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Private ADHD Titration

There is currently a national shortage of medications to treat ADHD symptoms. This is due both to manufacturing issues and an increased demand in the world.

Our service is able to offer private ADHD titration as an alternative to waiting for NHS funding through Right to Choose. Our assessments cost include the cost of one prescription.

Titration

A highly skilled consultant psychiatrist will conduct a thorough assessment of your ADHD. This includes a thorough medical history, and an assessment using the standard ADHD questionnaires and rating scales.

After your examination, you will be informed that medication may be beneficial steps for titration your situation. The discussion will take place at your follow-up appointment (which may be scheduled in person, via video link or by phone). Your clinician will explain the various options for medication and if you decide to begin taking medication, we will recommend titrating the dose to maximize the balance of benefits and side effects for you.

This process can take a few weeks and it involves gradually altering your child's dosage until the proper balance has been achieved. It's not uncommon to have to titrate up to three different medicines before you can find the one that is most suitable for your child's ADHD. It is essential for parents to participate in this titration process and keep an eye on their child's behavior, so that they can inform the doctor if the medicine is helping or private causing side effects.

Unless you have decided to return to NHS treatment, your medication will be issued with a private prescription which you will need to pay for at the pharmacy (this is not included in your consultation fees). You will need to attend six-monthly appointments to monitor your medications. This includes the measurement of pulse and blood pressure. Annual reviews are also required.

Follow-up appointments

After the assessment is completed, you'll be able to make follow up appointments with your psychiatrist, if necessary. The appointment usually takes place via a zoom video call but in certain circumstances it may be possible to do an audio only consultation (again at an extra cost).

We will then go over the options for treatment and then decide on a bespoke, individualised ADHD medication titration. This will include an assessment of your medication dosage and a discussion of any possible negative side effects you may be experiencing. The cost for these titration appointments is PS150 for face-to face sessions and PS60 for telephone or online video consultations. The pharmacy will charge you for any charges for medication.

The psychiatrist will ask questions about your family history, the effects of your ADHD symptoms on your life and any mental health issues you might be suffering from. ADHD can be a genetic condition, which is why it's crucial to examine your family history to determine if you are at a greater chance of developing this disorder.

During this examination, it is crucial that you are honest and open with the doctor who will be using the information you provide to determine whether you are able to meet the diagnostic criteria for ADHD. This is a vital step in the process, as failing to do so could result in an incorrect diagnosis and therefore inappropriate prescribing of medication.

If you've decided that you would like to receive treatment for your ADHD, we will then set up a follow-up appointment with one of our psychiatrists who specialise in this field. If you'd like to start treatment immediately, you can do this at the time of diagnosis. Or you can wait two weeks to consider the implications of the diagnosis and the options available to you.

If you aren't sure which one you prefer, we suggest that you speak with your GP before booking your private assessment as some providers have different policies about whether they require an GP referral letter or not. Find out if your GP accepts a Shared Care Agreement, which means you will be referred to them after you leave the clinic for prescriptions for medication.

Medication

For many who wish to obtain a private diagnosis of ADHD, medication is a key element of their treatment. Getting prescriptions from an NHS psychiatrist can be a challenge and lengthy. NHS waiting lists are notoriously long, and GPs may be reluctant to refer patients to specialist services.

One method to circumvent this is to ask your GP to refer you through Right to Choose (see psychiatry-uk and ADHD 360). This means that you can choose a provider that offers a private assessment and titration. This can cut down on wait time significantly and is more convenient if you're working and have a busy schedule.

If you are recommended, your physician will evaluate your condition to determine if you require medication adjustment. You will be asked to fill out forms that vary by provider but the most important ones are self-report questionnaires as well as medical histories from childhood and adulthood. These forms will assist your doctor to determine if there are any circumstances that indicate you shouldn't take ADHD medications, when they've been prescribed.

If you are titrated, the medication will consist of a mixture of stimulants and nonstimulant medications. They will be carefully tested and monitored to determine the best combination for you, taking into consideration any current conditions you suffer from. The titration process can be long and could require several additional appointments before you're stable on your dose.

Depending on the type of medication you're taking, follow-up appointments could be scheduled monthly or quarterly. Your clinician will check that you are stable with the medication, document any side effects you've experienced, and make any needed adjustments to ensure that you remain on a dose that is safe. You'll also be required to undergo a regular health check that may include blood pressure, pulse and weight readings and an annual review.

For some individuals it could be because they are happy with their medication and private don't need any further discussion on their titration. For those who do need further discussions about their titration and treatment plan it is possible that they will be referred back to the private clinic that performed their initial assessment. If this occurs, the titration appointment will be included in their consultation fees and they will receive their medication through a private prescription (see Consultation fees above). This can cost more than a prescription from the NHS because the pharmacy will charge you for the medication.