Continuing ADHD and psychiatric medicines in Spain

Key rules

• Adult ADHD funding: Public funding for adult ADHD medicines is limited, and new adult diagnoses are often restricted by regional rules.
• Private prescriptions: A private psychiatrist can prescribe, but you pay the full price at the pharmacy unless the medicine is funded.
• Private diagnosis: Public doctors may or may not accept a private diagnosis, so ask before you pay for one.
• Antidepressants and anxiety medicines: These are widely available and generally funded when prescribed in the public system, with a copago.

The short version

Expect the process to take longer and cost more than at home, especially for ADHD. Antidepressants and anxiety medicines are easy to get. Adult ADHD medicines are harder: public funding is limited, and public diagnosis services are patchy.

ADHD medicines: what is sold

Four active ingredients are sold in Spain. Use the active ingredient, not the brand, when you check your own medicine.

• Methylphenidate, sold as Concerta, Medikinet, Rubifen and Equasym.
• Lisdexamfetamine, sold as Elvanse.
• Atomoxetine, sold as Strattera and generics.
• Guanfacine, sold as Intuniv. It is for children.

Brands can differ from the ones you know, so ask a doctor or pharmacist to match your medicine to the Spanish version.

Who pays for ADHD medicines

Public funding follows the uses a medicine is officially approved for. Methylphenidate and lisdexamfetamine are funded for children.

• Elvanse Adultos and some methylphenidate products are approved for adults who have been treated since childhood.
• Atomoxetine is approved for adults.
• Funding for a new adult diagnosis varies, and regional rules often restrict it.

Ask your regional health service whether your medicine is funded for adults where you live. If it is not, you pay the full price at the pharmacy.

Getting a diagnosis

Public route. Your GP refers you to mental health services (salud mental). You may see a psychiatrist, or sometimes a neurologist. Waits are often many months and vary widely by region. Adult ADHD services are patchy, so ask what your area offers.

Private route. Many adults pay for an assessment with a private psychiatrist or psychologist. A private psychiatrist can prescribe, and you buy the medicine at the pharmacy unless it is funded.

Private diagnosis, then public care. You can ask the public system to take over your treatment after a private diagnosis. Some public doctors accept it and some do not. Ask your public doctor before you pay for an assessment. The decision block below helps you compare the routes.

Antidepressants and anxiety medicines

These are widely available and need a prescription. They include:

• SSRIs such as sertraline, escitalopram and fluoxetine
• SNRIs
• mirtazapine
• tricyclics
• benzodiazepines such as lorazepam, diazepam and alprazolam

When a public doctor prescribes them, they are generally funded. You pay a co-payment (copago) that depends on your income and status. Pensioners and some other groups pay less or nothing. Some brands are not funded. A private prescription is paid in full.

This is an easier route than ADHD. If you are on one of these, book a GP appointment soon after you are registered in the public system, and bring your current prescription and a doctor's letter.

What to do

1. Look up your medicine by active ingredient to confirm it is sold in Spain.
2. Choose a public, private or mixed route for diagnosis.
3. Plan for paying out of pocket for a while.

The checklist below covers these steps, and the FAQ answers common questions.

Choosing between options

Should you get your adult ADHD diagnosis through the public system or privately?

• Public system: Choose this if you can wait many months and want treatment funded where available. Your GP refers you to mental health services, a psychiatrist or sometimes neurology.

• Private assessment: Choose this if you need an answer sooner and can pay for the assessment.

• Private diagnosis, then public treatment: Choose this if you want a fast diagnosis but hope for public follow-up. Your public doctor may accept it, but practice varies.

If you can wait and your region has an adult ADHD service, go public. If you cannot wait, go private, and ask your GP first whether they will take over treatment.

Waits and acceptance of private diagnoses vary widely by region; confirm locally with your GP.

Checklist

• Check that your ADHD medicine is sold in Spain, using the active ingredient (methylphenidate, lisdexamfetamine or atomoxetine) rather than the brand name.

• Ask your GP for a referral to mental health services (salud mental) if you want a public assessment.

• Book a private psychiatrist or psychologist for an assessment if the public wait is too long.

• Ask your public doctor whether they will accept a private diagnosis before you pay for one.

• Ask a private psychiatrist for a Spanish prescription and buy the medicine at the pharmacy if it is not funded.

Frequently asked questions

Will Spain's public system pay for my adult ADHD medicine?

Public funding for adult ADHD medicine is limited, and it depends on the medicine and the region. Atomoxetine is authorised for adults, and some methylphenidate and lisdexamfetamine (Elvanse Adultos) presentations cover adults already treated since childhood. For a new adult diagnosis, funding is often restricted by regional rules, so ask your regional health service.

Can I get diagnosed privately and then move my treatment to the public system?

Yes, many adults get a private diagnosis and then ask the public system to take over treatment, but public doctors do not always accept it. Ask your GP early whether they will take a private report. If they will not, the public mental health service may need to assess you again.

Are antidepressants and anxiety medicines easier to get funded than ADHD medicines?

Yes, common antidepressants and anxiolytics are generally funded when prescribed in the public system, unlike most adult ADHD medicines. You pay the standard co-payment (copago) based on your income and status, and pensioners and some groups pay less or nothing. Some brands are not funded, and private prescriptions are paid in full.