What is titration?
Medication titration is the process of starting and fine-tuning the dose of medication to find the most effective dose that provides maximum benefits with the least possible side effects for individuals.
The National Institute for Health and Care Excellence (NICE) state that medication should only be initiated and regularly reviewed by a healthcare professional that is experienced in diagnosing and managing ADHD. If you already have a diagnosis of ADHD from The Edinburgh Practice or from elsewhere, and you are considering starting medication, you can complete a self-referral form to request medication titration.
Throughout titration you will have regular appointments with one of our Consultant Psychiatrists/Specialty Doctors, who will adjust and monitor your medication until you reach a stable and optimal dose. Consultations can be offered remotely and/or in person.
The Titration Process at The Edinburgh Practice
If you have been diagnosed outwith The Edinburgh Practice, prior to accepting your referral, we will request that you send us your ADHD Assessment report alongside any other relevant documents to review. Our Clinical Lead will review your assessment report to ensure that it meets best practice guidelines and that all the necessary information is provided.
Initial Consultation
Once your referral has been accepted you will be offered an initial 1-hour consultation with one of our Consultant Psychiatrists/Specialty Doctors. At this initial appointment, our Consultant Psychiatrist will review your diagnosis of ADHD, your mental and physical health and will advise as to whether it is appropriate for you to start medication. If appropriate, you will discuss medication options available to you with the doctor including potential benefits and side effects.
Before starting medication, we will obtain baseline physical observations such as blood pressure, pulse and weight. You may be asked to send in results of an ECG and/or blood tests if these have been advised by your doctor. Once your baseline observations have been received, these will be reviewed by the doctor and if your observations are within a normal range, you will be ready to start the treatment process and you can then receive your first prescription.
Titration review appointments
During the titration process, you will meet with the doctor for 30-minute titration review appointments every 3-4 weeks to monitor your progress and to adjust your medication where necessary. Your physical observations will be reviewed prior to each new prescription and prior to/at each review appointment.
Post-titration medication reviews
The length of the titration process differs from person to person, however the process usually takes a minimum of 8-12 weeks. You will be fully titrated when your body has adjusted to the new medication, and you have found your optimal dose.
Once you have completed titration and are on a stable dose, you no longer require medication reviews every 3-4 weeks. Our doctors will let you know how often you require medication reviews post-titration, for example this may be every 3 or 6 months initially.
Prescriptions
During titration you do not need to request prescriptions as you will get these at your review appointments. After titration is complete you will need to request prescriptions via the client portal.
If you do not wish to run out of medication, please ensure you request your prescription 14 days before your medication is due to run out. It can be helpful to set a reminder to prompt you to make your prescription request on time.
Shared Care
Shared care is when your NHS GP agrees to enter into a collaborative care agreement with a doctor at The Edinburgh Practice following completion of titration. The GP takes over the responsibility of providing prescriptions, whilst you receive monitoring from The Edinburgh Practice at agreed intervals (e.g. 3 months, 6 months).
We are aware that as of June 2024 many GP practices across Scotland are no longer accepting shared care requests from private healthcare providers. Many GP practices in Scotland are no longer providing shared care to clients with a private ADHD diagnosis due to lack of funding and expertise in the field of ADHD care. If you would like to have the option of shared care, we advise that you liaise with your GP prior to commencing medication with The Edinburgh Practice to find out whether your GP practice will be able to provide shared care for you. The decision of whether GP practices accept clients for shared care is at the discretion of the GP practice.
GP communication
We must write to your GP when we are prescribing medication for you regardless of whether your GP agrees to shared care, this is for safety reasons, so that all involved in your care are aware of the diagnoses you have and the medication you are prescribed.
Our Fees
£360
Initial Psychiatry Titration Consultation (up to 1 hour)
£200
Titration Review Follow Up Appointment (up to 30 minutes)
£200
Post-Titration Follow up Appointment (up to 30 minutes)
£25
Prescription
£35
Prescription outwith appointment
Happy Monday! This Monday, ‘M’ stands for Moments and we are sharing how we can savour the little moments in our lives to increase our happiness, sense of gratitude and quality of life.
Learning to savour the moment in life is a free and effective way to increase your happiness, reduce stress and improve quality of life. Enjoying what you have can help you to appreciate what you’ve got rather than ruminating on what you don’t have.
How to savour the moment in your everyday life:
💛 Focus on the positives: Consciously notice what is going right for you and appreciate it! Positive thinking isn’t the same as pretending you are happy when you are not, it is about noticing the things that can lead to greater happiness.
