Starting medication for ADHD is a big step, and we’ll be with you throughout the process to make sure it’s done safely and at a pace that works for you. This stage usually takes around 12-16 weeks. During this time, your prescriber will carefully adjust your dose and check in with you, so that together you find the treatment that helps your symptoms with the least possible side effects. 

How online titration works

  • You’ll be paired with a specialist prescriber. 
  • All communication happens safely through your patient portal. 
  • This gives you flexibility: you can reply to notes and requests when convenient. 
  • To keep treatment on track, please respond promptly to any information requests. 

Important: You must be in the UK throughout titration, with regular access to a BP monitor, phone or computer, and the internet. We cannot deliver medication or provide treatment outside the UK. 

How long does it take?

Every journey is different, but titration usually takes around 14 weeks.

For the majority of patients the titration process takes between 12 and 16 weeks, but for some individuals, this may take longer and can be discussed with your clinician.

This allows your prescriber to: 

  • Adjust your dose gradually until you’re stable. 
  • Try a different medication if the first one isn’t right for you. 
  • Make sure you’re safe and supported along the way. 

You can learn more about ADHD medications at the Choice and Medication website or by downloading our guide: ADHD Medication for Adults. 

Getting started

When you reach the top of the titration waiting list: 

You’ll be allocated a prescriber. They’ll review your medical information. 

If it’s safe to begin, your prescriber will share your personalised treatment plan (a PDF you’ll find in your portal). 

  • Please note: you can’t open PDFs in the Companion App—you’ll need to log into your portal on a web browser. 

Next, you’ll give your consent: 

  • Confirm in writing that you agree to the plan. 
  • Agree to send in your monitoring information (BP, pulse, weight, side effects if any). 
  • Share any questions or concerns via the portal—your prescriber will respond once you’ve been allocated. 

 

Ordering your first medication

Once you have read your treatment plan, and given your consent to proceed with your ADHD medication, your prescriber will arrange your first prescription via the patient portal.
The way that your medication is dispensed will depend on whether e-prescribing is available in your local area, via your Integrated Care Board (ICB).

If you receive your medication via home delivery (PPG):
Once your prescription has been processed, the pharmacy will arrange delivery directly to your address. Delivery times may vary, and you will usually be contacted to confirm a suitable delivery date.

If your prescription is sent to a local pharmacy (electronic prescribing):
Your prescription can be sent securely to a pharmacy of your choice, helping to reduce the time it takes for your medication to reach you.

Many ADHD medications, including methylphenidate and lisdexamfetamine, are controlled medicines. Because of this, some pharmacies may not always keep them in stock and may need to order them once they receive your prescription.

To help avoid delays, it can be useful to:

  • Build a relationship with a local pharmacy you plan to use regularly.
  • Contact the pharmacy ahead of time to check whether your medication is in stock.
  • If not available, ask whether they can order it in. Your pharmacy team can usually advise when your medication will be ready for collection.

If your pharmacy cannot supply your medication, you have a few options:

  • Your pharmacy can release your prescription back into the NHS electronic system so another pharmacy can access it.
  • Another pharmacy may then retrieve and dispense your prescription if they have the medication in stock.
  • Your pharmacy or prescriber can provide a prescription code, which you can take to another pharmacy.

If you have any questions about ordering your prescriptions, please contact your prescriber by creating a note in your patient portal.

Missed a delivery?

If you receive your medication via home delivery, please contact the pharmacy to re-arrange:
Email: [email protected]
Call: 0330 124 4305 

Include: 

  • Your full name and date of birth 
  • Current address on your record 
  • Preferred delivery address 
  • Whether you’d like weekday or weekend delivery (Tue–Sun; timeslots can’t be chosen). 

Start taking your medication

When your first prescription arrives, it’s an exciting step forward in your treatment journey. Here’s what to do next: 

Read the leaflet carefully 

  • Each pack comes with a patient information leaflet. Please read it before starting, so you know what to expect. 

Take your medication as prescribed 

  • Follow the exact instructions from your prescriber—don’t change the dose or timing unless advised. 

Complete your first monitoring form 

  • On Day 5, fill out your ADHD Monitoring Form (found in your portal under ‘Pending Forms’). 
  • This first form must be submitted within 10 days of your first prescription being issued. 

Check your readings 

  • Take your blood pressure and pulse 1–2 hours after taking your medication. 
  • Record these readings in your monitoring form. 

Report side effects promptly 

  • If you experience palpitations, chest pain, dizziness, or any distressing side effects, contact your prescriber immediately via the portal. 

