ADHD medications in Scotland

What is prescribed, how it works, and what Scottish NHS guidance says

Reviewed by ADHD Scot,

This page summarises publicly available NHS Scotland medicines guidance for information only. It is not medical advice and not an advertisement. Brand names are included only to help you recognise what you may be prescribed or dispensed in NHS Scotland, not as a recommendation or endorsement of any product. Your prescribing clinician is the right person to discuss which medication and dose is appropriate for you.

How ADHD medication is prescribed in Scotland

In Scotland, ADHD medication must be initiated by a specialist, typically a consultant psychiatrist, associate specialist, or nurse prescriber with specialist ADHD training. Once a stable dose has been established, ongoing prescribing can be continued by your GP under a shared care arrangement, if accepted.

This page summarises the medications listed in the NHS Scotland Right Decisions medicines guidance for ADHD. Right Decisions is NHS Scotland's guidance platform, and this specific page is one health board's adult formulary - but it can be useful for patients to read for an understanding of how it works.

First-line: methylphenidate

Methylphenidate is the most commonly prescribed ADHD medication in Scotland. It works by increasing dopamine and noradrenaline activity in the brain.

Immediate-release tablets

Immediate-release methylphenidate typically lasts 3–5 hours per dose, so it is usually taken two or three times a day.

Brand Strengths
Generic methylphenidate 5mg, 10mg, 20mg tablets
Ritalin® 10mg tablets
Medikinet® 5mg, 10mg, 20mg tablets

Modified-release formulations

Modified-release (MR) formulations deliver methylphenidate throughout the day from a single morning dose. Different brands release the dose in different proportions and over different periods, which affects how long they last and when the medication reaches its peak level in the body.

Approximate methylphenidate release profiles, illustrative patient information diagram. Original work by ADHD Scot, not clinical reference material.

Illustrative diagram, original work by ADHD Scot. Release-profile proportions are taken from each product's Summary of Product Characteristics (SmPC) on the Electronic Medicines Compendium (EMC), Concerta XL, Equasym XL, and Medikinet XL, and NHS Scotland Right Decisions formulary guidance. For photographs and full product details of each tablet or capsule, see the product's patient information leaflet (PIL) on the EMC.

NHS Scotland formulary guidance groups modified-release methylphenidate by how the dose is released across the day. The immediate-release portion gives an early effect and the extended portion sustains it. Because these profiles are not interchangeable, the MHRA advises, and NHS Scotland formularies echo, that MR methylphenidate is prescribed and dispensed by brand name, not generically. If your pharmacy substitutes a different brand without clinical review, speak to your prescriber.

The NHS Scotland Right Decisions formulary groups them by release profile. The brands prescribed in NHS Scotland include:

Release profile Brands used in NHS Scotland Strengths
~22–25% immediate : 75–78% extended, around 12 hours Concerta XL®, Xenidate XL®, Xaggitin XL® 18mg, 27mg, 36mg, 54mg tablets
30% immediate : 70% extended, around 8 hours Equasym XL® 10mg, 20mg, 30mg capsules
50% immediate : 50% extended, around 8 hours Medikinet XL® 5mg, 10mg, 20mg, 30mg, 40mg, 50mg, 60mg capsules
50% immediate : 50% extended, around 8 hours Focusim XL® 10mg, 20mg, 30mg, 40mg capsules

Concerta XL® is the original OROS product in the 12-hour group; Xenidate XL® and Xaggitin XL® are bioequivalent brands also prescribed across Scotland. Other bioequivalent brands are licensed in the UK and some Scottish boards list them too; because they are not interchangeable, your prescriber will name the brand and your pharmacy should dispense that brand.

For patient information leaflets (PILs) and full product details, visit the Electronic Medicines Compendium (EMC) and search by the brand name on your prescription.

Second-line: lisdexamfetamine (Elvanse®)

Lisdexamfetamine is a prodrug that the body converts into dexamfetamine, the active compound. This design makes it longer-acting (up to 13–14 hours) and reduces the potential for misuse compared to shorter-acting stimulants.

It is typically considered when methylphenidate has not provided adequate benefit or has caused unacceptable side effects.

Brand Licensed for Strengths
Elvanse® Children aged 6 and over, and adults 20mg, 30mg, 40mg, 50mg, 60mg, 70mg capsules

Elvanse used to be sold as two brands, Elvanse for children and Elvanse Adult for adults. In 2025 these were combined into a single Elvanse range licensed for both children aged 6 and over and adults, so the separate Elvanse Adult brand has been discontinued.

