Treatment FAQs

Please update your address and GP details under the ‘My Profile’ tab on your portal dashboard. 

Note that if you move and register with a GP outside England during your treatment, you will no longer be eligible for Right to Choose. To continue your treatment, you should ask your GP to be referred to a local ADHD service in your new area. 

Alternatively, we could continue your treatment on a private basis. 

Our medication/titration service is fully remote, which means that you will be able to communicate with your prescriber via notes left on your MedQare portal. 

This gives you the flexibility to respond to notes or requests when convenient, without having to take time away from your working day or usual routines. 

How do I contact my prescriber? 

• You can reply to any requests from your doctor or prescriber via a case note on your portal. Please note that our prescribers work to a 2-3 working day response time. 
• If you need urgent advice or support, please follow the guidance on our website. 
• If you have any other queries, please contact the Virtual Assistant, available on our website or via the portal, and open 24/7. If you need to speak to an advisor (available between 8am – 6pm, Monday to Friday), the Virtual Assistant can direct you to this option. 
• If you have a smart device, we highly recommend you download the MedQare Companion App. This way, you will receive a notification if any new notes are added to your portal dashboard. You can download it from the Apple App Store, or via Google Play. 

All our communications take place via our purpose-designed MedQare platform; we regret that we are not set up to call patients. 

If you think you will find this difficult, we may not be the right provider for you. Your GP should be able to help you find an in-person service in your local area. 

While you are on our wait list, our titration admin team will be working behind the scenes to ensure that you are fully prepared to start titration when you reach the top of the list. We will contact you when we are getting ready to allocate you a prescriber, and let you know that you need to look out for notifications from us. 

Once your prescriber has been allocated, they will send you a welcome note via email, SMS and the portal to let you know that your treatment is due to start. They will review the information in your patient record and may ask you to send in a new set of readings (blood pressure, pulse and weight), or additional health information to ensure that it’s safe for you to start medication. 

Please respond within the set timeframe to ensure there are no delays to the start of your treatment. 

Our prescribers currently work to a 2-3 day response time due to the high number of patients under our care, although we will always try to respond to portal messages as quickly as we can. Please bear in mind that your note may also need to be forwarded to your doctor, which could result in a slightly longer response time. 

If you need a faster response to your query or concern, we recommend that you contact us via our Virtual Assistant service (Mon-Fri: 8am-6pm). 

Please note: While we endeavour to provide timely assistance, we are not an emergency service and cannot offer emergency medical services for urgent or crisis situations, or for patients who are acutely ill. 

Please follow our guidance for urgent assistance or download our guide to seeking urgent help. 

If you receive a positive ADHD diagnosis, your doctor will recommend a treatment plan that is personalised to your individual needs. This is often a combination of medication, therapy and lifestyle changes, such as a balanced diet, regular exercise and adequate sleep. They will take into account factors such as the severity of your symptoms and any co-existing conditions. 

NICE guidelines recommend medication as a first-line treatment option, especially for those with severe or moderate symptoms, but your doctor will advise whether they think this is necessary. Although medication can’t cure ADHD, it can help to improve functioning and reduce symptoms. For example, it can help you feel calmer, improve concentration and executive function, and reduce impulsive behaviour. 

We recommend spending some time researching the pros and cons of taking medication to make an informed decision. Some types of medication, for example, can be taken just on work or school days. 

If you decide to try medication, you will be referred to our team of experienced ADHD prescribers, who will tailor your treatment to your individual response to the medication prescribed. 

Non-pharmacological interventions, which include therapy, coaching and counselling, can help to gain a deeper understanding of the condition and suggest coping strategies to help manage symptoms. 

Further information 

Visit our ADHD Medication page on the Choice and Medication website. 

Download our guide: ADHD Medication for Adults. 

For more information about therapies and other forms of non-pharmacological support, visit the NHS website. 

Medication may not achieve complete eradication of symptoms and should be considered as part of a holistic treatment plan. However, it can make some of the common ADHD symptoms easier to manage in everyday life. 

