Medication Management
How medical treatment is run at Kiam: baseline checks before anything is started, titration with regular review, monitoring while you are stable, and shared care with your GP.
- per prescription
- Online or in person
How medical treatment is managed at Kiam
This page describes the process, not the medicines. Which treatment might suit you is a clinical decision, discussed with you in an appointment where we can answer your questions properly — it is not something to advertise on a web page, and UK advertising rules rightly prohibit naming prescription-only medicines to the public.
What we can set out here is exactly how the process runs, so you know what to expect before you commit. It follows NICE NG87 throughout.
Baseline assessment
Before treatment starts
The baseline assessment set out in NICE NG87. Some of these can be arranged through your GP; where a practice would rather not, they can be done privately.
- A review confirming the diagnosis still fits and that treatment is needed
- Your mental health and social circumstances, including any co-occurring condition
- Your current education or employment circumstances, and your care needs
- A risk assessment covering substance misuse
- Your medical history and anything you already take
- Height and weight, recorded against the normal range
- Baseline pulse and blood pressure, measured with a correctly sized cuff
- A cardiovascular assessment, including listening to your heart
- Blood tests, to rule out conditions that can mimic or complicate ADHD
- An ECG where it is clinically indicated
Cardiology
When a cardiology opinion is needed first
NICE NG87 asks for a cardiology opinion before treatment begins if any of the following applies: congenital heart disease or previous cardiac surgery; a sudden death in a first-degree relative under 40 suggesting a cardiac cause; breathlessness on exertion compared with your peers; fainting on exertion or in response to fright or noise; palpitations that are rapid, regular and start and stop suddenly; chest pain suggesting a cardiac origin; signs of heart failure; a murmur heard on examination; or blood pressure in the hypertensive range.
Occasional fleeting bumps in the chest are usually ectopic beats and do not normally need investigating. If you are not sure whether something on this list applies to you, tell us and we will work it out together.
How the dose is established and kept under review
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Review every 3–4 weeks
While the dose is being established, so it can be adjusted based on how you actually respond.
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Observations after every change
Blood pressure and pulse after each dose change, then roughly every three months once stable.
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Review every 3–4 months once stable
Longer intervals once the right dose is settled and holding.
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Six-monthly specialist review
For safety, continued effectiveness, and continued NICE alignment.
A home blood-pressure monitor is worth buying
Because your blood pressure and pulse need checking after every dose change and then every few months, a home monitor makes the process far easier — and means a reading is never the reason an appointment cannot go ahead. They are inexpensive and widely available; no particular brand is needed.
Your GP
GP liaison and your Summary Care Record
Your GP needs to know about any proposed treatment for ADHD, and we need to know what your GP knows. With your consent we request your Summary Care Record so that clinically relevant information is shared properly — this is a condition of safe prescribing, not a formality. You can also request a copy directly from your practice.
We will ask you to complete a short consent form allowing us to liaise with your GP. You can decline, and we will explain what that means for what we are able to offer.
Shared care
Moving routine prescribing to your GP
After at least four weeks stable on the right treatment, we can put a Shared Care Agreement in place: your GP takes on routine prescribing, and we remain responsible for specialist review. We make no charge for arranging one.
Shared care is an agreement between three parties, and some practices decline it. It is worth raising with your GP as early as you can, so you know where you stand — and we are happy to speak to them directly.
Telling the DVLA is your responsibility
The DVLA must be told about any condition that affects your ability to drive safely, and that includes ADHD. Their guidance is that you must tell DVLA if your attention deficit hyperactivity disorder (ADHD) affects your ability to drive safely. Notifying them is your responsibility, not your clinician's, and it is a legal duty rather than a recommendation. We will talk this through with you, and the guidance is on our resources page.
Questions about how treatment works?
Ask us. We would rather answer before you book than after.