What to expect during titration

Summary: During titration you'll have a minimum of 3 appointments – starting at week 1, then weeks 4 and 8. Your clinician will review how you're getting on and adjust your medication. Between appointments, you’ll need to track your symptoms and stay on top of medication payments. Most people reach a stable dose within 12 weeks. 

• Before you begin

• Your titration appointments

• Your first appointment (T1)

• Your week 4 review (T2)

• Your week 8 review (T3)

• What you’ll need to do between appointments

• If your medication needs further adjustment

• How to get medication longer term FAQs 

This article only applies to patients diagnosed with ADHD, or ADHD together with other conditions like autism – where treatment is often different. 

Starting titration can feel like a lot to take in – especially if you're new to ADHD medication. This article walks you through the process step by step, so you know  what to expect at each stage and what you need to do along the way. 

Once your medical history has been reviewed and your appointments are booked, you're ready to begin titration. 

Over 12 weeks, you’ll have a series of titration appointments with a clinician to work out the most effective and safe ADHD medication for you. 

If you can't make an appointment, please let us know as far in advance as possible. ADHD waiting lists in the UK are very long, and with notice we can offer your slot to someone else. Missed appointments can also disrupt your medication supply. 

At your first appointment, you'll sit down with your clinician to: 

• Talk through the medications available to you

• Discuss your treatment goals and target symptoms

• Ask any questions you have before starting medication 

After your appointment, your clinician will send your prescription to our partner pharmacy. They'll email you – usually within 3 working days – with a link to pay for your medication. Once you’ve paid, they'll send your medication directly to your home address. If everything’s completed promptly, your medication should arrive within a week of your appointment.    

You'll start on a low dose to allow your body to adjust gradually. The goal from here is to find your "optimal dose" – the amount that gives you the best symptom relief with the fewest side effects. 

At your second appointment, your clinician will: 

• Review your monitoring form

• Check how you're getting on since your last appointment

• Discuss any side effects or concerns

• Adjust your dose or medication if needed 

After your appointment, your clinician will send your next prescription to the pharmacy. The pharmacy will again be in touch with a payment link, and your medication will be sent once your payment is made. 

Your third appointment follows the same format as T2. By this stage, many people are at or close to their optimal dose. If your medication is stable, your clinician will also talk you through your options for accessing medication long-term – you can read more about these in our “Managing ADHD medications and prescriptions” article. 

NHS Right to Choose patients are also offered a fourth appointment (T4), giving more time to fine-tune your medication if needed. Private patients are welcome to purchase additional titration appointments for £140 per appointment. 

1. Complete your treatment monitoring form 

Before each appointment, you'll need to complete a treatment monitoring form. This helps your clinician: 

• Understand how your medication is working

• Identify any side effects or concerns – and offer guidance for managing these

• Issue a new prescription based on your progress

• Prepare for your review so you can make the most of your time together 

Please be open and detailed about any side effects you’re experiencing and make sure you submit the form before each appointment. 

2. Track your symptoms and side effects 

Between appointments, keep a note of: 

• Any changes to your symptoms

• Any side effects

• Any questions you want to raise with your clinician 

A diary or notes on your phone work well. The more detail you can bring to your appointments, the better your clinician can personalise your treatment to you. 

3. Stay on top of medication payments 

What to do:

• Pay for each batch of medication as soon as you receive the payment link.

• If your next batch hasn't arrived before your current supply runs out, you can safely reduce or stop taking your medication in the meantime.

• ADHD medication can be stopped abruptly without adverse effects and doesn't need to be tapered. 

• Try to bring it forward rather than push it back – postponing can lead to running out of medication before your next batch arrives.

• Cancellations or missed appointments with less than 2 working days' notice lead to a fee for private patients – so please try to avoid this. The fee is £150 for a missed assessment appointment and £75 for a missed titration appointment. 

Don't worry if you haven't found the right dose by week 8 – this isn’t uncommon. 

• Private patients – further appointments are available to purchase if needed.

• NHS Right to Choose patients – you have access to more appointments, with more available after that if needed. 

Once your medication is stable, you'll need to decide how you'd like to access it longer term. You can read more about your options – including shared care with your GP and ongoing private prescriptions – in this article. 

Once your medication is stabilised, you have two options for how your prescription is managed long-term. 

• Shared care – this is when your GP takes over the prescribing and management of your medication. Find out more here.

• If shared care isn't possible – we’ll aim to keep prescribing for you. For NHS patients, the cost is £9.90 per prescription. For private patients, a £20 processing fee applies, with medication costs payable to the pharmacy. Read more about prescriptions. 

What if I feel unwell because of my medication? 

Stop taking your medication immediately and contact your GP or visit your nearest hospital. ADHD medication can be stopped abruptly without adverse effects. Please also let your clinician know at your next appointment. 

How will I know when my medication is stable? 

Your clinician will let you know when they feel your medication is working well and your dose is consistent. This usually happens somewhere between weeks 8 and 12, though it can take longer for some people. 

How does my prescription work? 

For full details on how prescriptions are issued and how to get your medication, see our prescriptions page. 

What if my medication isn't stable after 12 weeks? 

You can access more titration appointments, these being free for Right to Choose patients and available at an extra cost for private patients. See our pricing page for details.