Everyone responds differently to medication, but below are some of the improvements you may experience: 

• Increased attention span; less likely to daydream or become distracted. 
• Improved executive function (skills that help you manage everyday tasks, e.g. making plans, following instructions, solving problems, adapting to new situations). 
• Improved motivation to start and complete tasks. 
• Feeling calmer, less restless. 
• Improved emotional regulation (control of your emotions). 
• Ability to take a more measured approach to decision making; considering the consequences before acting. 
• Improved ability to prioritise and manage workload at school, university or in the workplace. 

Your doctor will discuss the medication options available to treat your ADHD during your assessment. NICE guidelines recommend the stimulant medications Methylphenidate or Lisdexamfetamine as the first-line treatment for adults. If stimulants are not effective, or the side effects are intolerable, your prescriber may recommend the non-stimulant medication Atomoxetine. 

Please visit the Choice and Medication website for more information about treatment options and the way different medications work. 

ADHD medication does not usually change personality. However, patients have reported ‘feeling different’ due to the effects of the medication on managing symptoms. 

If you are noticing changes that concern you please discuss with your prescriber, who will be able to give you further advice. 

There is a small chance this can happen. Please check the Choice and Medication website for specific information about the medication you have been prescribed. It’s important to discuss this with your prescriber, so they can allay your concerns and support you further. 

The evidence on whether ADHD medication can worsen tics is unclear. 

Stimulant medications can sometimes worsen tics, in which case a reduction in dose can help. Always discuss this further with your prescriber. 

Yes, it’s possible. Once your clinician is satisfied that the medication they have prescribed is working, we ask your GP to enter into something called a shared care agreement. This would then allow you to get medication through the NHS and still have private care. 

The other option is to continue with private treatment while your GP refers you to the NHS, so that you will still be receiving ongoing medication in the meantime, albeit at a higher price. 

Right to Choose patients 

If you were referred to Psychiatry UK via Right to Choose, your prescription will be dispensed by our linked pharmacy, the Private Pharmacy Group (PPG), unless you choose otherwise. 

If PPG prepares and sends out your medication, you will not pay a prescription charge. 

However, please note: 

If you choose to have your prescription sent to your home address (rather than to our linked pharmacy), you will need to pay for your medication as a private prescription (prescriptions issued for Right to Choose patients are private prescriptions, not NHS prescriptions). 

Local NHS ADHD service patients 

If you were referred to us by your local NHS ADHD service, you can select whether you would like your prescription to be sent: 

• Directly to the address supplied on your prescription order form. You can then take it to a pharmacy of your choice for dispensing. 
• To our linked pharmacy, who will prepare and send out your medication to be delivered securely by their approved courier service. 

If you choose for our linked pharmacy to send out your medication, you will need to pay your usual NHS prescription charge. However, you can apply for any exemptions that usually apply to your NHS prescriptions, such as pre-payment or medical exemption. 

Private patients 

If you are a private patient, you will need to pay both a prescription charge (the charge for issuing your prescription) and the cost of your medication. 

The prescription charge will be payable via an invoice on your portal. Please pay this promptly to avoid any delays in issuing your prescription. 

You can select whether you would like your prescription to be sent: 

• Directly to the address supplied on your prescription order form. You can then take it to a pharmacy of your choice for dispensing. 
• To our linked pharmacy, who will prepare and send out your medication to be delivered securely by their approved courier service. The pharmacy would send a payment link for you to pay for the medication before it can be sent out 

If you order your prescription through our linked pharmacy, PPG, it may take around 7 days for your medication to be issued.

Your prescription will be sent via Royal Mail to the pharmacy for processing, and they will arrange for your medication to be delivered to your home via our approved courier service.

Your first prescription will be sent out with a treatment plan, which will give guidance on how and when to take the medication.

This allows time for: 

• Your prescriber to check your response to your treatment and make any adjustments to the medication or dose if indicated 
• Answer any queries or concerns you may have about your medication 
• Prepare your next prescription 
• Your next medication supply to be dispensed and collected/delivered to avoid any break in treatment. 

Read your treatment plan and start taking your medication as soon as it arrives. Make a note of any changes or side effects (if applicable). 

Complete your first ADHD Monitoring Form on Day 5 after starting your treatment. You will find this under the ‘Pending forms’ tab in the ‘Forms’ section of your portal. Please note that the forms expire after one week. 

