Update 18.4.24 – Takeda, the manufacturers of Lisdexamfetamine, say that their supply problem has now been resolved and that pharmacies should see stock levels of this medication returning to normal over coming weeks.
Thankfully also, NHS waiting times for ADHD assessments seem to have come down in most but not all parts of South Wales (though sadly the Welsh Government keeps no national data on this).
Dr Davies has over 10 years experience in diagnosing and treating Attention Deficit Hyperactivity Disorder (ADHD) in adults, in both NHS and private clinics. We have appointments available in the Cardiff area over the Summer for ADHD diagnosis and the option of medication titration and short-term-follow up while you wait for an NHS appointment.
Late Spring / early Summer is a time when University students with undiagnosed ADHD begin to crash up against deadlines or wonder where all the months have gone. Effective treatment of ADHD can be life changing. But with academic deadlines or work performance reviews, then maybe time is of the essence for you. If you have changed address because of work or study, then you may find yourself at the back of a different NHS waiting list. A private appointment can be the temporary solution for some, while waiting for an NHS slot to come up. A doctor’s letter to academic Tutors can lead to understanding and adjustments. Effective treatment can mean all the difference to completing your degree or staying in your job. Dr Davies is able to offer a small number of ADHD assessments for new patients who are already on NHS waiting list over Summer 2024. If diagnosed with ADHD, he can offer you private prescriptions and dose titration plus short term follow-up over 6 months. Longer term, the aim is that the NHS specialist services see you and take over your care. If that is not feasible and you need a long-term private specialist, then you might want to look at what other providers are offering. Scroll down for costs.
What is ADHD?
Many of us have problems with attention, hyperactivity or impulsiveness at times. In people with ADHD these problems are there most or all of the time, and have a substantial impact on ability to function in multiple ways. ADHD is classed as a neurodevelopmental condition. Put simply, parts of the brains of people with ADHD have developed a bit differently and work a bit differently. Genes that affect how dopamine works in the brain are known to play a role. But there are probably many different genes that can be involved (over 100 at the last count). This could explain why the condition shows itself differently in different people. It could also explain the overlap with other neurodevelopmental conditions such as autism, dyslexia and dyspraxia (developmental coordination disorder). People with ADHD are more prone to develop problems with anxiety and depression, low confidence or will start to use street drugs or gamble. There has been recent research about how people with ADHD are more likely to sustain fractures, develop obesity and startlingly, die on average 7 years earlier than people without ADHD. The hope is that treatment will begin to address these impairments, and the good news is that overall, ADHD responds better to treatment than any other mental health disorder you can think of.
Who gets ADHD?
ADHD tends to run in families and heritability is about 70%. It shows itself by age 12 usually, and affects 3-5 % of people of school age (up to 1 in 20). Of people who have this condition as a child, around half will still have it as a young adult. If a person has ADHD, it will almost always be present from childhood. But sometimes it is not picked up until adulthood – especially if the problem is more inattentiveness than hyperactivity. Historically, more males have been diagnosed with ADHD than females – but it may show itself differently in women and get missed. Nowadays, many adult adhd clinics are seeing more new women patients than men.
How is ADHD diagnosed?
The diagnosis is made by a careful assessment of symptoms and how they affect the person. It takes at least a couple of hours, and information from people who know the person well is needed. Often standardised assessments such as DIVA are used. Really they are just a collection of standardised questions about symptoms. There is no “test” such as a blood test or brain scan. Many NHS and private clinics send out pages and pages of forms, and they won’t see you unless you fill them all in. We think this is really silly because people with ADHD are mostly not good with long forms (Secret – a lot of the forms don’t get read when they are sent back!). Most of our patients have already done forms and lots of research by the time to they look for a private appointment. But – ok, if you want a short screening test, the ASRS-5 has just 6 questions and was developed for the World Health Organisation
Who can diagnose ADHD?