💛 Focus on the details: Notice the little things that can make a day special such as someone’s smile, the kindness of a stranger or a beautiful sunny day.
💛 Express gratitude: Notice all the nice things others do for you and thank them when you can! Keep a journal and write down the things in your day you are grateful for.
💛 Focus on sensations: Engage your senses! Pay attention to everyday sensations like the feeling of cold wind on your face, the smell of fresh coffee or fresh bread.
💛 Do what you enjoy: Life is meant to be enjoyed and savoured! Add activities into your schedule that you love doing.
We encourage to savour these little moments in you week so you can live fully in the present!
#moments #theedinburghpractice #mentalhealth #positivity
This Friday we are checking in with our Speech and Language Therapist Michelle!
Michelle is one of the lead clinicians for our child autism assessments, she is passionate about improving outcomes for individuals who have neurodevelopmental differences. Michelle’s clinical work holds individuals and their families at the centre to help them understand their neurodevelopmental profile and provide supports to reduce the impact of any challenges.
At TEP, we provide ‘gold-standard’ autism assessments, ensuring that individuals and families can access expert clinical assessments in a timely manner.
Check out our new practice videos on our YouTube Channel to find out more! (link in bio)
#fridaycheckin #theedinburghpractice
This week, TEP are supporting #antibullyingweek!
The theme this year is ‘Choose Respect’ which has come about following consultation with teachers and pupils by the Anti-Bullying Alliance (ABA) who are the official organisers of this important week. Teachers and children wanted a theme that empowered them to do something positive to counter the harm and hurt that bullying causes.
We know that the term ‘respect’ can mean different things to different people. When we talk about respect, we talk about showing that you value someone, including valuing their feelings, views, and opinions, even if they differ from yours. We also talk about accepting and understanding others, giving others the same consideration you would expect for yourself.
We also want to highlight that bullying does not end in the playground, but can continue for adults within the workplace and at home.
How to actively ‘Choose Respect’:
⭐️Actively listening: making effort to listen to other’s perspective without interrupting
⭐️Use “I” statements: Frame your thoughts and feelings using “I” statements to avoid accusing others
⭐️Stay calm and take breaks if you feel overwhelmed
⭐️Focus on behaviour not character
⭐️Seek common ground
⭐️Reflect and learn
We encourage you to always ‘Choose Respect’ even if you don’t always agree with others or even like them.
#antibullyingweek #ChooseRespect #mentalhealth #theedinburghpractice
Happy Monday everyone! We’re back with another ‘M’ word - Meeting others!
🙌 The power of connection cannot be overstated. It’s through connection that we build support networks that uplift us in tough times and remind us that we are not alone. Positive interactions nurture self-esteem, create a sense of belonging, and offer comfort during stressful periods. Meaningful connections with others can be essential for reducing symptoms of anxiety and depression. Whether we’re talking with friends, joining support groups, or simply sharing a smile, each interaction contributes to emotional stability and resilience.
🤝 Beyond support, meeting others opens doors for personal growth, learning, and collaboration. It broadens our perspective, fuels creativity, and encourages empathy and compassion as we understand experiences different from our own.
💛 So maybe your next conversation could be a reminder that you are seen, heard, and valued!
#MentalHealth #ConnectWithOthers #MeetingOthers #TheEdinburghPractice
Happy Friday everyone! This #fridaycheckin we are checking in with our emotions!
Emotions are always sending us messages, just like the characters in Inside Out 🧠💬. Sometime we can feel all kinds of emotions at once - joy, sadness, anger, fear, and anxiety. At times, these feelings can be overwhelming, but it’s important to remember that they are part of being human.
💛 This #fridaycheckin, let’s take a moment to check in with ourselves and embrace our emotions.
😊 Our weekend watch recommendation is Inside out or Inside out 2! For children and adults!
#InsideOut #EmotionsMatter #MentalHealth #TheEdinburghPractice
It’s International Stress Awareness Week! Let’s focus on simple steps that can make a real difference in managing stress and improving wellbeing - small actions to make big changes!
👫 Connect with someone: Check in with your support network. A quick check-in or chat with a friend can lift spirits and remind us we’re not alone!
😴 Prioritise sleep: Take small steps to improve your bedtime routine. Wind down by minimising screen time and/or create a clean and restful sleep environment. Rest is essential as good sleep helps us recharge and face challenges with a clearer mind!