Take your blood pressure and pulse readings 1-2 hours after taking your medication. Tell your prescriber if you have any side effects and score any improvement in your symptoms, compared with the symptoms you were experiencing before starting treatment. 

Please share any concerning side effects straight away, such as palpitations, chest pain, dizziness or any distressing side effects. You can do this by creating a note on your portal for ‘Your prescriber’ (prescribers work to a 2-3 working day response time) or contact our Customer Support team via our Live Chat during opening hours. 

Submit your monitoring form and keep checking for any advice from your prescriber in response to the information you have given. 

If you are experiencing any problematic side effects, your prescriber will advise a change in medication, if appropriate, before preparing your next prescription. 

If your medication has been delayed, please let your prescriber know straight away. 

If you miss your medication delivery, please email the pharmacy to ask for the medication to be re-delivered. 

Ensure you include the following in your email: 

• Name; 
• Date of birth; 
• Current address on your record; 
• Address you would like your prescription to be sent to; 
• Whether you prefer weekday or weekend delivery (Tuesday to Sunday); 
• Please note that you can nominate a delivery day, but not a time, as this depends on the courier’s schedule. 

Pharmacy contact details: 

• Private Pharmacy Group (PPG) 
• Email: reception@privatepharmacygroup.co.uk 
• Tel: 0330 124 4305 

If you are on a long-release stimulant medication, taking it late in the day may impact your sleep at night. We recommend taking it early in the morning after eating your breakfast, preferably before 9am. If you miss or have forgotten to take your stimulant medication, please do not take it in the afternoon as it may impact your sleep. Wait until the next morning to take your medication at your usual time.   

If you are on a short-release stimulant medication, establish a daily routine for taking your tablets, leaving a 4-hour gap between each dose. At the start of your titration, avoid taking the last dose too late as it may impact  your sleep at night. We recommend that you take the last dose before 4pm until you have established that taking it later than 4pm will not affect your sleep at night.   

Take your medication with, or immediately after, food and eat regularly throughout the day. This will help reduce the risk of nausea, which is a common side effect. Eating regularly will help keep your energy levels stable.   

You will need to submit a prescription request when you have 7 days of your medication left. We regret that we do not have the capacity to request on your behalf. 

Always give 7 days’ notice before your current medication is due to run out. Our pharmacy will not be able to expedite your prescription if you run out of medication. 

Please be aware that you cannot receive a new prescription if you have not submitted your weekly monitoring forms. Your safety is our priority. 

Unfortunately, we are not able to expedite the prescription and delivery process if you run out of your medication before your new prescription is delivered. 

We always recommend that you request your prescription 7 days before you are due to run out of medication. 

To speak to our linked pharmacy, PPG, please call: 0330 124 4305. 

For your own safety you should never take medication that has not been prescribed for you. 

When a controlled drug is prescribed, it is prescribed to a specific person. It is not safe to take anyone else’s medication. 

The doctor or prescriber who issued the prescription will have checked for any potential contraindications (situations in which the drug will not be safe) and cleared their patient to take the medication. Anyone else who takes the medication will not be able to rely on the medication being safe for them. 

The prescriber will also tailor the dose to the needs of the person being treated. For these reasons, it is very important to adhere to the guidelines issued with the medication. 

Your treatment may be stopped if there is a change in your physical or mental health which indicates that it may not be safe for you to continue with your medication. Your safety is our priority and the reasons for stopping your medication will be explained by your titrating prescriber or doctor. 

Some of our patients are experiencing additional delays in the prescribing of medication for ADHD due to global drug shortages. Please download the latest Update Regarding National ADHD Medication Shortage for further information. This information is updated regularly. 

ADHD is a condition that can persist into adulthood, contrary to the outdated belief that it only affects children. Despite this, many medications for ADHD are still only licensed for use in children, and the patient information leaflets have not been updated to reflect current knowledge. 

