Areas › Focus, starting, and ADHD › Medication and how it works
When a dose that was working seems to stop working in a growing child, check height and weight before you reach for the word tolerance. These medicines are dosed by body weight, and a child can simply have outgrown the dose.
It is the cheaper explanation and the more common one, and it takes a single appointment to test. Bring the growth chart and the dates when you noticed the change. If growth does not explain it, the conversation moves on to timing, sleep, what has changed at school, and only then to switching medicines.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Qur’an and Sunnah
You can ask those who have knowledge if you do not know (Quran 16:43). Taking the question to the prescriber instead of settling it at the kitchen table is what that recommends.
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
An open label study following adults through a year of routine treatment found benefit alongside substantial dose adjustment, a reminder that doses are expected to move rather than being set once and left. That study was in adults and was not designed to test tolerance. What it supports is treating a change in effect as a prompt to review the dose rather than to abandon the drug.
Fredriksen M, Dahl AA, Martinsen EW, Klungsøyr O, Haavik J, Peleikis DE. (2014). Effectiveness of one-year pharmacological treatment of adult attention-deficit/hyperactivity disorder (ADHD): an open-label prospective study of time in treatment, dose, side-effects and comorbidity.. 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 dose set for a smaller body delivers less for each kilogram as the body gets bigger.
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
Saying that medication helps is not the same as saying everyone should be on it. If you have walked in braced for a push, it is fine to say so at the start.
One of the amphetamine medicines arrives switched off. It is bound to a simple building block of protein and only wakes up once the body cuts the two apart, which is why crushing or snorting it gets you nowhere faster.
If a small child cannot swallow tablets, that is a solvable problem rather than a reason to give up on treatment. One methylphenidate preparation comes as a skin patch.