What is Titration?
Titration is the process of starting ADHD medication and gradually adjusting the dose. The aim is to find the dosage that gives you the most benefit with the fewest side effects. NICE (the National Institute for Health and Care Excellence) says medication should only be started and reviewed by a healthcare professional experienced in diagnosing and managing ADHD.
If you already have an ADHD diagnosis – from The Edinburgh Practice or elsewhere – and you’re thinking about starting medication, you can complete a self-referral form to request titration.
You’ll attend regular appointments with one of our Consultant Psychiatrists, Specialty Doctors, Advanced Practice Clinical Pharmacists or Nurse Prescribers. They’ll adjust and monitor your medication until you reach a stable, optimal dose. Appointments can take place remotely or in person.
If you were diagnosed elsewhere
If your ADHD diagnosis came from somewhere other than The Edinburgh Practice, we’ll ask you to send us your assessment report and any other relevant documents.Our Clinical Lead reviews this report to make sure it meets best-practice guidelines and includes everything we need.
Please check our policy on existing diagnoses before you refer.
We can’t progress your referral until we’ve received your assessment report.
Stage 1: your initial consultation
Once we’ve accepted your referral, you’ll be offered an initial consultation with one of our Advanced Practice Clinical Pharmacists, Nurse Prescribers, Consultant Psychiatrists, or Specialty Doctors. Our Clinical Lead will recommend who’s most appropriate based on your medical history.
At this appointment, your clinician will: review your ADHD diagnosis, medical history, and physical health; talk through whether starting medication is right for you; and discuss the medication options available to you, based on your history and NICE guidelines, including the benefits and possible side effects.
Before you start medication, we’ll take some baseline physical measurements – blood pressure, pulse, height, and weight. You may also be asked for an ECG (a simple heart tracing test) and/or blood tests.
Once your clinician has reviewed these and confirmed they’re within the expected range, you’ll be ready to start treatment and receive your first prescription.
Stage 2: titration review appointments
During titration, you’ll see your clinician for review appointments every 3-4 weeks. These appointments ensure we can monitor your progress and adjust your medication if needed.
Your physical observations are reviewed before each new prescription and at every review appointment.
Titration usually takes a minimum of 8-12 weeks, though this varies from person to person. You’re considered fully titrated once your body has adjusted to the medication and you’ve found your optimal dose.
Stage 3: once you’re stable
Once you’re on a stable dose, you won’t need reviews every 3-4 weeks any more. Your clinician will let you know how often you’ll need medication reviews going forward, based on your individual care needs – this is often every 3 or 6 months.
Prescriptions
During titration, you don’t need to request prescriptions yourself – you’ll receive these at your review appointments.
Once titration is complete, request your prescriptions through the client portal.
Request your prescription 14 days before you’re due to run out of medication. It can help to set a reminder so you don’t miss this.
Working with your GP
Shared care is when your NHS GP agrees to take over your prescriptions once titration is complete, while The Edinburgh Practice continues monitoring you at agreed intervals (for example, every 3 or 6 months).
Many GP practices across Scotland stopped accepting shared care requests from private healthcare providers from June 2024 onwards, often due to funding and ADHD-specific expertise. Whether your GP practice accepts shared care is entirely their decision – we’d recommend checking with them before you start medication with us if shared care is something you’re hoping for.
Whether or not your GP agrees to shared care, we’ll always write to them once we prescribe medication for you. This is a safety measure, so everyone involved in your care knows about your diagnosis and any medication you’ve been prescribed.
FAQs
Medication titration is the process of gradually adjusting the dose of a medication to find the amount that works best for you. During titration, your clinician starts you on a low dose and increases it step‑by‑step while monitoring how effective it is and whether you experience any side effects. This helps ensure you receive the most effective dose with the fewest side effects, tailored to your individual needs.
During the titration phase you do not need to request a repeat prescription as you will be meeting with the clinician every few weeks to review your medication and you will receive your prescription following the review appointment.
Once you are fully titrated and on a stable dose of medication, you will be required to have a review appointment at less regular intervals than during titration e.g. once every 3-6 months. At this stage you can then request a repeat prescription via our online client portal, along with your physical observations.