Keep up with monitoring 

  • Submit a new monitoring form every 2 weeks. 
  • Prescribers usually respond within 2–3 working days, so please keep checking your portal for their advice. 

Request your next prescription 

  • Around 3 weeks after starting (when you have about 1 week of medication left), send a portal note to ‘Your Prescriber’. 
  • They’ll review your progress and, if all looks safe, prepare your next prescription. 
  • If there are side effects, they may adjust your dose or suggest a change before re-prescribing. 

 

Monitoring your progress

Monitoring is the most important part of titration—it’s how your prescriber keeps you safe and helps fine-tune your dose. 

What you’ll do: 

  • Day 5 after starting medication: complete your first ADHD Monitoring Form (in your portal under “Pending Forms”). This must be submitted within 10 days of your first prescription. 
  • Take readings: check your blood pressure and pulse 1–2 hours after taking medication. 
  • Every 2 weeks: complete a new monitoring form with BP, pulse, weight, and how you’re feeling. Forms expire after 1 week, so please submit promptly. 
  • Every 3 weeks: complete an ASRS (Adult ADHD Self-Report Scale) for progress review. 

Always click Submit after completing forms (even if it says “100% complete”). 

Tips: 

Note down improvements or side effects—your prescriber can give advice or adjust your plan. 

Most minor side effects improve as your body adjusts. 

Prescribers respond to monitoring forms within 2–3 days. 

 

Struggling to keep up with your monitoring forms?

We understand that filling in forms can feel repetitive or overwhelming at times — but they are a vital part of your treatment. The information you provide is what allows your prescriber to: 

  • Track how well your medication is working 
  • Adjust your dose safely 
  • Minimise side effects 
  • Find the best long-term treatment plan for you 

Why It’s Important 

Because this is an online service, we rely on your updates instead of face-to-face checks. If forms aren’t submitted regularly, your prescriber can’t safely monitor your progress. 

  • If you miss three updates in a row, your case will be reviewed and you may be discharged from the service. 
  • If this happens, your GP can re-refer you in the future, but you would need to attend a review appointment before restarting treatment. 

What to Do If You Can’t Complete a Form 

Life happens — holidays, illness, or other commitments might get in the way. That’s okay, but please: 

  • Let your prescriber know in advance if you won’t be able to submit a form. 
  • This helps them adjust your treatment plan so it stays safe and effective. 

If You Are Discharged 

  • You will be fully informed about how to safely stop your medication. 
  • You can choose to be re-referred later through your GP. 
  • If re-referred, you’ll attend a review appointment and then be placed back on the titration waitlist if treatment is still appropriate. 

Tip: Think of your monitoring forms as your way of “checking in” with your prescriber. They keep your treatment on track and ensure you get the most benefit from your medication. 

Staying safe with medication

  • Read the medication leaflet carefully. 
  • Avoid or limit alcohol—it can raise risks of side effects. 
  • Never use illicit drugs such as cocaine or amphetamines while on ADHD medication. 
  • Avoid cold/flu medicines containing decongestants or caffeine. 
  • Tell us if: 
    • You become pregnant. 
    • You’re prescribed any new medication. 
  • Store medication securely and legally (see our guide: Safe Storage of Medication. 

Understanding ‘unlicensed’ or ‘off label’ medication

Some ADHD medications are only officially licensed for children, but are recommended for adults by NICE guidelines. This is known as “off-label” prescribing, and it’s safe and evidence-based. 
Read more: Unlicensed Treatment for Adults with ADHD. 

What happens when my titration is completed?

  • You’ll have an End of Titration Review with your prescriber. 
  • We’ll write to your GP and request a shared care agreement, so your GP can continue prescribing your medication. 
  • Until shared care is agreed, prescriptions continue through your prescriber—there will be no gap in treatment. 
  • If your GP accepts shared care, they’ll monitor your health every 6 months. 
  • Psychiatry UK will check in with you again at your 12-month annual review. 
  • If your GP declines shared care, we’ll continue prescribing for you. 

How can I get in touch?

  • Reply to prescriber requests via case notes in your portal. 
  • For urgent help, see the guidance on our website. 
  • For other queries, use our Live Chat (available 24/7 via portal or website). 
  • Download the MedQare Companion App for instant notifications. 

Remember: Titration is a team effort! By sharing your monitoring updates and responding to your prescriber’s notes, you’ll be giving yourself the best chance of finding the right medication and dose for you.