What happens after your diagnosis.
This page explains ADHD medication and the titration process.
We have written this to be genuinely useful rather than reassuring but vague. If you have questions not covered here, speak to the team before you commit to anything.
Do you need medication?
Medication is not the right choice for everyone with ADHD, and a diagnosis does not mean you are obliged to pursue it. Many adults choose to start with medication because the evidence base is strong and the difference it makes to focus, emotional regulation and daily functioning can be significant. Others prefer to explore non-medication strategies first, or to take time to decide.
That decision is yours. Our role is to give you accurate information and clinical guidance — not to push you toward any particular outcome. Treatment decisions are always clinician-led and made in partnership with you.
Understanding ADHD medication
There are two main categories of ADHD medication: stimulants and non-stimulants. Most adults start with a stimulant. Within each category, medications come in short-acting and long-acting forms. This is a plain-English overview — your prescriber will discuss specific options with you based on your clinical picture.
Stimulant medication
The most commonly prescribed category for adult ADHD. Works by increasing dopamine and noradrenaline availability in the brain. Effective for most people and usually the first choice clinically. First-line treatment
Non-stimulant medication
Used where stimulants are not suitable or not effective. Works differently and can take longer to reach full effect. A clinically appropriate option for a significant minority of patients. Alternative pathway
Short-acting formulations
Work for a defined number of hours and wear off through the day. Can offer more flexibility in dosing but require consistent timing. More commonly used in children than adults. Duration: 4–6 hours
Long-acting formulations
Designed to provide consistent coverage across the working day. Usually preferred for adults because they require less active management and reduce the risk of rebound effects. Duration: 8–12 hours
This information is educational only. Specific medication choices are made by your prescriber based on your individual clinical presentation, health history and preferences. We do not recommend any specific medication on this page.
What happens if you decide to pursue medication?
If you choose to explore medication after your diagnosis, the next step is an appointment with one of our nurse prescribers. Before any medication is started, baseline health checks are completed — and an ECG where clinically indicated. Medication is then started at a low dose and adjusted gradually based on how you respond. This process is called titration.
Select “I am already in titration” above, or carry on reading below to see the full titration explainer, or continue reading about shared care below.
The titration process
Titration is the process of finding the right medication and dose for you. It is not a single appointment — it is a structured sequence of reviews designed to reach a stable, effective dose safely. It cannot be rushed, and we will not rush it.
Most people reach a stable dose within approximately three months. Some respond quickly to their first medication. Others require dose adjustments or a change in medication type. Your prescriber will discuss progress at every review.
Baseline health checks and prescribing initiation
Blood pressure, heart rate and general health checks completed. ECG arranged where clinically indicated. Your prescriber discusses medication options, answers your questions and initiates treatment at a low starting dose. Included in assessment bundle or titration pathway
First titration review
Review of how you are responding to the starting dose. Side effects discussed. Blood pressure and heart rate checked. Dose adjusted if appropriate. Most patients are still on a low or moderate dose at this point.
Second titration review
Further review of effectiveness and tolerability. Dose adjusted upward, maintained or — if the medication is not suiting you — a change of medication type may be discussed. Your prescriber documents progress and clinical rationale at each stage.
Third review and stability assessment
By this point most patients have reached a stable dose. Your prescriber assesses whether the current dose and medication type are optimal. If stable, the process of initiating shared care with your GP begins. If further adjustment is needed, the titration pathway continues. Shared care letter prepared at this stage if stable
Annual review
A NICE NG87 requirement for all adults on ADHD medication. Covers medication efficacy, side effects, any changes in circumstances and whether the current treatment plan remains appropriate. A letter is sent to your GP following every annual review regardless of shared care status.
What if the medication does not work?
Not every medication works for every person, and first-line treatments do not suit everyone. If your initial prescription is not effective or causes unacceptable side effects, your prescriber will review the situation and discuss appropriate alternatives. There are several licensed medication options for adult ADHD and different clinical approaches to titration.
We will not close the pathway because a first attempt did not succeed. Finding the right medication sometimes takes longer than three months, and your prescriber will work with you until a clinically appropriate outcome is reached.