An ADHD annual review is a planned check, at least once a year, where a clinician trained in ADHD looks at whether your medication still helps, what side effects it causes and whether you still need it. NICE says everyone taking ADHD medication should have one. It also keeps your prescriptions safe, and shared care agreements often depend on it.
In short
- NICE guideline NG87 (recommendation 1.10.1) says a healthcare professional with training and expertise in managing ADHD should review ADHD medication at least once a year.
- The review covers benefits, side effects, sleep, mood, blood pressure, pulse and weight (and height for children), and whether you still need medication, a lower dose or a break.
- Children and teenagers are checked more often: height every 6 months, and weight every 3 or 6 months depending on age.
- If a review lapses, a prescriber may pause prescribing until it is done, because they need current information to prescribe safely.
- Privately, you pay for each review. In 2026/27 NHS England’s guide price for an adult annual review is £150 with shared care and £265 without. With us, a review is a medication review appointment at one per-appointment fee.
What is an ADHD annual review?
It is a planned appointment, at least once a year, to look at your treatment as a whole. You can also have a review sooner, for example after a dose change, when side effects appear, or when a child’s growth, blood pressure and pulse checks are due. See how we run ADHD treatment and medication reviews.
The NICE guideline on ADHD (NG87) says the review should be done by a healthcare professional with training and expertise in managing ADHD. Your preferences, or your parents’ or carers’ preferences if you are a child, are part of the discussion.
What is checked at an annual review?
- Benefits. How well treatment works through the day, and what happens when it wears off or you miss a dose.
- Side effects. Such as appetite and weight changes, headaches, palpitations, anxiety, tics or low mood.
- Sleep and mood. NICE says to monitor sleep patterns, for example with a sleep diary.
- Daily life. How things are going at work, school or university, at home and in relationships.
- Physical checks. Blood pressure, pulse and weight, plus height for children (see the table below).
- Whether to continue. Whether you still need medication and whether the dose is right.
Treatment breaks and dose reductions
NICE says clinicians should consider trial periods of stopping medication or reducing the dose when the balance of benefits and harms supports it. If medication continues, they should record why. A break is a clinical decision made with you, and not something to try alone. Don’t stop or change your medicine without advice.
Which health checks do adults and children need?
| Check | Adults | Children and teens |
|---|---|---|
| Blood pressure and pulse | Every 6 months, and before and after each dose change | Every 6 months, and before and after each dose change |
| Weight | Every 6 months | Every 3 months if aged 10 or under. If over 10, at 3 and 6 months after starting, then every 6 months |
| Height | Not part of routine monitoring | Every 6 months |
| Growth chart | Not needed | Height and weight plotted and reviewed by the responsible clinician |
Between reviews, these checks can be done by your GP surgery under shared care, or by you at home with a validated upper-arm blood pressure monitor and scales. If sustained readings show a very fast resting heart rate, an irregular rhythm or raised blood pressure, NICE says to reduce the dose and refer you for specialist advice.
How should you prepare?
- Gather your recent blood pressure, pulse and weight readings, with dates.
- Keep a short side effect log. NICE encourages people to monitor and record side effects themselves.
- Note when your medicine starts and stops working, and how sleep, appetite and mood have been.
- List everything else you take, including supplements, caffeine and alcohol.
- Write down what you want from treatment now. Goals can change over a year.
- For a child, ask the school how things have gone, and let your child give their own view.
Tip from our clinicians
Take readings at about the same time of day, sitting quietly for a few minutes first, and note whether you had caffeine or had just taken your medicine. Readings taken in the same way are easier to compare.
What is different for children and teenagers?
Children are still growing, so monitoring is closer: height and weight are plotted on a growth chart, and checks happen every 3 to 6 months depending on age. School feedback is a key source of information. Teenagers’ own views are central to decisions.
NICE also says young people in children’s services should be reassessed at school-leaving age to decide whether treatment continues, with the move to adult services usually complete by age 18. Read about transferring ADHD care for what to ask at that stage.
Why does shared care depend on the annual review?
NICE says that after titration and dose stabilisation, prescribing and monitoring should be carried out under shared care arrangements with primary care. In practice, the specialist keeps responsibility for the yearly review and your GP takes on the prescribing and regular checks. The BMA lists an annual specialist review among the typical requirements. For example, one English ICB’s July 2026 guidance expects a private provider to review at least yearly, and NHS Lothian expects a specialist re-evaluation every 12 months.
GPs can decline shared care for any reason, so a current review does not guarantee an agreement. Read ADHD shared care agreements, explained, or what to do if your GP won’t agree.