NICE Guidelines and Unlicensed Use 

In the UK, the NICE guidelines recommend several pharmacological treatments for adults with ADHD. These include: 

• Methylphenidate: This is the first-line treatment and includes various formulations such as Xaggitin XL, Concerta XL, Medikinet XL, Equasym XL, and short-release methylphenidate. 
• Lisdexamfetamine: Recommended if methylphenidate is not effective or tolerated. 
• Dexamfetamine: Considered if lisdexamfetamine is not tolerated due to prolonged effect. 
• Atomoxetine: An alternative for those who are not clinically suitable for or cannot tolerate stimulants or if there is a risk of misuse. 
• Guanfacine: Third line option, particularly if other treatments are not suitable. 

Unlicensed Use of Medications 

While these medications are primarily licensed for children, they are commonly prescribed off-label for adults based on clinical guidelines and evidence of their effectiveness. This practice is known as unlicensed or off-label use. It is important to understand that: 

• Unlicensed use means the medication is not officially approved for a specific age group or condition, but it is prescribed based on clinical judgement and guidelines. 
• Safety and efficacy: The safety and efficacy of these medications for adults with ADHD have been supported by clinical studies and real-world use. 

Further Information 

For more information, please visit the NICE website or the Choice and Medication website and search for their Handy Fact Sheet: Unlicensed Uses of Licensed Medicines. 

Titration is the process that introduces your body to medication safely and works out the most suitable medication and dose for you.  

Safe clinical practice involves careful prescriber monitoring and supervision until you have reached a stable or ‘optimised’ dose to help you achieve the maximum benefit with minimum side effects. Your prescriber will ask you for regular feedback (including the reporting of any side effects). 

During your assessment, you may discuss with your doctor whether medication would be appropriate to help you manage your ADHD symptoms. If you decide that you might find this beneficial, you will be referred to our titration team. 

If you are a private patient funding your own treatment, titration costs £105 per month. This is payable at the start of each four-week period that you remain in titration. For some, the process will only involve one round of fees, but for others the process will take longer. There is no way for us to predict the final cost as it depends on your individual response to treatment. 

If you are a Right to Choose (RTC) patient, titration will be provided under the NHS, with no charge to you. You may decide to go down this route while you are on the waiting list, but please note that you won’t be able to backdate RTC for any aspect of your care that you have already received and paid for.  

The titration process is personalised to the individual and we do not place a specific timeframe on the length of the titration journey. As a guide, the titration process usually lasts 8-12 weeks. 

Once you have started your treatment plan, you will need to work closely with your prescriber. We ask you to submit weekly readings of your blood pressure, pulse and weight, along with information about any improvements or side effects you have experienced.

Your prescriber will use this information to monitor your response and find the type of medication and dose that suit you best, achieving a balance between alleviating your ADHD symptoms and experiencing the least possible side effects.

When you are referred to our titration service, you will be added to our wait list. We know that waiting for medication can be difficult, and we’ll contact you regularly to check on your wellbeing and share helpful articles and resources to give you additional support.

During this time, our titration admin team will be working behind the scenes to collect information we require about your health and wellbeing to ensure that you are ready to start titration as soon as you reach the top of the wait list.

Baseline readings

We will ask you to submit two sets of ‘observations’, which will include readings of your blood pressure and pulse, along with your height and weight measurements. These are known as your ‘baseline readings’ and will provide a reference point for your prescriber to monitor any changes when you start your medication.

Medical investigations

You will need to send the results of any medical investigations, if requested by your Psychiatry UK doctor.

Pre-titration checklist

When you are approaching the top of the wait list, we will ask you to complete your ‘pre-titration checklist’. This includes:

• Giving us your written consent to start treatment and agreement to send in regular monitoring information.
• Submitting three forms:
  • Pre-Titration Checklist Form
  • Prescription Address and Payment Exemption Confirmation Form
  • Blood pressure, Pulse and Weight Form (with your up-to-date readings
• Checking that your proof of ID and address have been completed and accepted.
• Checking that your address and GP details are kept up to date on your patient profile.

Please note that you do not need to do anything until we contact you to request this information.

For further information, visit our Starting Your Treatment page.

Our 12-week titration model allows us to provide safe and effective care for our patients, while also ensuring that we can move patients who are still on our wait list into titration as soon as possible. In our experience, 12 weeks is sufficient time for patients to become stabilised on their new treatment plan.

NICE guidelines recommend that treatment for ADHD is commenced by a specialist ADHD clinician. Not all GPs have the knowledge to prescribe and titrate ADHD medications, and some prefer not to carry out this process.

