Treatment for ADHD / Medication Titration

Titration, in medical terms, refers to the careful process of working with the patient to ascertain the most effective medication and adjusting the dosage to achieve the optimal therapeutic effect. At ADHD Clinics, our team of highly skilled Consultant Psychiatrists specialise in this nuanced approach. They aim to identify the lowest effective dose that alleviates symptoms without causing significant side effects.

There is no way to predict the dosage of ADHD medication that will work best for any given patient. It takes trial and error to titrate ADHD medications. Consultant Psychiatrists at ADHD Clinics undertake the meticulous task of titrating medication. This means they systematically and gradually adjust the dosage, whether increasing or reducing it as the case may be, until you or your child reaches maximum symptom relief with minimal side effects.

This personalised and expert-guided titration process ensures that the treatment plan aligns precisely with individual needs, providing the highest standard of care. The Consultant Psychiatrists at ADHD Clinics bring their wealth of experience and specialised knowledge to tailor the treatment journey for optimal therapeutic outcomes.

Why is Titration Important?

There are different types of ADHD medications and they can have varying effects on individuals, and finding the right balance is crucial. The titration process allows our Psychiatrists to monitor responses closely, ensuring that the chosen medication effectively addresses symptoms while minimising any potential side effects. It is a personalised journey to discover what works best for each individual.

Benefits of Titration: Titration of medications for ADHD has several benefits, including-

— Finding the lowest effective dose: Titration helps to find the lowest effective dose of medication that improves symptoms without causing significant side effects. This can help to minimise the risk of side effects and improve medication adherence.

— Individualised treatment: Titration is a personalised process that takes into account the individual’s specific needs and response to medication. This can help to ensure that the individual receives the most effective treatment for their symptoms.

— Monitoring for side effects: Titration allows for close monitoring of the individual’s response to medication and the development of side effects. This can help to identify and manage side effects early on and ensure the safety of the individual.

Factors Influencing Titration:

Several factors contribute to the titration process, including age, weight, medical history, psychiatric history, concurrent medications, and the severity of ADHD symptoms. ADHD Clinics Psychiatrists carefully consider these elements when determining the initial dose and the rate of adjustment.

Before Titration:

* Before starting Titration/treatment please talk to your GP about eventually taking over your prescribing when you are ready, on a Shared Care Agreement SCA or a discharge to them.

ADHD Clinics Psychiatrists will need to know your Blood Pressure, Heart Rate and weight. Your Blood tests and ECG, as advised in your assessment report, will be reviewed.

GP patient summary is also required. This is a 2-3 page document which contains pertinent information about your medical and psychiatric history. It is the same as Summary Care Record SCR.  It is readily available from your GP Surgery reception.

The Titration process:

— The Titration process typically begins with a discussion to collaboratively agree on a particular medication and it is started at low dose, gradually increasing it over time.

– If Titration/treatment is started the GP will be informed.

– Psychiatrists at ADHD Clinics working ethos is Start Low Go Slow. We find this a better working method especially for ADHD medications.

— ADHD Clinics Psychiatrists conduct regular reviews, usually every 3-4 weeks, to assess the individual’s response to the medication.

— Depending on the situation, rarely, appointments might be more frequent if the history is complex, in the presence of psychiatric or medical comorbidity, severe side effects occur or if there are new developments.

— It usually takes 3-4 review appointments for the titration to be completed but depending on the case it may take longer. This may be in situations like if the medication needs to be changed, history is complex, in the presence of psychiatric or medical comorbidity, severe side effects occur or if there are new developments or new information becomes available.

— Please note that our Psychiatrists believe in collaboration with patients, they will take your choice and opinions on board on the choice of medications and the dose but their decision would be final. This would always be in the best interest of your health and safety.

Reviews and repeat prescription requests:

– Before any prescription is agreed and sent please confirm from your local pharmacies which medication and dose is available.

– During the Titration phase, we prefer the first two reviews to take place consecutively.

– After that, if required, patients can request one repeat prescription between reviews.

– A 7-day notice is expected for issuing prescriptions.

– Our psychiatrists cover each other during times of annual leaves and sickness etc. Sometimes a Prescription can also be done by another Psychiatrist who is not involved in a patient’s treatment. This is covered under our prescribing policy.

Shared Care Agreement SCA:

Once a stable dose is achieved, the expectation is that GPs take over prescribing. This transition often involves a Shared Care Agreement SCA between ADHD Clinics and the GP. If the patient prefers they can ask for a discharge to the GPs care. Patients can also choose another private provider.

After establishing an SCA with the GP, patients are required to attend at least a yearly review, if not 6 monthly. In cases where GPs decline the SCA, repeat prescriptions can be issued monthly for five months, after which a follow-up review at 6 month becomes necessary.

Patient-Centred Care:

At ADHD Clinics, we recognise the importance of individualised care. The titration process may take time, involving adjustments and trying different approaches, but our goal is to collaboratively work with each patient towards a stable and effective medication plan tailored to their unique needs.

Please note ADHD Clinics can change this Titration process without notice.