative to Ritalin for kids who do need medication to survive their school day?

@Hoardasurass not really the main issue tho' is it?

Discussion isn't about whether Paeds prescribe ADHD meds - it's about under what circumstances GPS will prescribe it

So pretty tangential

We've had a dreadful experience in our area I'm afraid with trying to get GP to prescribe what the private psychiatrist has prescribed. We are currently still using (and paying for) private care as they point blank refused us several times- including to our face, telling us she wasn't an urgent case.

She has diagnosed ADHD (combined type) and severe anxiety, not been in school for 18 months. It's the most amount of stress I've dealt with as an adult in my life. The hoop jumping and pleading/ begging/ communicating/ complaining is never ending. This is Herts/Beds/Bucks.

@Efacsen we will have to agree to disagree on this otherwise we risk derailing the thread

Private assessments for ADHD can vary enormously- and with the assessment initially being from another country there is a difficulty in ascertaining if the assessment followed the NICE guidelines. The CYPMHS service I work for partnered with Clinical Partners to undertake assessments under a strict policy to follow NHS guidelines on assessments. GP's cannot prescribe ADHD medication without a psychiatrist's overview.
In CYPMHS once a young person has been assessed for medication and has been settled on an appropriate treatment, and the dose has been titrated, the GP can prescribe repeat prescriptions under Shared Care guidelines but Medication Reviews are regularly undertaken. Can't remember precisely at the moment but I think NICE guidelines are every 3 months for under 10s and every 6 months for over 10s.

We are the same . I would like the same info xx

You could argue that in your mid 20s you begin to establish your life and compare yourself to those around you. Increasing the likelihood of depression, if you’ve struggled at school fell behind , never ‘ fitted in’ have had reduced life /
employment opportunities.
you could also argue that up until the age of 9 children with adhd receive approx 20,000 more negative comments about themselves than their peers. Potentially setting them up for low self esteem and likely depression
Im wandering if this trial was
potentially biased due to the intersectionality of individuals .which may or may not naturally cause or influence depression.
Rather than a drug causing the depression . Not discounting it , just like to really consider all elements.

Yes thanks @Efacsen exactly what I meant. In my experience (which I admit does not include Scotland), secondary aged children would be referred to a CAMHS psychiatrist and not a paediatrician which is where OP’s child fits into. Primary school children would be seen by a paediatrician but would not apply to this case.

Apologies if this is not setup elsewhere in England but as @Efacsen said, only secondary care providers will initiate treatment. No GP (NHS or private) would usually do this, even more so as the assessment wasn’t undertaken here

There's no hidden quick cheap work-around for initiating meds/follow up - for reasons of quality assurance, NHS funding and equity of access as described above.

It's either go private - quicker and costly

Or wait and get it free on the NHS

The best way forward is as @prescribingmum suggests to consult GP and ask for a referral under the shared care initiative with a private provider

And just as a PS whilst other symptoms will improve more quickly after starting meds it usually takes at least a full term to see significant improvements in academic performance. So don't be disappointed/feel its not working if this takes longer