2020–2025 — Years on lisdexamfetamine
Patient account
About five years on lisdexamfetamine (Elvanse), described as giving energy to move but limited benefit for thinking, wearing off part-way through short work shifts.
MJB ADHD · Static reading view · Interactive version
Status: drafted · Content checked 2026-10-06
One case, shown with each account labelled — the trust's records, the patient's account, other clinicians, and the records still needed to settle disputes.
Matthew was treated for ADHD for about five years, moved from lisdexamfetamine to a specific dexamfetamine product in 2025, and has been without that treatment since December 2025. How the treatment ended is disputed: the trust records that he asked to be discharged on 11 December; he says the request followed weeks of failed supply. What is not disputed is that, many months on, no service has yet made a restart decision.
The trust records a patient-requested discharge on 11 December 2025 after a review was offered; the patient's addendum says he had already been without medication for over two weeks because of supply failure.
AUTHOR-ACCOUNTFilter by whose account you want to see, or show only the disputed points.
Each card says whose account it is. Where accounts conflict, both are shown and marked disputed. 'Not found in reviewed records' never means 'did not happen'. Personal identifiers, family details and health disclosures beyond what is needed are deliberately left out.
Patient account
About five years on lisdexamfetamine (Elvanse), described as giving energy to move but limited benefit for thinking, wearing off part-way through short work shifts.
Trust record
The service recorded intake above the prescribed dose, called it misuse, moved to weekly prescriptions and held shared care pending review. It also recorded the patient's openness in discussing it.
Decision: Weekly prescribing; review booked
Unresolved: Must be presented alongside the plan that followed
Trust record
Consultant review records improvement at the higher intake and plans a switch to dexamfetamine, building to a maximum of 60 mg/day in divided doses.
Action promised: Titration plan
Evidence available: Quoted wording; original letter not attached
Patient account
Live logs describe specific functional change on Amfexa 10 and 20 mg (movement and typing 'auto completing', calmer thinking) and repeated short supplies, including a recorded 4-day gap.
Patient account · Disputed
The patient's addendum states he had been left without medication for over two weeks before the December call, and that the 'discharge' followed from that supply failure.
Trust record · Disputed
The trust's 5 March letter says that on a telephone call the team offered a medical review, the patient said he did not wish to continue, and asked to be discharged; a new GP referral would be needed to return.
Competing account: Patient addendum 6 Mar 2026 disputes the context
Next question: What do the call notes and dispensing record show for 25 Nov – 31 Dec?
Record needed · Disputed
Five different events are often merged: last dispensing, last dose, the discharge request, administrative closure and the formal discharge letter. The patient's compilations use 31 December; the trust uses 11 December. Dispensing history and the discharge letter would settle it.
Trust record
Asked for Amfexa 20 mg three times daily, the service said it would not be safe to restart at the previous dose after several weeks off and outside an active treatment plan, without a new assessment and a titration plan.
Trust record
The GP made a new referral; the patient complained to PALS. The trust said the referral would follow triage → acceptance → full medical review before any medication decision.
Trust record
The trust confirmed receipt, said a medical review was likely to be several months away due to demand, and noted the Right to Choose option.
Patient account · Disputed
The patient asked for an addendum to be attached to his record, describing physical deterioration and disputing the discharge narrative.
Other clinician
An independent consultant psychiatrist assessed him and recorded his report of benefit on Amfexa and deterioration since it stopped.
Status: Patient report recorded by a clinician — not an independent measurement
Record needed · Disputed
An Achilles tendon injury required surgical repair. Two incompatible accounts of how it happened exist in the patient's own documents; this guide uses neutral wording until hospital records settle it.
Trust record
Project records state the commissioner's ADHD referral policy (COM/46) was replaced by an all-age policy. The new policy text has not yet been obtained.
Trust record
The trust wrote that ADHD medication cannot be considered until full cardiology checks are completed, and set communication arrangements (contact PALS only, at most one email per week, no images).
What it is: A prerequisite, not a promise to restart
Next question: After the checks, what remained, and who owned it?
Patient account
The patient reports the ambulatory heart-monitor result as satisfactory. The result letter is not yet attached here.
Record needed: Cardiology result letter
Trust record
A trust occupational therapist and psychologist visited, recorded pain, mobility restriction and loss of function, and completed a quality-of-life questionnaire.
Record needed: Completed instrument and scoring before publishing a score
Trust record
A trust psychologist confirmed the medication gap had been raised internally, including with neurodevelopmental leads, but said she had no role allowing her to identify who would decide or when. Records were redirected to FOI — personal records are a subject access request instead.
Other clinician
A Right to Choose provider sent its assessment report to the GP. The patient reports it is considering restarting with lisdexamfetamine.
Record needed: Provider letters: proposed medicine, dose, titration and reasons
The records that would settle most disputes are listed under "Sources still needed" below. If you are in a similar position, the records route explains how to request your own.
This page does not use a running "days without treatment" counter, because the start date is disputed. Elapsed times are only meaningful against a stated start: from 31 December 2025 to 6 October 2026 is 279 days; from 11 December it is 299.
On 28 May 2026 the trust wrote that ADHD medication cannot be considered until full cardiology checks are completed.
AUTHOR-ACCOUNTThe patient reports that the heart-monitor result in June 2026 was satisfactory; the result letter is not yet attached.
AUTHOR-ACCOUNTSeveral entries rely on pointers to records that have not yet been attached as exhibits. They are labelled as such.
Original discharge record and call notes; pharmacy dispensing history; June 2025 consultant letter; June 2026 cardiology result; independent psychiatric report; August 2026 home-visit record and scored measure; October 2026 trust emails; current Right to Choose provider letters; the post-May 2026 commissioning policy.