My approach to treating ADHD
Trying a new medication can feel nerve-wracking and confusing. However, I want to reassure you I understand that taking medication is a big decision. I will always tailor treatment according to your preferences, and you won’t feel pressured into making any decisions until you feel ready.
I aim to provide a compassionate and supportive space where you feel comfortable sharing any questions or concerns. My goal is to identify the most effective type of medication and dosage for your needs while minimising side effects.
Together, we’ll work through the process of finding or starting your new ADHD medication, which typically involves the following steps:
Your first consultation
During your first consultation, I’ll spend some time getting to know you and asking questions about your symptoms, experiences, routine and goals for treatment. Understanding who you are as a person, including seemingly small things about your day-to-day life, will help me to determine what type of medication and dosage will suit you best.
I’m always curious to find out whether you have any preferences for your treatment and if you’ve started looking into medication options yourself. If you’ve already started doing your own research, that’s great! If not, I can provide you with all the necessary resources and information. I encourage my patients to ask me as many questions as they like and share any concerns they have throughout the process.
I enjoy answering complex questions and researching medication queries. I want to ensure that each patient gets the most up-to-date and relevant information for their circumstances.
Your personalised treatment plan
Once I have a comprehensive understanding of your preferences, needs, and goals for treatment, I’ll explain the medication options that would suit you best. My recommendations are always based on the latest scientific evidence and my professional opinion on your unique symptoms and circumstances.
I believe that optimising medication according to your routine is crucial for you to get the full benefits of treatment. For example, some patients only need to ensure their productivity and focus is high during the daytime, but some patients need to be more productive in the evenings too.
I’ll help you weigh the pros and cons of all medication options so that you feel confident making an informed decision about which medication to take (or whether you want to take medication). My goal is to help you explore every option and ensure that you’re content with whatever approach you choose.
Research shows that medication is most effective when combined with psychoeducation (psychological education). I also believe it helps patients feel empowered and better manage their symptoms. I’ll provide you with any information you need in a format that’s easy to digest and am always happy to explain any unfamiliar terms or concepts.
Finding your dosage (titration)
Titration is the process of finding the best medication, at the most effective dosage (amount), for your symptoms while also minimising side effects. It usually takes between 8-12 weeks to complete the titration phase. ADHD medication has to be gradually increased over time until you notice a significant improvement in your symptoms while closely monitoring any side effects like reduced appetite, anxiety or issues with sleep.
There’s no one-size-fits-all approach to starting ADHD medication because every patient responds differently. Your dosage doesn’t depend on your height, weight or age like other medications. This is because stimulant medications are influenced by other factors like your metabolism, genetics, medication history, and severity of symptoms. Fortunately, titrating medication helps us to find the right dosage for you. Rather than simply increasing medication dosages, I also consider whether splitting doses or adjusting timings can help your medication to last the whole day so that I can help you find the lowest possible effective dose.
Although the titration process can feel frustrating and confusing, my expertise in ADHD medications means I can guide you through the process and find the best medication for you as quickly as possible. My pharmaceutical knowledge and expertise in adult ADHD mean that I can help you avoid common pitfalls preventing your medication from working effectively. For example, Elvanse is a stimulant medication, but many people aren’t aware that eating a high-fat meal or consuming citric acid (like in a vitaminc C supplement) interferes with how well Elvanse is absorbed. I also consider whether other factors like caffeine or alcohol intake can influence your symptoms, depending on the timing and amount.
Managing side effects
If you’re suffering from unwanted side effects, I can prescribe non-ADHD medications, such as melatonin for sleep. However, I only prescribe medications when absolutely necessary and prefer not to introduce new medication to manage side effects. Instead, I will first focus on adjusting the dosage or recommending evidence-based lifestyle changes.
Lifestyle changes that focus on optimising your sleep, eating or physical activity habits can also be a powerful way to minimise or prevent unwanted side effects from medication. I encourage my patients to incorporate changes that will be helpful to their individual lifestyles rather than simply providing generalised recommendations. Lifestyle changes can also be beneficial for improving ADHD symptoms and enhancing how well your medication works.
For patients struggling with a loss of appetite from their medication, I might recommend splitting meals, changing their medication timing or switching to shorter-duration medications. Similarly, with sleep problems, this might involve adjusting medication, strategies to improve sleep hygiene, or trying daily habits that regulate your sleep-wake cycle.
Ongoing support
One of the best aspects of helping people with ADHD is seeing how the right treatment and support can make a great difference to their work, relationships and well-being. I find it incredibly rewarding to contribute in a small way to the transformation they experience with their ADHD symptoms.
While many patients will experience the positive benefits of treatment within a couple of months, a small subset of patients don’t typically respond to treatment with medication. In these cases, we will continue working with your consultant psychiatrist to discuss your alternative or non-medication options.
Education & Training
I’m a Pharmacist registered with The Royal Pharmaceutical Society of Great Britain (RPSGB) and The General Pharmaceutical Council (GPhC). I hold additional qualifications in Clinical Pharmacy Practice and Independent Prescribing. I have over 15 years of experience working in the NHS and private practice.
I have specialised in mental health for the last seven years, and in ADHD medication titration for over a year. During this time, I’ve had the opportunity to work with and learn from many consultant psychiatrists with expertise in treating adult ADHD. Previously, I have worked in various roles, including Clinical Pharmacist at Nightingale Hospital, Medicines Information Pharmacist for the 111 NHS Helpline Service, Pharmacy Manager and Lead Pharmacist.
Regarding my education, I completed my Diploma in Clinical Pharmacy Practice in 2017 and Independent Prescriber specialising in Mental Health in 2017, both at Robert Gordon University. I undertook my Master of Pharmacy (MPharm) at the London School of Pharmacy in 2005.
I’m committed to continuing training and professional development as a pharmacist, ensuring I’m always aware of changes to clinical practice laws or ethics legislation.
Personal interests
I like listening to podcasts about psychopharmacology, psychiatry and psychotherapy.
I also love learning about medications and watching therapeutics lectures while I have my dinner! I am a real geek for medicine and love solving medication queries from colleagues.
When I want to take my mind off work, I spend time with my family, go to the gym and read true crime novels. I love to bake cakes, macarons and anything with a lot of sugar. I also have a passion for clay pigeon shooting, and I try to do this whenever I get the opportunity.