We recommend that you request your prescription 14 days before you are due to run out of medication.
If you are a current client and have any questions regarding prescribed medication that you have been taking, please do not hesitate to get in touch with our Psychiatry Coordinators at coordinators@edinburghpractice.com or 0131 385 0934 (line 2). If you are having serious side effects, please seek urgent medical attention.
Yes, you need a confirmed diagnosis of ADHD before starting medication. If you have been diagnosed elsewhere, your diagnostic report will be reviewed by our clinicians to ensure it meets clinical guidelines.
Not necessarily. Some people take medication long-term, while others use it for a shorter period. This is reviewed regularly with your clinician based on your needs and preferences.
Titration Package
It can be a difficult decision to start medication following an ADHD diagnosis. The process to start medication can be quite confusing and knowing what options are available to you. We want to make this process as easy as possible and reduce any uncertainty or stress and are here to help you as much as possible through this ‘titration’ process.
The length of the titration process differs from person to person; therefore, it can be difficult to know how long the process will take and how many appointments will be required. Most clients find they require 4 to 6 appointments to find the correct medication and dosage for them. Your clinician will advise when you have completed the titration process. You will be fully titrated when your body has adjusted to the new medication, and you have found your optimal dose.
The practice offers a titration package to help facilitate the titration process. The package includes up to 6 appointments and 6 prescriptions (including delivery should you require this, to your home or chosen pharmacy). This provides you with reassurance that you will have up to 6 appointments available to you inclusive of prescriptions for a fixed cost.
Once you have completed titration and are on a stable dose, you no longer require medication reviews every 3-4 weeks. Your clinician will advise on how often you require medication reviews post-titration based on your individual clinical care needs, for example this may be every 3 or 6 months.
How does the package work?
- Pay upfront prior to starting the titration process and secure your appointments
- You will have an initial appointment with an Advanced Practice Clinical Pharmacist
- You can have up to 5 more 30-minute review appointments within the 6 months following your initial appointment
Why book the titration package?
- Peace of mind – all appointments within the titration process are included
- Cost effective – save money as the package costs less than paying for appointments one by one
- Flexibility – know you have the option to make a review appointment when you need it
Payment
We require full prepayment when booking the titration package. You can spread the cost of the package if you use Klarna (subject to their terms & conditions).
Titration package – practice diagnosis £795 (saving £249)
Titration package – other provider diagnosis £895 (saving £289)
*savings based on pay as you go review appointments, prescription and delivery charges
T&Cs
- Full prepayment must be made prior to appointments being booked
- Following your initial appointment your clinician will determine when future appointments are booked in line with your individual needs and health circumstances. This may mean all can be booked in upfront or some must be determined at your next review appointment
- Review appointments are up to 30 minutes and may not last the full 30 minutes
- Your clinician will write to your NHS GP following every review appointment
- Prescriptions are included when issued at your review appointment. If you have a virtual appointment and you cannot collect your prescription we will post this to you, a chosen pharmacy or our online pharmacy CloudRx. The cost for tracked delivery is included in the package cost
- All appointments must take place within the 6 months following your initial appointment
- Not all 6 review appointments may be required in the 6-month period of the titration package. If this is the case, no refunds will be offered for review appointments not taken
- Medication costs are not included in the package
- Only urgent queries can be responded to out with review appointments. For any other requests a review appointment should be booked to discuss issues, concerns or changes
- Appointments are booked in line with clinician availability. Clinicians do not work full-time at the practice
Our Fees
£895
Titration Package (Diagnosis from another provider)
£795
Titration Package (Diagnosis at The Edinburgh Practice)
£280
Initial Pharmacist/Nurse Prescriber Appointment (up to 1 hour)
£370
Initial Psychiatry Consultation (up to 1 hour)
£140
Pharmacist/Nurse Prescriber Review Follow Up Appointment (up to 30 minutes)
£210
Psychiatry Review Follow Up Appointment (up to 30 minutes)
£25
Prescription
£35
Prescription outwith appointment
Pay in 3 interest‑free payments with Klarna.
Subject to approval. See Klarna terms & conditions.