Hi Tink
I can't always keep up with everything on here, but from what I understand, you've not got an assessment lined up yet because both potential places each say you don't fall under their area remit?
On that assumption, I'm assuming you're going to GP to see what they're going to do about getting you properly assessed?
If you're not, then you need to do that. The GP needs to sort this out. If they don't then you need to speak to the Practice Manager, or the CCG to effectively make a complaint and tell them they need to sort out where you are going to have a proper assessment.
As far as meds are concerned, Zoloft is a name for sertraline, and I used to take this. At higher doses it took away all my motivation and I subsequently read up that, at higher doses, it acts to reduce dopamine. I don't believe this is the case at the regular dose. ( I was on max dose)
As far as meds are concerned, nothing will match the proper adhd meds, which are stimulants and atomoxetine. Your doctor is right that they're not supposed to assume all responsibility for prescribing these, although he could if he wanted. In your case, without a consultant or what they will accept as a proper diagnosis, it doesn't sound like he's acting harshly or unreasonably though.
blaze is right, Wellbutrin is mentioned as a fourth or fifth line treatment. The generic name is buproprion. It's licensed here for smoking cessation and generally comes under the brand name Zyban. I first took it to stop smoking (and before adhd diagnosis / medication) and it did make a difference to me, certainly in terms of energy, alertness, motivation. Although it felt like a harsh drug to me and I stopped taking it sooner than I should have (for smoking cessation).
I take it now for depression (as well as stimulants for adhd and a different anti-depressant). When I started it this time round, I was already taking stimulants, and so I didn't notice any difference with my adhd symptoms. However, there are enough studies to suggest it does improve adhd symptoms to an extent (enough for it to be mentioned in the guidelines).
But - and there's always a but of course - it's not licensed for depression or adhd in this country. Only for smoking cessation and only for a limited amount of time. However, it's licensed and widely prescribed for depression in the USA, and this, as well as it being used here for smoking cessation, means your GP will know of it / have experience with it, and therefore might be more willing to prescribe it off-license.
Another anti-d that is licensed and might be more effective as an anti-d for your adhd brain is venlafaxine. Some people report horrible side effects from it, others not so much, especially when they're used to it. It's an SNRI - which mean it affects norepinephrine too - which is what atomoxetine does. It used to be the case that GPs could prescribe this if they'd tried SSRIs and they didn't work, but that might be out of date.
The anti-d that made the most difference to me, which I've been on for 5 years now, is agomelatine (brand name valdoxan). It helped depression (though in a subtle way), but it made a massive difference to how alert I felt when I got up. I spent my whole life feeling like a zombie for the entire day, never fully waking up until the evening. Agomelatine makes me alert as soon as I get up.
It's hard to describe, because I do still feel low energy and tired in the day (even with stimulants), but previously I could sleep at the drop of a hat - anywhere, any time (except late evening and night). Now, although I could still sleep in the day, I don't do it often and I would go to bed to do so - ie make an effort of sorts / decision to sleep.
The NHS evidence pages accept it's an effective anti-d, and it used to be licensed (but only for secondary care I think), but it then didn't renew it a couple of years back, so it's unlicensed again. I was already on it, so my psych continues to prescribe it. My GP refuses - cos it's not on their approved list.
Finally, I think the adhd guidelines also make mention of clonidine (which is licensed for menopausal hot flushes) and I've got a feeling they also mention the older tricyclic anti-d's. I can't remember properly, you'd have to look in the NICE guidelines.
Hope this all makes sense and might help xx