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What can community pharmacists do to help their patients with ADHD?

Peter Kelly spoke to one of his patients about their journey with adult attention-deficit hyperactivity disorder (ADHD)

I qualified as a pharmacist 17 years ago. At that time, I rarely saw ADHD medication prescriptions for adults, but now I see loads. So, I decided to interview one of my adult patients with ADHD.

The patient I spoke to was born in Belfast in the early 1960s, and from a young age had difficulties in school. He was a disruptive student, and his dad was often called in to discuss his behaviour. His concentration was terrible and he was often unable to finish sentences. He left school – and Belfast – at 16 and came to London, where he found work at a hair salon on Oxford Street.

Read more: MHRA approves melatonin solution for children and adolescents with ADHD

In the late 1970s, he felt lonely and went back to Belfast for a visit. He was out drinking, but had a bit of a breakdown and didn't know where he was. He remembers his dad coming to pick him up and then being referred to a psychiatrist and being diagnosed with mania.

It wasn’t until the mid-1990s that he was diagnosed with ADHD and given Ritalin, which made a massive difference straight away. It helped him sleep, read and watch TV, which he had never had the concentration for before. However, he believes he ended up on quite a high daily dose because his body had got used to the dosage he was on. He was on about 140mg of Concerta at one point.

A doctor decided to take him off methylphenidate and put him on atomoxetine just before lockdown. He got stuck on it in Belfast looking after his dad for much of the COVID-19 pandemic, as he was unable to get back to London for appointments to change back to stimulants. 

This period was very bad for him, and he said his ADHD was possibly the worst it had ever been. He kept misplacing things like keys and TV remotes. He would also go to his bedroom to get something, and by the time he got there would have completely forgotten why he had gone there in the first place.

He has recently been taken off atomoxetine and put on Elvanse and that is working much better for him.

Read more: Non-drug treatments for ADHD

I finished our chat by asking him if he had a message for pharmacists about ADHD and he said medication is the only thing that works.

He added he knows people who resist putting their children on medication when they are diagnosed with ADHD, but he really wishes he had been given the medication when he was younger. This would have meant he did not have to go through all the confrontation he did at school, or wait as long as he did for a diagnosis.

The idea that taking a stimulant can help someone sleep seems counterintuitive, but for him this was absolutely the case.

 

Peter Kelly is a pharmacist at Kamsons Pharmacy

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