Combined stimulant & non stimulant for ADHD?

[adhd55]

Long shot but wondering if anyone here has had this prescribed in the UK? DC with severe adhd at uni has been on Concerta a few years, having tried everything during titration (stimulants and non stimulants). Concerta definitely helps somewhat with focus but does little for other areas of executive function. When DC tried Strattera/Atomoxetine it improved things like getting up and organising but did nothing for focus needed for school. Private psych has a couple of times mentioned that concerta and atomoxetine can be combined (this seems to be more popular in the US), often at a lower dose, and can be effective. Planning to broach this again over the summer but worried that if it was tried and it worked it would jeopardise the already precarious shared care agreement (DC2 also now diagnosed and we can't even ask the gp as they won't accept any new adhd shared care).

I imagine this isn't common here but thought it was worth asking in case anyone has tried it (or a different combination)? Thanks

Would you consider to re-diagnose again through the NHS? It's a bit of a lottery - my daughter who is severely suffering with ASD and OCD has been on the CAMSH waiting list for over 3 years without ever been seen by anyone from the NHS, while my son, who is nowhere near severely impacted, was diagnosed for ASD and ADHD and started titration within less than 5 months. He's also been seen almost weekly by NHS paediatrician and OT without hassle. No idea why one and not the other. So it's still worth trying to throw your name in the hat.

Hi yes she’s on the waiting list to be ‘re-diagnosed’ (what a waste of resources), it’s been nearly 2 years so far. That was a condition for the GP to continue shared care. However my immediate concern is the idea of trying the dual approach with meds and whether it is a recognised approach here.

Does your DC have anything else going on?

Alongside having ADHD, I was recently diagnosed with a serious MH issue. I now take sertraline, as well as Atomoxotine, and it’s been a game changer. Its like the atomoxotine has been turbo charged.

I had previously tried sertraline and it wasn’t effective. I need both medications to achieve a substantial therapeutic effect from either.

BUPA paid £175 per appointment for me to see a private physiatrist regrading my addition MH needs

Some take a stimulant and a non-stimulant in the UK. Often after trying a few medications on their own.

@perpetualplatespinning thanks. So you know people? Is this via nhs?

@RedGreenBlackGrey no, just need executive function to be better controlled. Glad you’ve found a combination that helps.

Yes, I know people taking a combination of stimulants and non-stimulants. A mixture of those who are under the care of the NHS and those who went private.

DS2 was diagnosed and initially titrated privately and then care was taken over by CAMHS. He takes atomoxetine, but at the last CAMHS appt we discussed adding in methylphenidate to try to improve his impulsivity and risk taking behaviours. In the end we/CAMHS decided against it for now because of the appetite suppression which could have a detrimental effect on another medical condition, which is why he was on a non-stimulant to start with.

Thank you, really good to hear that Camhs do suggest it. Obviously my DC is an adult and no idea when she will ever get seen by NHS but I do think a concerta/Atomoxetine combo worth a try in meantime (though I guess gp might baulk at the cost under shared care).

RedGreenBlackGrey
Are you still using the 2 meds with good results? My DS is about to start on atomoxetine. Tried guanfacine and it made him feel numb, very negative experience. Methylphenidate kills his appetite but is important for focus at school - so will continue this at low dose with atomoxetine. I think sertraline would be very helpful as he suffers with low mood, due to adhd. So far Gp wont try it as he is 17yrs, any suggestions?