The capsules can be opened and the contents dissolved in water, yogurt, or orange juice for people who cannot swallow capsules whole.

Older stimulant: dexamfetamine

Dexamfetamine sulfate tablets (5mg, 10mg, 20mg) remain available for people where other stimulants have not been effective. For ADHD it is licensed for children and young people aged 6 to 17, where methylphenidate has not worked well enough. It has a shorter duration of action than lisdexamfetamine and is typically taken two or three times a day.

Third-line: non-stimulant options

Atomoxetine (formerly branded Strattera®)

Atomoxetine is a non-stimulant used where stimulants are not suitable, for example where there is a history of cardiovascular problems, stimulant misuse, or significant anxiety. It is a selective noradrenaline reuptake inhibitor (NRI) and takes 4–6 weeks to reach full effect. It is licensed for children aged 6 and over and for adults.

Form Strengths Notes
Atomoxetine capsules (generic) 10mg, 18mg, 25mg, 40mg, 60mg, 80mg, 100mg The originator brand Strattera® has been discontinued in the UK; generic atomoxetine remains available in the same strengths
Oral solution (4mg/ml) Various volumes NHS Scotland restricts this to people who cannot swallow capsules

Guanfacine (Intuniv®)

Guanfacine is a non-stimulant option licensed for children and young people aged 6–17. It is used where stimulants are not suitable, not tolerated, or have not been sufficiently effective. It must be used as part of a broader ADHD treatment programme that includes psychological and educational support.

Strengths Notes
1mg, 2mg, 3mg, 4mg prolonged-release tablets Must not be crushed or chewed

Monitoring

NHS Scotland Right Decisions guidance recommends that before starting ADHD medication, a baseline physical assessment is carried out including weight, height (in children), blood pressure, and heart rate. These should be monitored at least every six months once medication is established. Blood pressure and heart rate are also usually checked around each change in dose, and younger children are weighed more often.

Height monitoring in children is important because stimulant medications can temporarily affect growth rate in some young people.

If you are starting a shared care agreement, speak to your GP surgery about whether the private provider's responsibility for these checks continues or transfers to the GP practice. Adults using private clinics can often self-report blood pressure, heart rate, and weight between appointments. Home blood pressure monitors are widely available from pharmacies.

Medication alongside other support

The Royal College of Psychiatrists and NHS Right Decisions guidance both note that medication alone is rarely the full picture. For children and young people in particular, medication is most effective when used alongside:

  • Parent training programmes
  • Educational support and adjustments
  • Cognitive behavioural therapy (CBT) adapted for ADHD, where available

For adults, psychological support (including CBT adapted for ADHD and coaching) can help with organisation, time management, and emotional regulation alongside or instead of medication.

Availability of psychological support on the NHS in Scotland is currently very limited. Many people access this privately or through peer support.

Scotland-specific clinical guidance

SIGN, Scottish Intercollegiate Guidelines Network

SIGN produces evidence-based clinical guidelines for NHS Scotland. Current NHS Scotland clinical and prescribing guidance for ADHD is published via NHS Right Decisions. All SIGN guidelines are free to access at sign.ac.uk.

Scottish Medicines Consortium (SMC)

The SMC evaluates new medicines and advises NHS Scotland on which should be accepted for routine use. Some medications accepted by NICE in England may have a different or delayed SMC recommendation for Scotland. If you are prescribed a medication and your GP says it is "not approved for Scotland," the SMC decision is the relevant reference. You can check decisions at scottishmedicines.org.uk.

Royal College of Psychiatrists (RCPsych)

RCPsych produces patient information reviewed by consultant psychiatrists. Their public-facing resources on ADHD in adults and ADHD in young people are written in plain English for patients and families. RCPsych Scotland is the Scottish division of the college and contributes to Scottish clinical standards.

Medication and shared care in Scotland

A common situation in Scotland is that a specialist initiates medication but the GP declines to continue prescribing under shared care, particularly after a private diagnosis. This leaves people either paying for ongoing private prescriptions or going without medication.

See our After your diagnosis page for more information on the shared care issue and what options are available if your GP declines.

References

ADHD Scot is an independent, non-clinical information project. Nothing here is medical advice. Decisions about medication should always be made with a qualified prescriber who knows your full health history.

Reviewed by ADHD Scot,