The titration service does not work within an appointment booking format. When you are picked up from the waiting list you will be contacted via the portal by a titrating prescriber. This is an effective and efficient system because it allows you and the prescriber involved in your care to be flexible in terms of exchanging information through the course of your treatment. It does not require you to take time away from your working day or usual routines at home or elsewhere to be in regular, direct contact with your prescriber. You will communicate with them through your portal notes. 

When your treatment begins, the required time will not be dictated or restricted in any way. You will just be asked to complete a regular feedback form to update your prescriber about how your treatment is progressing and iron out any problems along the way. We have found this to be an efficient and responsive approach to your treatment, compared to a traditional model based on follow-up appointments. 

Before starting your medication, we will ask you to send in some baseline observations including your blood pressure, pulse and weight. You may also be asked to send in the results of an ECG and/or blood tests if these have been advised by your assessing consultant.  

During the titration process, you will be asked to monitor and record your blood pressure, pulse and weight at regular intervals, reporting back to your prescriber towards the end of each four-week prescription period, so you may find it helpful to purchase a blood pressure monitor to keep at home. 

When you start the titration process, we will ask you to send in some baseline observations, including your blood pressure, pulse and weight. You may also be asked to send in the results of an ECG and/or blood tests if these have been advised by your assessing consultant. This information will be reviewed by your titration prescriber and, if your observations are within a normal range, we will send out your first prescription together with a treatment plan, which will give guidance on how and when to take the medication. 

Please note that since becoming a Right to Choose provider, we have seen a sharp rise in the number of referrals received. Unfortunately, this has led to the development of delays for patients waiting for titration. We are investing heavily and ask you to please bear with us while we onboard new staff as quickly as possible to minimise these delays. 

You can keep up to date with our current estimated waiting times here. 

Although you may opt to pay for your assessment privately, patients are added to our waiting list in order of the date that the referral is received and will be allocated to an available prescriber in the same order. We do not distinguish between private and non-private patients when allocating to a prescriber for titration. 

The titration process typically takes 8-12 weeks. This will allow your body to adjust to the new medication and find your optimal dose. This means that you will feel maximum treatment effects from your medication with minimum side effects.  

At this stage, you will be invited to attend an ‘end of titration review’. 

If your clinician is happy that your treatment is now stabilised, they will write to your GP to recommend that your prescription be continued under a Shared Care Agreement. This means that ongoing prescriptions will be issued by your GP surgery, and there will be an expectation that your medication will be reviewed on a six-monthly basis by your GP. You will also be offered an annual review by Psychiatry UK – or perhaps by another service, such as your local NHS team. 

Before starting your medication, we will ask you to provide a health update and to send in your baseline weight, height, blood pressure and pulse readings. If advised by your doctor, you may also be asked to provide the results of an ECG and/or blood tests. 

If you are an NHS or RTC patient, we will send you a blood pressure monitor free of charge to be able to record your observations. 

During the titration process, you will be required to complete medication monitoring forms every 2 weeks, recording your latest weight, blood pressure and pulse readings. You will also be asked to provide information about the way you are responding to the medication and let us know if you are experiencing any problems. 

You will find all forms under the ‘Pending forms’ tab in the ‘Forms’ section of your patient portal. 

You will also receive notifications via email or SMS, which will open up the form for you to complete. 

When you have completed your form, the portal will display the message ‘100% complete’. However, always ensure that you click ‘Submit’ to complete the process.

Completing fortnightly monitoring forms is an essential part of our online titration process. 

Your prescriber needs to see regular readings of your blood pressure, pulse and weight and information about any side effects, to safely monitor your response to the new medication. 

If your first treatment does not suit you, they may recommend that you try a different medication or adjust your dose before preparing your next prescription. 

The forms will prompt you to record the required information. Your prescriber needs regular reading updates to monitor any changes from your baseline readings. 

You will also be asked to note any improvements or adverse effects. In the case of minor side effects, your prescriber can reassure you that these are common and give you advice on how to manage them. Often these effects will reduce in time, as your body gets used to the new medication. 

If side effects are severe or intolerable, your prescriber will change your medication. 

