In the right to choose document it does not state which providers offer more than two medications once diagnosis has been made (Atomoxetine and Ritalin). I am looking for a provider that offers more than these two as I had serious side effects with Atomoxetine and can’t take Ritalin currently?
Thanks for this question. Medication choice is a conversation between your clinitian and you and we can not answer specific medication questions. General medication questions like this we can answer.
No Right to Choose provider should be restricted, or have restrictions, on their options on what UK licensed ADHD medications they can prescribe. We have heard that some RTC providers (and the clinitians within them) have preferences but not heard of any blanket restrictions.
Short answer - none should be restricted to those two medications alone and should be able to offer you all alternatives.
If you have heard differently please let us know which provider and we can ask them.
You can see the latest dataset on NHS prescriptions of ADHD medication (which includes Right to Choose) here: Medicines Used in Mental Health - England Quarterly Summary Statistics October to December 2025 | NHSBSA
In that you can see that the the two you mention are #1 amd #4 prescribed but also highlighting the other options are commonplace, which may ease your mind about restrictions. For simplicity a table of that NHS data is below. (Latest dataset: Q3 2025/2026).
| Row Labels | Sum of Total Items |
|---|---|
| Methylphenidate hydrochloride | 588,592 |
| Lisdexamfetamine dimesylate | 321,219 |
| Dexamfetamine sulfate | 68,993 |
| Atomoxetine hydrochloride | 63,699 |
| Guanfacine | 33,937 |
| Modafinil | 21,789 |
| Pitolisant hydrochloride | 161 |
| Caffeine | 23 |
Apologies to be clearer they said Atomoxetine was the only non stimulant drug they could offer. Everything else was stimulant where I would need to give up alcohol for 3 months to check its effectiveness. I wanted to see if there are other options as for 53 years alcohol is my once a week social strategy.
Thank you for sharing. It’s important to consider how your lifestyle and social life might be affected, and discussing these areas with your prescriber can help. Given your past difficulties with other medications, providing context is valuable for them to understand what might work best for you. If anything isn’t clear, don’t hesitate to ask for further explanation.
If anyone else has additional questions on a thread, please feel free to ask, as it’s likely someone else will be going through or has gone through something similar.
Hello, I wanted to come back to this thread to let you know that ADHD UK reached out to a trusted clinical service (CARE ADHD) for their perspective, and they were kind enough to respond.
They were clear that without the full context of what’s been discussed between the individual and their clinician, they couldn’t comment on the specific case, but they were happy to share some general clinical context, which is hopefully helpful to read. Two of their senior clinicians responded.
Clinician 1 responded with the context of the original question in mind, and noted that guidance in this area has evolved: “The latest advice is to offer first-line stimulants to all patients, as they are the most effective, unless the patient chooses otherwise. Treating the ADHD will usually reduce substance and alcohol use.”
Clinician 2: "Alcohol use does not automatically exclude someone from ADHD medication, but it does influence how cautious clinicians need to be. It is also worth recognising that for some people, alcohol can be a form of self-medication for underlying ADHD symptoms. If alcohol use is low to moderate, stimulant and non-stimulant medications can still be considered with appropriate advice and monitoring.
First-line treatments in adults are usually stimulants such as methylphenidate and lisdexamfetamine. Atomoxetine is the main non-stimulant option. Guanfacine is not licensed for adults and tends to be less effective on its own. Where alcohol use is heavier or there are concerns about dependence, it is usually appropriate to address or stabilise this first. If a provider is declining medication purely on the basis of any alcohol use, that would be unusual."
As always, this is general information rather than advice on any specific situation. The right course of aciton for any person is a conversation between them and their clinician. But I hope this helps give a clearer picture of where the guidance currently sits and that you find the best solution for you in good time.
Best wishes,
Joe
Your right to choose document really should reflect that once you have been assessed you can’t get the help from another. Harrow Health has continued to be difficult for me and my GP referral to Care ADHD was not accepted as I had received diagnosis from Harrow Health. I am now stuck with Harrow Health who since assessment has not been helpful and I I’m still trying to get stimulants. I really do think some of your providers you suggest in the right to choose document just want the funding for assessment and then do not have a good follow up service.
Hi, thank you for sharing and I’m really sorry to hear it’s been a struggle.
The Right to Choose page (under the RTC Framework section) says "There are certain restrictions on a patient’s Right to Choose that you should be aware of. Patients cannot use Right to Choose if they are:
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already receiving mental health care following an elective referral for the same condition"
Feedback on the pages are so welcome.. In the footer of each page on the site, there is a link to provide feedback. Please feel free to share via the form on the Right to Choose - ADHD UK page
The exception would be if your provider wasn’t able to provide treatment options, i.e., titration, which would make you eligible for titration only or reassessment with another provider. I appreciate this might not be the case here, and you might be on a waitlist for titration with your current provider.
I hope things move forward in some way soon, and feel free to post any more questions as they come up.