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InvestigatesInvestigatesIRELAND’S PUBLIC ADHD service for adults launched in 2021 and was quickly overwhelmed by demand.
In the years since, an ecosystem of private in-person and online providers has emerged to fill the gap, with patients paying between €1,000 and €1,500 for an initial two-hour ADHD assessment.
Senior figures in medical regulation have told The Journal Investigates they are concerned that some online providers, operating on a commercial basis, are now supplying the majority of ADHD care in Ireland.
Patients of one online clinic told this publication they experienced significant delays in care, including gaps in medication and difficulties accessing prescriptions, care plans and diagnostic reports.
The clinic said its service was affected by “unforeseen delays” and denied any accusations of poor practice.
ADHD (Attention-Deficit/Hyperactivity Disorder) is a neurodevelopmental condition affecting attention, impulse control and decision-making. Increased awareness of how it presents in adults has driven demand for diagnosis and treatment.
A HSE spokesperson told The Journal Investigates that its eight specialist ADHD teams are only accepting new patients in “some areas”, with waiting times ranging from 18 months to over two years.
A senior source in medical regulation believes this situation has created a “gap in the market” that could “be serviced quite easily once you have any medical qualification”.
“It doesn’t necessarily have to be psychiatric,” they added.
They said that the worst actors are not those providing patchy or delayed care, but those who appear to be homing in on this gap in the market for a short time.
“These providers, styled as specialist clinics, are run on a commercial basis. They are often run as a business rather than a medical practice. Some people do it on the fly, and on the fringes,” the source said.
Private, in-person assessment typically costs between €1,000 and €1,500 for an initial appointment lasting around two hours. Medication reviews – which can take place as often as every six months – cost between €100 and €200 for a 10-25 minute appointment, and some practices charge between €50 and €100 for fulfilling documentation requests and issuing letters.
Many patients are opting for online providers, which often charge slightly less.
ADHD Ireland, an advocacy and support non-profit, has a list of providers on its website. It does not vet those included in the directory and has no regulatory role. Oversight of doctors rests with the Irish Medical Council.
An ADHD Ireland spokesperson said delays in reports, care plans and prescriptions are a known issue across the sector, and that it is aware of providers who became unresponsive or ceased operating after diagnosing patients.
They added that online ADHD services have grown rapidly since the pandemic.
Four clients of one online practice – Cloud Clinic – spoke to The Journal Investigates about what they claimed to be “stressful delays” in their care.
All said they became aware of the clinic through ADHD Ireland. (The charity no longer lists the clinic on its website. Cloud Clinic claims this is because it asked to be removed from the directory).
Cloud Clinic is an online-only provider, addressed to an office in Rathmines, which was co-founded by psychiatrist Dr Joe McAndrew-Lima.
A spokesperson for the clinic said that it has assessed around 500 ADHD patients since 2024, and that it is “one of the cheapest”, and therefore accessible, options for those seeking ADHD care in Ireland.
They said the clinic has experienced technical problems that have caused unforeseen delays to care, which it has since sought to remedy.
They also accused internet users of conducting a so-called “sabotage campaign”, which it said made it more difficult to address its backlog of requests for prescriptions, care plans and diagnostic reports.
In December 2025, Cloud Clinic emailed patients apologising for recent “chaos”, and explained that the psychiatrist overseeing their care was “working very hard (4 nights without sleep in last seven days)” in order to fulfil outstanding requests for care plans.
In February 2026, the firm told The Journal Investigates that it was still working to clear this backlog. A spokesperson said at the time that they were also continuing to accept new patients.
Four patients who spoke to this publication described repeated prescription delays in this period, and a lack of response to requests for documentation they were seeking to transfer to another provider.
Two patients said they had to pay €400-€450 to switch providers, while two were still trying to obtain documentation in February to do so.
One of these patients has filed a complaint with the Medical Council, while another was unable to as they did not know the name of the psychiatrist who assessed them, and they were no longer listed on the Cloud Clinic website.
The person who was able to make a complaint has not been informed on whether it is progressing or not, and no findings have been made in respect of it.
One patient said he had to submit a GDPR request to the clinic to obtain his diagnostic report.
All the patients The Journal Investigates spoke to were prescribed Tyvense by Cloud Clinic.
Tyvense is a lisdexamfetamine-based stimulant that’s commonly prescribed for ADHD and to treat binge-eating disorders. It is a controlled drug in Ireland due to its potential for misuse.
Guidance recommends monitoring blood pressure and pulse before treatment, during dose adjustments and at least every six months.
