To ask for help re adhd meds

[Behappyandbehave]

My dd (20) has just being diagnosed through right to choose on nhs. Unfortunately this was with a private clinic that doesn't include titration. So for her to start meds we need to pay privately. Or wait for a never ending nhs appointment for diagnosis to come through.
It seems to be a minefield of which medication will suit her. I know they are the experts and will suggest what they think suits her but I'm still worried about negative side effects.
She has in the past suffered migraines and all meds say headaches can occur.
She's just come off sertraline and is fairly settled now without it but has previously had anxiety and depression.
She's also overweight and unmotivated to do anything about despite this being the main thing that upsets her.
She won't be in a relationship with anyone and ignores calls/texts from friends alot.
She is impulsive and takes risks, talks too much etc etc.
Really unsure whether she needs stimulants or non stimulants.
Would really appreciate any advice and other's experiences. Just want to get this right for her and help her improve her life. Not to mention the fact that each appointment is going to be around £250 and meds and prescription all extra!

It is if you want other people e.g. the GP to accept the diagnosis. Many will disagree that a nurse can diagnose, and if the diagnoser isn't a prescriber then they're asking the GP to prescribe something that they can't do themself.

This isn’t a bad deal at all, you just need to pay for titration and meds til they are stable.

Yes as I said in my post above, this doesn’t prevent NHS/GP from accepting the diagnosis, since the organisations using specialist nurses are commissioned by the NHS for provision of ADHD diagnosis services therefore NHS finds this acceptable.

If you check the NICE guidelines you will see clearly that a doctor or psychiatrist is not a requirement

I've seen multiple ADHD360 diagnostic reports from pharmacists. I would agree to avoid, particularly if you have a complex history.

If you want to maximise the chances that your GP will accept the diagnosis, get it made by a psychiatrist.

If she has just come off anti-depressants, she should wait up to 6-months before starting ADHD medication - source: my titration but everyone is different. Nearly all come with a risk of increased depressive or anxiety moods.

That said, if she’s still low moods and no motivation, why has she come off anti-depressants? Why is she not doing therapy? She would be better off tackling her depression first and then the ADHD as while the two go hand in hand, depression is harder to medicate away.

Interesting, but not true.
the area I live start everyone on medikinet

Things are a bit atypical at the moment because of shortages, they may be doing that as you can get medikinet more reliably than other preparations.

no, this goes back at least 3 years ( when many of my family were titrated and I started working within adhd field)

DB had a really awful experience with stimulant meds.
Since then he’s also now diagnosed with ASC and is hyper sensitive to any medication so is waiting to try non stimulants now.

The stimulants affected his bowels and from that he ended up with an eating disorder.
Obviously meds work differently for everyone but just remember these are drugs (even if the doctors say it’s not the same as illegal ones - seems no different if you react like he has).

Hopefully it’ll be a similar road for your DD.

Okay, the standard procedure is to start everyone on methylphenidate. Is that better?

Everyone else I know who has been through titration privately or via the NHS has started on Concerta but Medikinet is still methylphenidate, just a different formulation/release speed.

My point stands. It's standard to start on (whatever brand of) methylphenidate before moving to alternatives, but I was allowed to start on lisdexamfetamine.

Simpler* 🤦🏻‍♀️

Much better yes thanks!

as an obviously adhd person you should probably know better than getting into an argument with another adhd person, we both want to be right.

That's very much an autistic trait so if you haven't already been diagnosed, you might want to look into that

(Yes, I'm also autistic!)

I’m already dual diagnosis but it’s actually a trait of both conditions 😛

Zero surprise from me - we can spot each other a mile away 😅