ADHD Medication in the UK: What Happens After Your Diagnosis

Getting an ADHD diagnosis is a significant moment. For many people it brings relief, clarity and finally an explanation for years of difficulty.

But the diagnosis is just the beginning of a process, not the end of one. What comes next, medication, titration, shared care, prescriptions, is where many people find themselves confused, unsupported and surprised by things nobody warned them about.

This guide explains exactly what happens after your ADHD diagnosis in the UK in 2026. Every medication named here is licensed for use in the UK. Every clinical detail is based on NICE Guideline NG87, the authoritative standard for ADHD diagnosis and management in England.

Whether you were diagnosed via the NHS, NHS Right to Choose or a private clinic, the immediate next steps are broadly the same.

Your diagnosing clinician will discuss medication options with you. They will take baseline measurements including blood pressure, heart rate and weight, since these are required by NICE guidelines before starting any ADHD medication.

If you are diagnosed privately, your clinic will typically manage the start of your medication and the titration process. At some point during or after titration, the question of shared care will arise. This is the arrangement under which your NHS GP takes over prescribing your repeat prescriptions, which significantly reduces your ongoing costs.

If you are diagnosed via the NHS or Right to Choose, your prescribing is managed within the NHS system from the start and shared care is less of an issue.

ADHD medications in the UK fall into two broad categories: stimulants and non-stimulants. Here is a plain-English guide to what is available and what NICE recommends.

Stimulant medications

Stimulants work by increasing the levels of dopamine and noradrenaline in the prefrontal cortex, the part of the brain responsible for attention, impulse control and planning. They typically work within hours of the first dose and have the strongest evidence base of any ADHD treatment.

Lisdexamfetamine (Elvanse)

NICE guidelines recommend lisdexamfetamine as the first-line medication for adults with ADHD in the UK. It is a prodrug, meaning it is converted into its active form in the body after you take it, giving it a smoother onset and longer duration than some alternatives.

Elvanse is available in doses of 20mg, 30mg, 40mg, 50mg, 60mg and 70mg. It typically lasts 12 to 14 hours and is taken once daily in the morning.

Elvanse is a controlled drug (Schedule 2) in the UK. Prescriptions cannot be issued electronically, must be written on a paper FP10 form, and cannot cover more than 28 days supply at a time.

Methylphenidate

Methylphenidate is the most widely prescribed ADHD medication globally and NICE recommends it as a first-line option alongside lisdexamfetamine for adults. Several brands are available in the UK with different durations and release profiles.

Like lisdexamfetamine, methylphenidate is a controlled drug subject to the same 28-day prescription rules.

Dexamfetamine

Dexamfetamine is considered a third-line option under NICE guidance. It may be prescribed if both lisdexamfetamine and methylphenidate have been tried and were either ineffective or not tolerated. It is an immediate-release medication taken 2 to 3 times daily.

Non-stimulant medications

Non-stimulant medications take several weeks to reach their full effect, rather than working within hours. They are typically used when stimulants are not tolerated, are contraindicated, or have not been effective.

Atomoxetine (Strattera)

Atomoxetine is a selective noradrenaline reuptake inhibitor. Unlike stimulants, it is not a controlled drug, meaning prescriptions can be issued electronically and for longer periods. It is taken once or twice daily and typically takes 4 to 6 weeks to show meaningful effect.

Guanfacine (Intuniv)

Guanfacine is licensed in the UK for children and adolescents aged 6 to 17. It is not typically a first-line option for adults. Your prescriber will advise whether it is appropriate for your situation.

Titration is the process of finding the right medication and the right dose for you. It is not a single prescription. It is a structured clinical process that takes weeks, involves regular monitoring, and requires honest communication between you and your prescriber throughout.

1. 1
   Baseline measurements

   Before starting any medication, your prescriber takes your baseline blood pressure, heart rate and weight. These are required by NICE guidelines and serve as your reference point for monitoring throughout titration.

2. 2
   Starting dose

   You start on a low dose of your chosen medication. The goal at this stage is not to find the right dose immediately but to see how your body responds and whether any side effects occur.

3. 3
   Regular review

   Every 1 to 2 weeks your prescriber will review how you are getting on, typically by phone or video. They will ask about symptom improvement, side effects, sleep and appetite. Based on your response they will maintain the current dose, increase it, or consider switching medication.

4. 4
   Finding the right dose

   This continues until you reach a dose where symptoms are meaningfully improved and any side effects are manageable.

5. 5
   Ongoing monitoring

   Blood pressure and weight monitoring is required throughout titration. NICE guidelines specify six-monthly checks once your dose is stable, and an annual review of whether medication remains beneficial.

Four to twelve weeks is the typical window for reaching a stable dose, regardless of which medication class is used. Some people find the right medication and dose within four weeks. Others take longer, particularly if the first medication tried is not effective and a switch is needed.

Be patient with this process. Rushing titration by requesting early dose increases is counterproductive and increases the risk of side effects. The goal is the right dose, not the fastest dose.

If you are going through titration privately, be aware that once titration is complete the question of shared care becomes urgent. The sooner you begin that conversation with your GP, the sooner you can move to NHS prescribing and reduce your costs significantly.

What shared care means

Shared care is an arrangement where your NHS GP takes over the prescribing of your ADHD medication from your private clinic or Right to Choose provider.

Under a shared care agreement your GP issues your monthly repeat prescriptions on the NHS, meaning you pay the standard NHS prescription charge of £9.90 per item in 2026, or nothing at all if you are exempt.

Without shared care, you continue to get your prescriptions from your private provider at a cost of £80 to £200 per month.

Based on standard NHS prescription charge 2026 vs typical private prescription costs.

Why some GPs refuse shared care

NHS England guidance states clearly that GPs should not refuse shared care solely because a diagnosis was made privately. However, refusal rates vary significantly depending on your GP surgery, your local area and sometimes your individual GP.

Some GPs refuse because they are unfamiliar with the shared care protocol. Some cite local ICB policies. Some simply decline without providing a clear clinical reason.

Check your GP surgery before your assessment

The most important action you can take before committing to a private assessment is to find out whether your GP surgery is known to accept shared care.

Our free GP Shared Care Checker lets you enter your postcode, find your surgery, and see what other patients have reported about whether that surgery accepted or refused shared care. It takes 30 seconds. It is completely anonymous. And it could save you hundreds of pounds a month.

1. 1

   Ask for the refusal in writing

   Ask your GP to provide their specific clinical reason for refusing in writing. Many GPs reconsider when asked to formally document a refusal that is not clinically grounded.

2. 2

   Reference NHS England guidance

   NHS England's Patient Choice Guidance states that GPs should not refuse shared care solely because a diagnosis was made privately, provided the diagnosing clinician is appropriately qualified.

3. 3

   Use our free GP refusal letter

   Our free GP refusal letter template generates a personalised letter citing NHS England guidance directly. It takes two minutes to complete and is ready to send to your GP immediately.

   GP refused shared care?

   Get a free personalised letter citing NHS England guidance directly. Takes 2 minutes.

   Get my refusal letter
4. 4

   Ask your diagnosing clinic for a shared care support letter

   Most private ADHD clinics will write directly to your GP outlining the titration data and monitoring plan. This addresses many GPs' clinical concerns and often resolves a refusal.

5. 5

   Escalate to your ICB

   If your GP continues to refuse without a clinical reason, you can escalate to your Integrated Care Board. ICBs have a duty to investigate concerns about refusals of care that are not clinically justified.