Post by Deleted on Mar 31, 2009 16:00:29 GMT
As I am aware that many on this forum have struggled with access to assessment and treatment, I thought it might be useful for me to share my experience.
I am 46 and was diagnosed with Adult ADHD at the Maudsley in Jan 09. As I live in Barnet, my GP had to request the funding for the assessment as it was outside my PCT. The problem was that the funding was for the assessment only, so even though the psychiatrist made the treatment recommendation to my GP, which was Concerta. my GP was unable to prescribe the meds as I needed to be under the ongoing care of a psychiatrist in order for her to do so. So my GP found a psychiatrist in Barnet who was willing to go into a shared care agreement with her, which allowed her to prescribe the meds on the understanding that I would be seen by the psychiatrist in due course. Theoretically, this sounds fine, but in practice it was a struggle. As Concerta is a controlled substance and GP's are not obligated to prescribe it, some GP's will refuse to do so as they are not willing to take the risk. Fortunately, my GP was fantastic and agreed to prescribe the meds, but this was after a partners meeting at the surgery wherein she was the only doctor out of approx 10 who was willing to prescribe it. There was also one other doctor who was willing to support me in my GP's absence.
So, I got the meds and was delighted. I am still trying to work out what the right dosage is for me and I expect that this will take time. However, the first couple of weeks were rough. Although the meds dealt with the ADHD symptoms, I had some funky side effects - dry mouth, sleeplessness, no appetite, feeling like I was on speed, feeling extremely tired and totally awake at the same time, achy muscles and greasy skin - during those first few weeks and thought there was no way that this was the drug for me, but everyone around me told me to persevere, which I did and now most of the side effects have gone away. I still have a reduced appetite and don't crave food like I used to and feel quite dehydrated, but that's about it. The only other thing that I am finding difficult is not actually a side effect, but more of a result of taking the meds. As with most adults who have undiagnosed ADHD, I had built quite a complex network of strategies to cope and appear "normal". What has come as quite a shock is that those strategies were built around my ADHD symptoms and that everything I did was driven by emotion and not cognition. In the absence of the ADHD symptoms, I am finding it difficult to approach and assess day to day situations using cognition as everything in the past was gauged using my emotional barometer, so in essence I now have to retrain my brain.
I went to see the psychiatrist today and I am seeing him again in 5 weeks time for a follow up. We have agreed to increase my dosage. I started on 18mg, increased to 36mg a few weeks ago, but am feeling that my concentration could be improved, so am now going to start on 54mg and we will review it when I see him next. I was also hoping for some psychotherapy (pref CBT) to help me with this transition from emotion to cognition, but none is available in my PCT and the psychiatrist stated that there is no proof that such therapy works in patients with Adult ADHD.
The Concerta has transformed my life for the better and I can't imagine being without it, but I also accept that there is still quite a journey ahead and it is a journey that I will have to take alone. I understand that Adult ADHD treatment is very new in the UK but I do feel that in addition to prescribing meds there should also be a system in place that provides the necessary emotional and psychological support.
I do hope that this helps. If not, apologies to all for blathering.........
I am 46 and was diagnosed with Adult ADHD at the Maudsley in Jan 09. As I live in Barnet, my GP had to request the funding for the assessment as it was outside my PCT. The problem was that the funding was for the assessment only, so even though the psychiatrist made the treatment recommendation to my GP, which was Concerta. my GP was unable to prescribe the meds as I needed to be under the ongoing care of a psychiatrist in order for her to do so. So my GP found a psychiatrist in Barnet who was willing to go into a shared care agreement with her, which allowed her to prescribe the meds on the understanding that I would be seen by the psychiatrist in due course. Theoretically, this sounds fine, but in practice it was a struggle. As Concerta is a controlled substance and GP's are not obligated to prescribe it, some GP's will refuse to do so as they are not willing to take the risk. Fortunately, my GP was fantastic and agreed to prescribe the meds, but this was after a partners meeting at the surgery wherein she was the only doctor out of approx 10 who was willing to prescribe it. There was also one other doctor who was willing to support me in my GP's absence.
So, I got the meds and was delighted. I am still trying to work out what the right dosage is for me and I expect that this will take time. However, the first couple of weeks were rough. Although the meds dealt with the ADHD symptoms, I had some funky side effects - dry mouth, sleeplessness, no appetite, feeling like I was on speed, feeling extremely tired and totally awake at the same time, achy muscles and greasy skin - during those first few weeks and thought there was no way that this was the drug for me, but everyone around me told me to persevere, which I did and now most of the side effects have gone away. I still have a reduced appetite and don't crave food like I used to and feel quite dehydrated, but that's about it. The only other thing that I am finding difficult is not actually a side effect, but more of a result of taking the meds. As with most adults who have undiagnosed ADHD, I had built quite a complex network of strategies to cope and appear "normal". What has come as quite a shock is that those strategies were built around my ADHD symptoms and that everything I did was driven by emotion and not cognition. In the absence of the ADHD symptoms, I am finding it difficult to approach and assess day to day situations using cognition as everything in the past was gauged using my emotional barometer, so in essence I now have to retrain my brain.
I went to see the psychiatrist today and I am seeing him again in 5 weeks time for a follow up. We have agreed to increase my dosage. I started on 18mg, increased to 36mg a few weeks ago, but am feeling that my concentration could be improved, so am now going to start on 54mg and we will review it when I see him next. I was also hoping for some psychotherapy (pref CBT) to help me with this transition from emotion to cognition, but none is available in my PCT and the psychiatrist stated that there is no proof that such therapy works in patients with Adult ADHD.
The Concerta has transformed my life for the better and I can't imagine being without it, but I also accept that there is still quite a journey ahead and it is a journey that I will have to take alone. I understand that Adult ADHD treatment is very new in the UK but I do feel that in addition to prescribing meds there should also be a system in place that provides the necessary emotional and psychological support.
I do hope that this helps. If not, apologies to all for blathering.........