Adult ADHD

The symptoms of ADHD include:

Inattentiveness – inability to concentrate for a long time or finish tasks, disorganisation and forgetfulness.

Hyperactivity – fidgetiness, inability to stay still or restlessness.

Impulsivity – speaking and doing things without thinking about consequences, interrupting other people.

People with ADHD may also experience sleep difficulties, academic underachievement, clumsiness (dyspraxia), temper tantrums, anger outbursts, mood swings and find it hard to socialise. They may also have co-existing conditions (co-morbidity) such as anxiety, depression and other mental health conditions, conduct disorder, oppositional defiance disorder and learning difficulties.

Although some people still use the old term ADD (coined in 1980 as ‘ADD with or without hyperactivity’), it was changed and simplified in 1987 to just ADHD. The term ADD has technically expired and has been out of use by medical professionals for 30 years.

ADHD was further and better defined in 1994 when three subtypes of ADHD were introduced as follows:

1. Combined Type: chronic and functionally impairing symptoms of inattention WITH chronic and functionally impairing symptoms of hyperactivity/impulsivity;

2. Predominantly Inattentive Type: chronic and functionally impairing symptoms of inattention WITHOUT symptoms of chronic and functionally symptoms of hyperactivity/impulsivity;
3. Predominantly Hyperactive-Impulsive Type: symptoms of chronic and functionally impairing hyperactivity/impulsivity WITHOUT symptoms of chronic and functionally impairing symptoms of inattention.

Whilst there are currently ongoing discussions around redefining the symptoms and subtypes to better reflect an increased understanding and knowledge of the disorder and its impact, there are no new proposals for changing the umbrella term ADHD.

So, in a nutshell, the name ADD has been officially retired for the last 30 years and replaced by the generic and inclusive term ADHD, which includes the Combined Type, the Predominantly Inattentive Type, and the Predominantly Hyperactive/Impulsive Type. We are all ADHD!

ADHD can significantly impact family life and relationships with friends (World Federation for Mental Health, 2005.) Parents of children with ADHD need a great deal of support to help them manage their child’s problems. Parents/carers have to manage the day-to-day challenges of living with a child/young person with ADHD.

Parents also have to deal with school problems which are common in these children, with many requiring a statement of special educational needs. Children with ADHD require much more support and guidance than their peers in most of their everyday lives. ADHD is a full-time disorder requiring full-time care. Professionals need to understand the stress and exhaustion that many parents experience the ability to wait or take turns.

• If you are initiated on a medication trial, then you will usually require in average between 3-6 follow-up appointments to reach the correct dose. NICE and GMC guidelines recommend a review by a specialist after each dose titration for safe prescribing practice.

• During the follow-up appointment, your doctor will monitor your response to treatment, any adverse side effects, physical observations (BP, pulse and weight). We will communicate with your GP informing them of your progress as per GMC guidelines on safe prescribing.

*Clients will be required to pay for follow-up appointments and private prescriptions fees during this time.

• Once you are established on a stable medication regime, then we can set up a shared care agreement with your GP, if they are willing to accept this. We have standard protocol documents for this procedure.

• At this stage, your GP would then take over the prescribing of any medication. This would mean that your prescription would then become an NHS prescription and charged at their lower, standard rate.

* Please note we cannot guarantee a Share Care arrangement with your GP, but most of our clients that go down the medication route do end up on a shared care. We would suggest you discuss this with your GP in advance*

Any medication we can prescribe and for your clinical safety, in accordance with NICE and GMC guidelines. Once the test results are back you will need a follow-up appointment with your consultant to start you on medication. This follow-up appointment is chargeable.

● If you are going abroad for less than 3 months and will be taking less than 3 months supply, you will not need a personal import licence. However, some countries may have their own import regulations for controlled prescription medications so you should check with the embassy or embassies of the country or countries that you are travelling to or through.

● The Home Office recommends that you also get a letter from your prescribing doctor which will confirm your name, travel itinerary, names of prescribing controlled drugs, dosages, and total amounts of each that you will be carrying. It is also a good idea to take a similar letter for any other medications you are taking which are not controlled drugs.

● You would normally carry the letter in your hand luggage with the medications, but these days it would be wise to check with your carrier before your travel date to make sure that you will be allowed to carry the entire amount in your hand luggage.

● You can download an application form for the personal export licence and see a list of contacts for embassies and consulates on the Home Office website.

● Unfortunately for us, Methylphenidate (Ritalin, Concerta, Equasym, & Medikinet) and Dexedrine are both categorised as Class B drugs which means anyone caught possessing them (illegally without a prescription) could get up to 5 years in prison or an unlimited fine or both. Anyone caught dealing Methylphenidate and Dexedrine could get up to 14 years in prison or an unlimited fine or both. There is a bit more information on the Home Office website.

• You can transfer your care at any point in full to NHS services, if these are available in your area. You are advised to discuss this directly with your GP.

• Please note we cannot guarantee a Share Care arrangement with your GP, but most of our clients that go down the medication route do end up on a shared care. We would suggest you discuss this with your GP in advance

Experienced mental health workers who are compassionate, experienced and knowledgeable about mental health issues, they will be happy to take your call and discuss all your queries in a discreet and confidential manner. 

At CRL Psychiatry we endeavour to keep our costs as low as possible whilst at the same time continuing to provide high-quality care. The cost of treatment varies depending on the level of care needed and the length of the treatment plan required. The best way to ascertain this cost would be to speak to one of our experienced mental health workers to determine what treatment plan will be the most effective for you in achieving your desired goals.

Yes, most private health insurance companies cover the assessment treatment, you will have to check your policy to see if you qualify.

Some private health insurance companies cover the assessment and treatment, you will have to check your policy to see if you qualify.

All CRL Psychiatry staff are qualified for their specific roles with many years of experience working in the mental health field. In addition, all our staff are always up to date with all their relevant training and registrations.

Yes, our staff are specially trained in trauma, grief/loss and attachment, we know very well the negative impact these can have on someone’s mental health which can then trigger alcohol/drug misuse and other negative behavioural health challenges. Among our treatment approaches to trauma is EMDR therapy which is very effective in easing and treating PTSD.