🏃♀️ Move in your own way: Get moving the way you want to! This could be walking, stretching, yoga, or doing some gardening. Moving your body releases tension and stress.
🌱 Spend time in nature: Take some time out of your day to step outside and get some fresh air. Even a few minutes outside can bring a sense of calm and a fresh perspective!
🫁 Breathe deep: Short, shallow breaths can heighten anxiety, so taking time to breathe deeply can help us shift into a relaxation mode.
🧘♂️ Practice mindfulness: This allows you to focus on the here and now. Try to find time each day to observe and just be.
Remember, even the smallest steps can lead to big changes. Take it one moment at a time! 💛
#StressAwarenessWeek #InternationalStressAwarenessWeek #TheEdinburghPractice
This Monday, ‘M’ stands for Mental Health Myths!
💛Mental health matters and so does the truth! Stigma around mental health isn’t just a barrier, it’s a wall that keeps people from seeking help, sharing their stories and finding comfort within their community. The impact of stigma can also worsen mental health difficulties!
💛At TEP, we believe in breaking the stigma surrounding mental health by challenging myths and creating an encouraging culture where everyone feels safe to seek the support they need. We encourage you to talk openly about mental health myths, listen compassionately to others experiences and support one another!
💛Let’s be part of the solution, not part of the problem!
#mentalhealthmyths #theedinburghpractice
Happy Friday! This #fridaycheckin we are checking in with your sleep with our Clinical Director, Dr Fiona!
💭Sometimes, the pace of everyday life barely gives us time to stop and rest. It can make getting a good night’s sleep on a regular basis seem like a dream.
😴Sleep is an important part of our daily routine and is essential for good health and wellbeing. Dr Fiona discusses why we may be struggling with sleep, what is “healthy” sleep and the effect of sleep on one’s mental health! Watch until the end for her top tips for a good night’s sleep!
💤We encourage to check in with your own sleep routine as it is as important as diet and exercise!
#sleep #fridaycheckin #theedinburghpractice #mentalhealth
Today as part of ADHD Awareness Month our Head of Growth and Operations, Hazel and Assistant Psychologist, Frances headed down to Atria One (@atriaone) to share more information about our services and assessments to a range of businesses!
Head to our website (link in bio) to find out more about our gold standard ADHD assessment and support services for children, young people and adults.
#adhdawarenessmonth #mentalhealth #theedinburghpractice
👋 Welcome back to our Monday ‘M’ series! This week, ‘M’ is for Minute!
We all have moments when emotions can start to take over and sometimes, we just need to ‘take a minute’ to step back. The STOPP technique is a powerful tool from CBT than can help us pause and respond to challenging situations in more helpful ways.
How to use STOPP:
✨ Practise the first 2 steps often for a few days
✨ Read through the steps often
✨ Carry written reminders with you or use the STOPP app
✨ Practise it by running through all the steps several times, every day, even when you don’t need it
✨ Start to use it for little upsets
✨ Gradually, you may find that you can use it for more distressing situations
Like any new habit or skill, we need to practise it and eventually it will become automatic.
#TakeAMinute #MentalHealth #CBT #TheEdinburghPractice
Welcome back to another #fridaycheckin! This week we are checking in with our new Child and Adolescent Consultant Psychiatrist, Dr Alex Beadel.
Dr Alex prioritises creating an open, empathetic, non-judgemental, and reassuring environment where young people feel safe and understood. He believes in a collaborative approach, ensuring that a young person’s unique needs and preferences guide the treatment journey.
At TEP, our psychiatrists have expertise across a range of areas including;
💛ADHD
💛Autism
💛Anxiety and Panic Attacks
💛Depression
💛OCD
💛Social and behavioural difficulties
💛Trauma
💻For more information about psychiatry, head to our website (link in our bio).
#fridaycheckin #theedinburghpractice #childpsychiatry #psychiatry
🌟 October is ADHD Awareness Month and this years theme is ‘Awareness is Key’.
💡 ADHD is much more than what meets the eye. It affects people in different ways, often falling under two categories: Inattention and Hyperactivity & Impulsivity. Many people experience a combination of both. In Scotland, approximately 5% of children and between 2-4% of adults are diagnosed and living with ADHD. Though the exact statistics are unknown because data on ADHD is not currently being routinely published and it is thought that many people may not have obtained a diagnosis or be receiving treatment.
