Areas › Focus, starting, and ADHD › Getting assessed and diagnosed
When someone says their heart races on their medication, ask whether it ever did before they started. It is the cheapest question you have and it usually sorts the answer out.
Go looking for the old settings: waiting to be called on in class, standing outside a room before a difficult conversation, three in the morning with nothing solved. If the sensation has a history, the tablet is at most turning the volume up, and that makes for a very different conversation with the prescriber than starting from nothing. Write down what you find, including when in the day it happens.
Qur’an and Sunnah
'We have knowledge only of what You have taught us' (Quran 2:32). The angels state the limits of what they know before they speak, which is a good posture when a symptom could belong to either of two causes.
قَالُواْ سُبۡحَٰنَكَ لَا عِلۡمَ لَنَآ إِلَّا مَا عَلَّمۡتَنَآۖ إِنَّكَ أَنتَ ٱلۡعَلِيمُ ٱلۡحَكِيمُ
They said, ‘May You be glorified! We have knowledge only of what You have taught us. You are the All Knowing and All Wise.’
Qur’an 2:32read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
There is a real effect to take seriously here. A meta-analysis of stimulant treatment in adults with ADHD found small but measurable increases in heart rate and blood pressure, which is one reason monitoring belongs in ongoing care. Small on average is not the same as small for everyone, so anything out of the ordinary goes back to the prescriber instead of being explained away as anxiety.
Mick E, McManus DD, Goldberg RJ. (2013). Meta-analysis of increased heart rate and blood pressure associated with CNS stimulant treatment of ADHD in adults.. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
A sensation that was there before the medication cannot have been created by it.
When not to
Chest pain, fainting or a racing heart at rest needs medical assessment the same day, not a formulation.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
Ask whether anyone kept the old school reports. The same lines turn up generation after generation: not working to potential, talks too much, never has the right books with him.
A clinician trained thoroughly in autism and ADHD may know almost nothing about coordination or reading difficulties, and can spend years working above foundations nobody ever checked. Ask yourself which of those categories your own training left out.
Very sweet, very salty, very fatty food acts on the reward system in a way that has more in common with a drug than with dinner. Reaching for it when you are flat is self-medication, not greed.