Are Private ADHD Titration As Important As Everyone Says?
Private ADHD Titration
There is currently a national shortage of medications to treat ADHD symptoms. This is due to manufacturing issues and the growing demand for ADHD medications worldwide.
Our service is able to provide private ADHD titration as an alternative to waiting for NHS funding through Right to Choose. Our assessments are free and include the cost of one prescription.
Titration
A highly skilled consultant psychiatrist will conduct a thorough evaluation of your ADHD. This will include medical history and an assessment using the standard ADHD rating scales and questionnaires.
After your examination, you will be advised that medication may be beneficial in your case. This will happen during your follow-up appointment (which could be in person via video link or by telephone). Your clinician will explain what medication options are available and, if you decide to start on medication we will offer to titrate the dose to optimise the balance of benefits and side effects for you.
This process may take a few weeks and involves gradually adjusting your child’s medication until the appropriate balance is achieved. It's not uncommon to have to titrate several times before finding the best one for your child's ADHD symptoms. It is essential for parents to take part in this process of titration and keep a close watchful eye on their child's behavior to inform the doctor if the medicine is helping or causing adverse effects.
If you decide to go back to NHS treatment you will receive a private prescription for your medication. You will have to pay the pharmacy. This is not included in the consultation cost. You will be required to attend every six months to check your medication. This includes blood pressure and pulse readings. Annual reviews are also mandatory.
Follow-up appointments
After the evaluation is completed after the assessment is completed, you can make appointment with the psychiatrist. Usually the appointment will take place through a video call using zoom however in some instances it is possible to schedule an audio only consultation (again at an extra cost).
We will then go over treatment options and decide on an individualised, bespoke ADHD medication titration. This will include a discussion and review of your dosage of medication and any side effects that you may be experiencing. The cost for these titration appointments is PS150 for face-to-face sessions and PS60 for online or phone video consultations. Costs for medication are extra and are paid directly to the pharmacy.
The psychiatrist will ask questions about your family history, the impact of your ADHD symptoms on your life and any relationship problems or mental health issues that you might be experiencing. This is due to the fact that ADHD can be a genetic disorder and it is important to look into any family history that may suggest that you are at risk of developing the disorder.
It is important that you are honest and open with the clinician during this evaluation, as the information they get will be used to determine if your ADHD fits the diagnostic criteria. This is a crucial part of the process, as failing to do so could lead to an inaccurate diagnosis, and thus an incorrect prescribing of medication.
If you decide to seek treatment for ADHD, we'll arrange an appointment for a follow-up visit with a psychiatrist that is skilled in this area. This can be scheduled in the wake of your diagnosis if you are keen to begin treatment immediately, or within two weeks if want to think about the implications of your diagnosis and the alternatives that are available to you.
If you aren't sure which one you prefer it is recommended that you speak to your GP prior to booking your private examination as some providers have different rules regarding whether they require a GP referral letter or not. We also suggest that you check whether your GP accepts a "Shared Care Agreement', which means that once you are discharged from the clinic, you will be sent back to them to get the medication prescription.
Medication
Medication is a key part of the journey for many people seeking a private ADHD diagnosis. It can be difficult to get a prescription from a psychiatrist on the NHS. NHS waiting lists can be extremely long, and GPs may be reluctant to refer patients to specialist services.
One method to avoid this is to request your GP to refer you to Right to Choose (see psychiatry-uk and ADHD 360). This means you can select a provider that offers an assessment and titration. This can help you reduce time and be more convenient, particularly when you are on a tight work schedule.
If titration adhd are referred through this route, your chosen clinician will assess you and decide whether or not you need to be monitored for a dose of medication. You will be asked to fill in forms that differ by doctor but the most important ones are self-report questionnaires and medical histories from childhood and adulthood. These forms will assist your doctor identify any conditions that could suggest you should not take ADHD medications if they're prescribed.
If you are being titrated the medication will be a combination stimulants and nonstimulant medications. These will be carefully trialled and monitored to determine the most suitable combination for you, taking into consideration any current conditions you suffer from. The titration procedure can be a lengthy process and may require multiple appointments before your dose is stable.
The frequency of your follow-up appointments will be contingent on the type and amount of medication you're taking. They can be scheduled for monthly or quarterly. Your clinician will check that you are stable with the medication, record any adverse reactions you've experienced, and make any needed adjustments to ensure that you remain on a safe dosage. You are required to attend an annual review as well as a regular health check-up that includes blood pressure, pulse, and weight measurements.
For some, it may be that they are satisfied with their medication and don't need any further discussion on their titration. If you're required to discuss your titration plan or treatment plan more thoroughly it is likely that you will be referred back to the private doctor who performed your initial assessment. If this happens, the titration appointment will be part of their consultation fee, and they will be given their medication via a private prescription (see Consultation fees above). This could cost more than an NHS prescription as the pharmacy will charge for the medication.