During your assessment, your doctor may discuss 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 Service.

Titration is the process that introduces your body to medication safely. During this period you will have regular contact with a member of our specialist prescribing team, who will adjust and monitor the treatment until you reach a stable or ‘optimised’ dose to help you achieve the maximum benefit with minimum side effects.

What does the process involve?

Getting started

You will have an Initial Assessment with one of our doctors. If they believe that you would benefit from receiving ADHD medication then your name will be put on our Titration waiting list. You can check for waiting time updates here.

When you reach the top of this list one of our prescribers will get in contact with you via the patient portal to introduce you to the process and give you some background information.

Your feedback and observations are an essential part of the process

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 doctor. Your doctor will have written to your GP to request these, but it often helps if you can contact them directly to make the arrangements go more smoothly.

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 via monitoring forms. If you are referred to us by your local Integrated Care Board (ICB) or Right to Choose, we will send you a blood pressure monitor. If you are a private patient, you will need to purchase a monitor from a local pharmacy.

Once your baseline information has been received, it will be reviewed by your titration prescriber and if your observations are within a normal range you will be ready to start the treatment process.

Receiving your medication

At this stage we will send out your first prescription, together with a treatment plan, which will give guidance on how and when to take the medication.

The guidance we send will contain details of how to check your blood pressure, and what to do if it is outside the normal range. If you are ever unsure or feel that you need more support during this process, please contact us via our Virtual Assistant service. If our Virtual Assistant is unable to answer your query, you will be transferred to a member of our Customer Support team during our opening hours (Mon-Fri, 8am-6pm). 

In Week 3, we will ask you to complete an Adult ADHD Self-Report Scale (ASRS). If there is anything of concern in your updates, we will get in touch.

In Week 4 we will review your progress and, if everything is going smoothly, we will send out your second month’s prescription. This may be a continuation of your current treatment titration, or we may need to make some adjustments to your treatment plan.

End of Titration Review

Once you have begun titration, the process typically takes 8-12 weeks. This allows 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 sent an appointment 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.

Can I receive titration through my GP?

Right to Choose Patients

If you live in England and have been referred to Psychiatry UK via the NHS Right to Choose (RTC) scheme, we are bound by the guidelines of the National Institute for Health and Care Excellence (NICE) to ensure that any medicine you receive is issued by a specialist ADHD titration service.

Your prescription will be delivered by our private online pharmacy, TPP, and you will only be required to pay the standard NHS prescription fee.

Private Patients or ICB Referrals

If you have been referred by your GP and your assessment is being funded by your local Integrated Care Board (ICB), or if you are a private patient, you can choose which pharmacy to use.

Why do we need to wait for titration?

Over recent years, the UK has seen a dramatic rise in the number of people seeking ADHD and ASD assessments under the NHS Right to Choose  scheme. This has inevitably led to growing waiting lists.  

Our patients are having to wait longer than we would like for both assessment and titration. We actively recruit year-round to onboard new doctors, prescribers and non-clinical staff to our teams, and we are introducing new technology to speed up processes and reduce our waiting times. 

In the meantime, we ask you please to be patient with us. We really are working as fast as we can to make a difference and increase patients’ accessibility to our mental health services. 

Why do waiting times vary?

It is difficult for us to give you an exact start date as the titration period varies from patient to patient, making it difficult to assess how quickly you will move up the list. Please be assured we are doing everything we can to reduce our waiting times.

Kate Bevan, Titration Team Lead