What happens if you miss your annual review?
Nothing punitive, but your prescriber may pause or limit prescribing until the review is done. With us, if a check is due when you ask for a repeat prescription, the clinician may ask you to book a medication review first. They need up-to-date information about benefits, side effects, blood pressure, pulse and weight to prescribe safely, and ADHD stimulant medicines are controlled drugs with extra safeguards. Under shared care, an overdue review can put the agreement at risk, because a yearly specialist review is a typical condition.
- Book as soon as you realise it’s due or overdue.
- Tell the prescriber how much medicine you have left.
- If you may run out first, contact your GP for advice. Don’t stop suddenly or change your dose without advice.
- If you feel unwell or unsafe, get help now: see our urgent help page.
Is an NHS annual review different from a private one?
The clinical content should be the same, because both follow NICE. The differences are practical. NHS reviews are free at the point of use and are usually with the NHS service that prescribes for you, so if an NHS service already looks after you it is usually safest to stay with it. A private review is with your private prescriber, and you pay for it.
Prescriptions differ too. NHS prescriptions cost £9.90 an item in England in 2026/27, with exemptions such as for under-16s, and are free in Scotland, Wales and Northern Ireland. Those charges don’t apply to private prescriptions, where the prescriber may charge a fee and the pharmacy sets the price of the medicine. See how private ADHD prescriptions work.
How much does a private ADHD annual review cost?
| Review | ADHD Health fee | NHS England 2026/27 guide price |
|---|---|---|
| Adult medication review (about 30 minutes) | £199 per appointment | £150 with shared care, £265 without |
| Child or teen medication review (about 30 minutes) | £199 per appointment | No annual price. A 3-monthly review is £100 with shared care, £130 without |
NHS England’s guide prices are non-mandatory benchmarks for commissioners, and the £130 figure includes £10 a month for prescribing until the next review. They give a rough sense of what a review costs to deliver. Our fees page lists every price, and our guide to GP-refused shared care shows how the costs add up over a year.
If you’re with ADHD Health
We don’t sell a separate annual review. Your yearly review is a medication review, booked as a titration appointment: about 30 minutes by video, at one fee per appointment. Adults see Sophie Turner, ADHD Specialist Nurse Prescriber. Children and young people see Dr Arjun Mehta, Consultant Child and Adolescent Psychiatrist, and need reviews more often because growth, blood pressure and pulse are checked more closely. You can book a review whenever you need one, not only once a year.
If you take medication through our repeat prescription service, a clinician looks at every request and may ask you to book a review first if something has changed or a check is due. If your GP prescribes under shared care, your GP practice does the checks in between, and you can come back to us for reviews. Medicine is paid for separately at the pharmacy.
Next step
Thinking about starting or reviewing treatment?
Titration finds out whether medication helps and which dose suits you, at reviews that are usually monthly. Most people need about three appointments. Each appointment costs £199, including any prescription issued. The medicine itself is paid for at the pharmacy.
Common questions
Can an annual review be done by video?
Yes, ours are by video. You share your own blood pressure, pulse and weight readings, taken at home or at your GP surgery, and the clinician goes through them with you.
Do I need an annual review if I’m not taking medication?
NICE’s yearly requirement is about reviewing medication. It also says people receiving ADHD treatment should have follow-up in line with their needs, whether or not they take medication. You can ask for a review at any time.
Can my GP do my annual review instead?
Your GP may do the health checks between reviews. But NICE says the medication review should be done by a healthcare professional with training and expertise in managing ADHD, so a routine GP appointment doesn’t replace the specialist review.
Can I ask for a review sooner than a year?
Yes. Contact your prescriber if you have side effects, if your medicine stops working as well, or if your health or circumstances change. With us, you can book a medication review appointment at any time.
Sources
- NICE. Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations 1.1 (transition), 1.8 (monitoring) and 1.10 (review). Last updated 2025.
- NHS England. 2026/27 NHS Payment Scheme: ADHD and autism payment guidance, section 4.4. March 2026.
- British Medical Association. Prescribing in general practice. Updated 28 April 2025.
- Nottinghamshire Medicines Management (NHS). Guidance on the management of private shared care prescribing requests. July 2026.
- NHS Lothian. Freedom of information response 11738. 2026.
- Community Pharmacy England. NHS prescription charges frozen for the second year running. 2026.
- General Medical Council. Good practice in prescribing: controlled drugs and other medicines where additional safeguards are needed. 2021.