It can have side effects including weight and appetite loss, insomnia and an increase in heart rate and blood pressure.
Only one of the four said they submitted their vitals (including heart-rate and blood pressure) before or after being prescribed the medication Tyvense – and that person did so after disclosing that they were being treated in hospital following an accident at the time of their diagnosis.
The other three said they did not submit information related to their vitals at any stage, including a patient who was 18 years old when he first started on the medication.
Cloud Clinic told The Journal Investigates that patients were advised to monitor their vitals and submit them by email. Additional resources around monitoring have since been added to its website.
ADHD can affect a person’s relationships, work, education and everyday tasks.
For Freddie*, who was diagnosed as a teenager, medication has had a transformative effect.
When he returned to Ireland after living abroad, his GP told him he would need to be reassessed privately due to a lack of public healthcare options.
He received a new diagnosis following an assessment with Cloud Clinic co-founder McAndrew-Lima, and began taking daily Tyvense last September.
Freddie said he was asked to submit his vitals once a care plan arrived, but he didn’t receive it until February of this year.
He said that in December he started experiencing issues with prescriptions, leading to a two-week gap in his medication.
When his prescription ran out, he said he could not reach anyone at the clinic as there was no phone number he could call.
“Once you get used to [the medicine], it’s very hard to suddenly be without it. For me to function normally, I absolutely need medication,” Freddie said.
“I lost 20kgs in those three months of taking Tyvense, but that was okay for me because I can manage it, but I did think like, what would this be like for someone who struggles with this? It really suppresses your appetite,” he said of the drug’s side effects.
Freddie received a corrected prescription in January after being issued the wrong dosage in late December, and a diagnostic report in February after making a complaint to the Medical Council and submitting a GDPR request. This enabled him to switch to another provider.
He has contacted the Minister for Health to highlight his experience.
Emily*, a 24-year-old office worker, was diagnosed with ADHD for the first time by Cloud Clinic.
Emily said she was without medication for two months between December and February, and ultimately paid €450 to switch to a different private practice.
“I’ve had to take out a loan for the first time in my life to pay to go elsewhere,” she said.
She said she raised concerns about regularly experiencing an increased heart rate and that she was told to get in touch if issues arose.
“But I’d have to pay €100 for a session… emails were not generally replied to, plus there was no way to call them,” Emily said.
“They did tell me to go to an emergency department in the case of an emergency,” she added.
She said the issues with her care turned what was initially a “life-changing” experience into a “very stressful one”.
A spokesperson for Cloud Clinic told The Journal Investigates that they ended up offering “free medication reviews” to many patients as an “apology” and that patients who never saw a doctor for a booked appointment were “fully refunded”.
Stacey* (54), was also diagnosed by the clinic and said she experienced delays in prescriptions from December.
She said her initial appointment was cancelled twice after payment, but the assessment itself was “smooth”.
When her prescriptions ran out in December, she attempted to book a review, but she said she did not receive a response.
“I had to split my doses to try and make what I had last… I still haven’t heard from Cloud Clinic,” she said in February.
She said being without medication had a “debilitating effect”:
When I first started taking the medication I experienced this tsunami of grief. It explained so much in my life; why I wasn’t able to finish college, why I didn’t feel I was present enough for my kids.
“For the first time in my life, my brain was quiet enough that I could see myself clearly. For people with ADHD, medication is at the bottom of your pyramid of needs, along with sleep. Once you get used to it and get to experience what life is like when you can organise your thoughts, it is very hard to suddenly go back to your prior reality.”
Stacey paid €400 to another private practice to take her on, and was able to resume medication in February.
Medical professionals say the issues with ADHD care in Ireland extend beyond a single provider and include access barriers, exorbitant costs, limited follow-up care, and difficulties transferring between providers.
The Medical Council regulates individual doctors but does not oversee clinics or multidisciplinary teams. HIQA, a co-regulator in the medical sector, doesn’t regulate private clinics either – it has only recently started to inspect private hospitals.
Dr Suzanne Crowe, president of the council, said this creates a gap in oversight.
“The regulatory gaps which are seen across some health services means it becomes difficult to recognise failings of administration or within medical teams or clinics,” she told The Journal Investigates.
Cloud Clinic put a new system in place for how appointments and prescriptions are requested in February of this year.
If you’ve been affected by any issues similar to those described in this article, you can contact the reporter by email: eimermcauley@thejournal.ie
Reporter: Eimer McAuley • Editor: Sinéad O’Carroll • Social Media: Cliodhna Travers • Main Image Design: Lorcan O’Reilly
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