If you’ve been diagnosed with ADHD and decide to try medication, the next step is titration. Here’s what that means, how long it takes and what you’ll be asked to do.
What is titration?
Titration means finding the right medicine and dose for you. ADHD medicines affect people differently, so your specialist starts with a low dose and increases it gradually, checking how well it works and whether you have side effects. The aim is the lowest dose that gives you the most benefit with the fewest side effects.
Before you start
Your specialist checks it’s safe for you to take ADHD medication. In line with NICE guidance, this usually includes:
- Your physical health, any medicines you take and your family’s heart health
- Your blood pressure, pulse and weight, and your height for children
- An ECG (heart tracing) only if there’s a medical reason to need one
We’ll ask you to measure your blood pressure and pulse at home, or at a pharmacy or your GP surgery. Many pharmacies offer free blood pressure checks for adults.
What happens during titration
- You start on a low dose. Your specialist explains how and when to take it, and what to look out for
- You check in regularly. Usually every one to two weeks, by video, phone or a short online form. You’ll share your blood pressure, pulse and weight, and how you’re getting on
- The dose is adjusted. Depending on how it’s going, your dose may go up, stay the same or change to a different medicine
- You reach a stable dose. When the benefits are clear and side effects are manageable, titration ends
For children, we ask parents and school for feedback too. Teachers often notice changes that are hard to see at home.
How long does titration take?
Most people find the right dose within 8 to 12 weeks. It can take longer if the first medicine doesn’t suit you and you need to try another. Our titration fee covers up to 12 weeks of appointments and check-ins.
Side effects to tell us about
Side effects are common at first and often settle within a few weeks. Tell your specialist if you notice:
- Less appetite or weight loss
- Difficulty sleeping
- Headaches or stomach aches
- Feeling more anxious, irritable or low
- A racing heart or a rise in blood pressure
Get urgent help if you have chest pain, faint, have a very fast or irregular heartbeat, or have thoughts of harming yourself. Call 999 in an emergency or 111 for urgent advice. See our urgent help page.
Getting the most from titration
- Take your medication at the same time each day, as prescribed
- Keep short notes on how you feel, how you sleep and what you eat
- Tell us about any other medicines or supplements you take
- Be careful with caffeine and alcohol, and ask us if you’re unsure
- Don’t change your dose without talking to your specialist
Prescriptions during titration
Your specialist writes private prescriptions while your dose is being adjusted. Some ADHD medicines are controlled drugs, so each prescription usually covers no more than 30 days and must be collected within 28 days of the date on it. Allow time for the pharmacy to order your medicine.
Driving
You must tell the DVLA if your ADHD affects your ability to drive safely. It’s also illegal to drive if any medicine impairs your driving. If you’re unsure, don’t drive until you’ve spoken to your specialist, and carry details of your prescription with you.
After titration
Once your dose is stable, we write to your GP with a treatment plan and ask whether they’ll take over prescribing through shared care. You’ll still need an annual review with a specialist. If your GP declines, read what to do if your GP refuses shared care.
Our titration costs £695 for adults and £745 for children. See all fees on our fees page, or read more about ADHD treatment.