Every three weeks, your prescriber will ask you to complete an ASRS (Adult Self-Reporting Scale) Form to monitor progress in reducing symptoms. 

If side effects are severe or intolerable, your prescriber will change your medication.

Every three weeks, your prescriber will ask you to complete an ASRS (Adult Self-Reporting Scale) Form to monitor progress in reducing symptoms.

Completing your forms can feel tiresome or hard to manage some weeks. However, they are an essential part of our online process. Without this information, your prescriber cannot safely monitor any changes or side effects caused by the new medication.

If you have missed a form, contact your prescriber straight away to ask them what you should do next. 

Please remember that if you miss three monitoring forms, your case will be reviewed, and you may be discharged back to the care of your GP. 

When you are stable on your medication and your prescriber is satisfied that they have found the optimised dose to manage your ADHD symptoms with the least possible side effects, they will arrange an End of Titration Review. 

They will review your progress and discuss any questions or concerns you may have. 

After your End of Titration Review, we will contact your GP to ask if they will enter a Shared Care Agreement (SCA). 

Once you are stable on your new medication, we will arrange an End of Titration Review appointment, where your prescriber will review your progress and discuss how you are finding your new medication. 

If you are happy with the medication, we will contact your GP to ask if they will enter a Shared Care Agreement (SCA) and monitor your BP, pulse weight and height at six-monthly intervals. 

After 12 months, you will be invited to attend an Annual Review with Psychiatry UK. 

Once you are stable on your treatment, titration will be completed. We will write to your GP to let them know the details of your treatment to date and ask if they will accept a Shared Care Agreement. If your GP accepts shared care, we will ask them to arrange a medication review appointment after six months at your surgery. 

We will contact you after 12 months to attend an Annual Review with Psychiatry UK. 

If your GP declines a Shared Care Agreement, we will continue to prescribe your medication. 

We will contact you after 12 months to attend an Annual Review with Psychiatry UK.

If your GP declines a Shared Care Agreement, we will continue to prescribe your medication.

If your GP accepts shared care, your ongoing prescriptions will be issued by your GP surgery. Your blood pressure, pulse and weight will need to be monitored every 6 months.

We will contact you directly to arrange an Annual Review appointment. If a review is required before this is due, we will require a written request from your GP before a booking can be made.

Please note: If you are a patient with a local ADHD service, you will be transferred back to that service for shared care, and they will arrange annual reviews, or any other follow-up that is needed.

Most referring GPs are happy to take on a Shared Care Agreement (SCA), but there is no obligation for them to do so. There are also some areas of England where certain medications cannot be prescribed by a GP, and they are legally unable to accept the SCA. In these cases, we would continue to prescribe for you and invoice the ICB. 

If your GP declines shared care prescribing, we will require a letter or email from your GP to confirm this. Psychiatry UK will then continue to provide your repeat prescription. 

Please note: If you are a patient with a local ADHD service, you will be transferred back to that service for shared care. If your GP declines shared care, your local service will take over your prescribing. 

The titration process typically takes 8-12 weeks to allow your body to adjust to the new medication and find the optimal dose for you to feel maximum treatment effects with minimal side effects. 

At this stage, you will receive an End of-Titration Review, and a letter will be sent to your GP recommending that your prescription be continued under a Shared Care Agreement (SCA). This means that ongoing prescriptions will be issued by your GP surgery, and there will be an expectation that your medication will be reviewed on a 6-monthly basis by your GP. 

You will also be offered an annual review by Psychiatry UK – or another service, such as your local NHS team. 

After your End of Titration Review, a copy of your assessment report (sometimes referred to as your ‘clinic letter’) and Shared Care Agreement (SCA) will be sent to your GP. They will be requested to return a signed copy of the SCA. If we do not receive this within 4 weeks, we will contact your GP for their decision. We will inform you once we have had a response from your GP. 

If you need a prescription while your shared care request is being processed, please request this from your prescriber as  you have done during titration. If you are having trouble requesting a prescription, please contact us via our live web chat service. 

We would advise that you contact your GP directly as well to find out if they are accepting shared care, as they will not necessarily reach out to you. 

Please contact us via our Virtual Assistant service. This is available from our website, portal or Companion app (we are open Mon-Fri 8am-6pm).