The NICE guidelines say “A diagnosis of ADHD should only be made by a specialist psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise”. The NICE Guidelines also recommend medication over other non-medical treatments in adults who are impaired by ADHD. GPs do not start medication for ADHD so it will usually be a Psychiatrist who starts medication (but some Nurses and Pharmacists can prescribe too, Psychologist don’t). Unless you are sure that you don’t want medication, you might want to find someone who is both experienced in diagnosing ADHD, and who can prescribe. Dr Davies can assess and prescribe.
Is ADHD Over-diagnosed?
It is certainly diagnosed a lot more than it used to be. All of us at some time are restless, inattentive or impulsive. So it can be easy to convince yourself you might have ADHD. Haven’t we all wished we could concentrate for longer, get better grades,or be more organised? Yes! Does this mean we all have ADHD? No! If you have never lost your keys or phone, or been late for work or lost track of what someone is saying – well done! Most of us have done these things now and again, but it does not mean we have ADHD. It is people who are affected persistently and in more severe ways who have the condition. It is important to understand this, because some patients come to an appointment convinced they have ADHD, and can be disappointed – even cross – to be told the doctor is not convinced they have it. That said, for people who do have ADHD, the condition can restrict many aspects of life – work, study, relationships, family, leisure, health and more. Treatment can be life-changing.
ADHD Treatment
Medication can be very effective for ADHD in adults. Almost always, medication requires specialist input (and Dr Davies can issue private prescriptions for the condition). Usually a GP will take over prescribing when the patient is on an effective dose of the right medication (but check with your GP). ADHD coaching is also popular and there are some great self-help materials and support groups. There are forms of CBT (cognitive behavioural therapy) that have been adapted for helping with ADHD.
Private ADHD treatment in Cardiff
Dr Davies uses a standardised semi-structured interview, the DIVA. Sometimes, a diagnosis is all a person will want, or their employers or University may need confirmation of the diagnosis so that adjustments can be made. For those who choose medication, Dr Davies is able to prescribe long-acting stimulants (such as methylphenidate, lisdexamfetamine), Atomoxetine as well as sometimes other drugs. Dr Davies does not usually prescribe short-acting amphetamine-based drugs. Adderal is not prescribed in the UK.
Please note that Dr Davies sees patients aged 18 and over, and is not qualified to assess or treat children.
Costs
Dr Davies believes in being up-front about costs
New patient appointment ADHD – £800
(2 – 2.5 hours, DIVA) with report.
Review and take-over treatment – £360
(For patients already diagnosed with ADHD by someone else,
with a copy of the assessment).
ADHD dose adjustment appointment £120
(15 mins, includes prescription if needed)
Private prescription fee £30
(outside appointment)
Insurance – Sorry, we are no longer taking payment through any health insurers.
You would need at least 2 or 3 follow up appointments (maybe more) over the first few weeks after starting on treatment, to get to the right dose for you. Once you are on effective treatment that suits you, would usually the have specialist follow up every 6 – 12 months. If Dr Davies sees you privately, he can’t give you an NHS prescription – just a private prescription. With a private prescription, you will need to pay the pharmacy for the medication and this might be £40 – £100 or more for a month’s supply.Your GP might agree to take over prescribing once you are on a stable dose (shared care). Prescriptions through the NHS in Wales are free. So if your GP takes over prescribing, you won’t pay for the medication. We suggest involving your GP from the outset, and asking him/her for a referral. ***Warning*** – Dr Davies’s experience in South Wale is that many (though not all) GPs will not get involved with shared care prescribing – regardless of whether it’s with a private or NHS specialist.
So, if you have private assessment and treatment for ADHD, the cost of specialist appointments and medication is going to be £2,000 or more in the first year. That is a big commitment. But it is similar to the cost of, say, a private knee arthroscopy procedure lasting less than an hour. ADHD treatment can be very effective and sometimes life-changing.
If comparing prices, it’s worth noting that some providers have reduced the cost of initial assessment but doubled follow-up costs, which can really add up over time.
