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Filling Prescription

Medication Titration Plan

ADHD Medication (Please read this carefully)

 

Please note that I only prescribe if I have confirmed a diagnosis, I believe it is clinically indicated and not on demand. 

I follow NICE guidelines regarding first and second line medications and titration.  ​ADHD medications are controlled drugs and require additional consideration when prescribing and monitoring.

If medication is the right choice for your child then it is important to note that medication is more likely to be effective if part of a multi-modal psycho-educational approach with school and home-based ADHD specific support and behavioural strategies. Further reading: LINK1  LINK2  LINK3

Before starting medication, I will complete a risk assessment and a full physical examination that will include weight, height, and blood pressure. If there is a family history of heart problems then an ECG will need to be done prior to starting medication. 

 

My practice is to start on the lowest dose and then slowly increase depending on response and any complications (this is called medication titration).
 

Every child responds to medication differently. For some there is a quick and dramatic improvement but for others it sometimes takes trials of different medications and dosages to find the right regime. 

On average it takes around 3-6 appointments (6-12 weeks) to stabilise medication whilst carefully monitoring your child's health.

 

Read more about medicationLINK2  LINK3

Methylphenidate Information leaflet.

Elvanse Information leaflet.

 

Standard medication titration plan:​​

  1. Prescription issued. Each prescription is for 28 days supply.

  2. Day1. Start medication. Every day. Roughly same time every morning.

  3. If worried about severe side effects then please book a medication review appointment (Video) or stop medication pending further discussion.

  4. Every 2-3 weeks please book a Medication Review video appointment - includes issuing a new prescription. 20-30 mins max. These consultations are focused only on medication titration. These appointments are usually early evenings. I expect both parent and child to be present. 

  5. Unless I have specifically instructed I am unable to do medication reviews / give advice via emailPlease book a Medication Review appointment.

  6. For ADHD FOUNDATION PATIENTSBook an appointment.

  7. For GMG PATIENTS: Book an appointment.

  8. Repeat Prescription required in between appointments will cost £20 and posted via special delivery​. Email admin@manchesterpaediatrician.com for a repeat prescription. I try to respond and post out within 48-72 hours.

  9. Any changes to a prescription will require a Medication Review appointment.

  10. Presently, I am unable to send the prescription to your local pharmacy.

  11. Likely costs regarding ADHD Medication depends on type, brand and dose but typically between £40 - £150 for a month's supply. Price can vary a bit between pharmacies so you may want to phone around, although some pharmacies will not quote over the phone.

  12. Likely costs regarding stabilising medication depend on number of video appointments but typically between £300 (3 appointments) to £600 (6 appointments). 

  13. I try to minimise cost by offering convenient evening video appointments and do not charge for issuing prescriptions following an appointment. 

​​

Long Term 

  1. Once on a stable medication dose, I can then request shared care and on-going prescribing by your GP including referral to your local NHS ADHD care provider for on-going specialist care. Alternatively, I would be very pleased to provide on-going specialist review. After this any further enquiries and reviews will need to be via a General Review appointment and not a Medication Review.

  2. Please note that any young person on ADHD medication requires a specialist review 4-6 monthly. My fee for this General Review is £250 (F2F or video).

  3. Please note some GP's will not provide shared care from a private clinician and therefore will not take over prescribing. I would recommend discussing this with your GP prior to your first appointment with me.

  4. I only see young people up to their 18th birthday, although, if I’ve initiated treatment before then, I would be happy to provide on going care for a short time till care has been transferred and accepted by an adult specialist. 

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