🧠 The exact cause of ADHD is not fully understood, although it is thought a combination of factors are responsible. ADHD tends to run in families and in most cases, it’s thought the genes inherited from parents are a significant factor in developing ADHD. However the way ADHD is inherited is complex and is not thought to be related to any single gene.
🤝 While ADHD can present challenges, it can also bring unique strengths! People with ADHD can be adventurous, creative and resilient, just to name a few! Society can sometimes focus on the negatives of ADHD but there are so many skills and abilities beyond neurotypical counterparts. We want to challenge and break some common myths surrounding ADHD!
💛 Let’s celebrate the diversity in how ADHD minds work and raise awareness to support those who live with it every day. The more we know, the better we can offer understanding and help create spaces where everyone can thrive. At TEP, we offer gold-standard ADHD assessments for children, young people, and adults. We also offer post diagnostic support for children, adults, parents/carers and families, delivered at the practice, online and/or in educational settings.
#ADHDAwarenessMonth #ADHDStrengths #Neurodiversity
This Monday, ‘M’ is for Mantras!
🧘♀️The term ‘mantra’ means an instrument of mind or thought. It can be a word, sound or phrase that is rhythmically repeated during meditation.
💭Mantras can occupy the mind in a way that stops your normal train of thought and allow you to clear your mind. They have the power to focus the mind, body and breath in unison towards a certain goal, intention or purpose.
Using mantras in your meditation and in your day to day life may help with:
💛 Stress management
💛 A positive outlook
💛 Increased self-awareness
💛 Anxiety
💛 Low mood
💛 Cognitive functioning
💛 Staying focused on your goals
🫶Mantra-meditation can be helpful for times where you feel anxious, stressed or low. It can also be great for practicing mindfulness and bringing the attention back to self.
#mantramondays #mentalhealth #meditation #theedinburghpractice
Happy Friday! We’re back for our #fridaycheckin and today we are checking in with our body.
In today’s fast-paced world, burnout is more common than ever and our wonderful Sport Psychologist, Dr Zoe, is giving us some insight into how to prevent burnout.
😌 Taking the time to incorporate different types of rest is essential for maintaining our overall wellbeing. The different types of rest include:
🛏️ Physical rest: We often think of rest as just lying down or sitting, but it can also include stretching, taking a nap, getting a massage, or taking short breaks.
🧠 Mental rest: We live in a world that is always ‘on’, and it can be challenging to unplug. Mental rest can include turning off your phone, taking a break from social media, or practicing meditation.
💛 Emotional rest: Take a break from the emotional demands we face every day. This can include spending time alone, reducing stress where possible, talking to a trusted friend, practising self care, or spending time in nature.
🙋♀️ Social rest: We are social beings, but socialising can also be draining. Social rest can include spending time alone, considering when you want to socialise & when you don’t want to, or having a solo picnic, hike or lunch.
🔇 Sensory rest: We are constantly receiving sensory input from noise, light, and other stimuli and it can be overwhelming. Sensory rest can include turning off the TV, closing your eyes, spending time in a quiet room, listening to calming music, or practising deep breathing.
Remember - rest is not a luxury, it’s a necessity! Embracing and prioritising the different types of rest can help us live healthier, happier, and more fulfilling lives 😊
#theedinburghpractice #fridaycheckin #checkinwithourbody
This week is OCD Awareness Week!
At TEP, we are supporting and sharing awareness for #OCDweek. This worldwide event by @iocdf serves to dispel myths about obsessive compulsive disorder (OCD), break the stigma around mental illness, and provide education about the disorder and how to support those affected.
OCD affects 1 in 100 adults and 1 in 200 children but can be overlooked and belittled as a personality quirk or choice. In reality, OCD is a very real mental health difficulty that affects people of all ages and walks of life.
OCD is an anxiety disorder involving obsessive thoughts and compulsive behaviours. Obsessions are unwanted, intrusive thoughts, images, or urges that trigger intensely distressing feelings. Compulsions are behaviors an individual engages in to attempt to get rid of the obsessions and/or decrease distress. Compulsions can be internal (mental) or external behaviours.
Research has shown that most people have unwanted intrusive thoughts from time to time, but in the context of OCD, these intrusive thoughts come frequently and trigger extreme anxiety, fear, and/or disgust that gets in the way of day-to-day functioning.
At TEP, we offer psychology and psychiatry services to support individuals with OCD. Please head to our website (link in bio) to find out more or to submit a self-referral.
#OCDweek #ocdawarenessweek #theedinburghpractice #mentalhealth
