Areas › Focus, starting, and ADHD › Getting assessed and diagnosed
Where a relative has taken ADHD medication, take the details: who they are to your patient, what they were given, what it did, and what was tried and dropped. Then put it in the referral letter.
No blood test tells a prescriber where to start, so a brother's clear response to one drug, or a mother's bad reaction to another, is one of the few practical signals available. The failed trials matter as much as the successful ones. Prescribers rarely have any of this and are usually glad to be handed it.
Qur’an and Sunnah
'you can ask those who have knowledge if you do not know' (Quran 16:43). Passing the question to someone trained for it is the instruction, and passing on what you have gathered with it only helps them.
وَمَآ أَرۡسَلۡنَا مِن قَبۡلِكَ إِلَّا رِجَالࣰ ا نُّوحِيٓ إِلَيۡهِمۡۖ فَسۡـَٔلُوٓاْ أَهۡلَ ٱلذِّكۡرِ إِن كُنتُمۡ لَا تَعۡلَمُونَ
[Prophet], all the messengers We sent before you were simply men to whom We had given the Revelation: you [people] can ask those who have knowledge if you do not know
Qur’an 16:43read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
Two things are worth holding together here. Pooled double blind placebo controlled trials in children and adolescents show substantial symptom reduction with stimulant medication, so these are effective drugs. But a systematic review of adult medications found very few head to head trials, leaving the choice between them resting largely on indirect comparison, with no clear single winner. Family experience does not fill that gap with evidence, though it is a reasonable thing to bring to a decision that has little else to go on.
Faraone SV, Buitelaar J. (2010). Comparing the efficacy of stimulants for ADHD in children and adolescents using meta-analysis.. European child & adolescent psychiatry doi
Peterson K, McDonagh MS, Fu R. (2008). Comparative benefits and harms of competing medications for adults with attention-deficit hyperactivity disorder: a systematic review and indirect comparison meta-analysis.. Psychopharmacology doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Choosing a starting point with some family experience behind it beats choosing one with nothing behind it.
When not to
A relative's good experience is a suggestion for the prescriber and never a reason to share or borrow medication.
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
A man who could not get himself to bed kept his bedtime alarm upstairs, where his wife and baby were sleeping. Switching it off meant climbing the stairs, and leaving it meant waking them. The walk to the alarm was the thing he was trying to do anyway.
Hyperactivity and impulsiveness almost never turn up alone. When restlessness appears with no attention difficulty beside it, that is a reason to ask what else might be going on.
The scales worth using are the ones that ask about situations rather than symptoms alone. Home, school, work, and what actually happens in each.