Prescriptions and clinical reports

Prescriptions

All prescriptions are issued by Dr David Crocker following a consultation and sent securely to you or directly to your pharmacy, depending on your preference. All prescribing decisions are made on an individual basis, taking into account your clinical history, current presentation, and response to treatment. Medication is only prescribed where it is clinically appropriate and where the expected benefits outweigh the risks. The prescription fee is £30 for controlled medications (ADHD stimulants such as methylphenidate and lisdexamfetamine) and £25 for non-controlled medications.

We prescribe across the conditions seen at the practice: ADHD and autism, and conditions such as anxiety and depression where they occur alongside them. The cost guidance below focuses on ADHD medications, as these tend to be the higher-cost, controlled options patients most often ask about. Medication for other conditions, such as antidepressants, is usually much less expensive.

The cost of the medication itself is separate and paid directly to your dispensing pharmacy. The figures below are approximate monthly costs from a typically lower-cost pharmacy such as a supermarket chain. Prices at other pharmacies may be higher, so it is worth comparing before you settle on one. We can discuss medication costs during your appointment, and it is a perfectly reasonable factor in deciding which medication to try.

• Lisdexamfetamine (Elvanse): £70 to £105 per month depending on dose
• Methylphenidate modified-release: £19 to £48 per month depending on dose
• Methylphenidate immediate-release: £10 to £30 per month depending on dose
• Dexamfetamine: £17 to £100 per month depending on dose

There are a number of other medications used in the treatment of ADHD, including atomoxetine, guanfacine, and various different formulations of the drugs listed above. For a detailed breakdown of costs by medication and dose, see our medication cost guide. The right choice depends on your symptoms, how you respond to treatment, and what suits your daily routine. We work this out together during the titration period, and there is no need to decide anything before your appointment.

Caledonian Psychiatry always advocates for shared care with your GP so that routine prescribing can transfer to the NHS. Unfortunately, local policy varies with regard to the acceptance of shared care arrangements, and this is not always within our control.

Before any stimulant medication is started, pre-treatment baselines (cardiac and family cardiac history, blood pressure, pulse, weight and height) are recorded in line with NICE guideline NG87, and travel with any later shared care request.

Clinical reports and letters

Standard letters

Certain letters are provided as part of your routine care at no additional charge. These can be requested during any appointment:

• Confirmation of diagnosis for employers, insurers, universities, or other agencies.
• Travel letters confirming your medication and diagnosis for carrying controlled drugs abroad.
• Letters to your GP or other clinicians as part of ongoing clinical communication.

Additional reports and letters

Some situations require clinical documentation beyond your initial assessment report. These are quoted individually depending on complexity and turnaround.

Your diagnostic report from the initial assessment is often sufficient on its own for many purposes, including employer requests for reasonable adjustments, student support applications, and benefit claims. Where a separate letter or more detailed report is needed, Dr Crocker can provide one. Common examples include:

What we don’t provide

Caledonian Psychiatry does not provide medicolegal reports, expert witness work, or reports for legal proceedings including tribunals.

If you need any additional documentation, please raise this during your appointment. Your psychiatrist will confirm the scope and fee before any work is carried out.

Driving

According to DVLA guidance, a diagnosis of ADHD is not in itself a bar to holding a driving licence. If you have already passed your driving test, the DVLA only needs to be notified if there is a change to your condition, or if there are concerns about your ability to drive safely: for example, significant difficulties with attention, concentration, impulsivity, or emotional regulation. You must also notify the DVLA if your prescribed medication or its side effects are likely to impair safe driving. In practice, ADHD medication often improves driving safety. Your psychiatrist will discuss driving with you as part of your treatment plan.

Useful links

• Access to Work
• Disabled Students’ Allowance (Scotland)
• Disabled Students’ Allowance (England)
• DVLA and ADHD
• Equality Act 2010 guidance
• UKAAN (UK Adult ADHD Network)
• ADHD UK
• National Autistic Society

Fees summary

Prescription fee: £25 per prescription for non-controlled medications, or £30 for controlled medications (ADHD stimulants).

Standard letters: included as part of your care.

Additional reports and letters: quoted individually and agreed in advance.