Areas › Focus, starting, and ADHD › Medication and how it works
The realistic difficulty with this medicine is not misuse. It is forgetting, since part of what is being treated is the very ability to remember to do something later.
So put the reminder outside your head. A weekly pill organiser sitting on top of whatever you pick up every morning, an alarm with the name of the medicine in it, the box beside the kettle. Attach it to something you already do without thinking rather than trying to remember it on its own. If weekend doses keep getting missed, decide with your prescriber whether that actually matters for you rather than carrying a low hum of guilt about it.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Qur’an and Sunnah
Do not enter all by one gate, use different gates. I trust in Him (Quran 12:67). The sensible precaution and the trust in God sit in the same passage, not on opposite sides of it.
وَقَالَ يَٰبَنِيَّ لَا تَدۡخُلُواْ مِنۢ بَابࣲ وَٰحِدࣲ وَٱدۡخُلُواْ مِنۡ أَبۡوَٰبࣲ مُّتَفَرِّقَةࣲۖ وَمَآ أُغۡنِي عَنكُم مِّنَ ٱللَّهِ مِن شَيۡءٍۖ إِنِ ٱلۡحُكۡمُ إِلَّا لِلَّهِۖ عَلَيۡهِ تَوَكَّلۡتُۖ وَعَلَيۡهِ فَلۡيَتَوَكَّلِ ٱلۡمُتَوَكِّلُونَ
He said, ‘My sons, do not enter all by one gate- use different gates. But I cannot help you against the will of God: all power is in God’s hands. I trust in Him; let everyone put their trust in Him,’
Qur’an 12:67read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
A clinical practice guideline for school age children sets out that treatment should follow accurate diagnosis and combine medication with behavioural approaches and agreed target outcomes, which is where practical scaffolding belongs. In adults already taking medication, a randomised trial found that adding cognitive behavioural therapy improved core symptoms, with mixed effects on other problems. In both, medication and habit work are partners rather than alternatives.
Subcommittee on Attention-Deficit/Hyperactivity Disorder Committee on Quality Improvement (2001). Clinical Practice Guideline: Treatment of the School-Aged Child With Attention-Deficit/Hyperactivity Disorder. PEDIATRICS doi
Young S, Khondoker M, Emilsson B, Sigurdsson JF, Philipp-Wiegmann F, Baldursson G, Olafsdottir H, Gudjonsson G. (2015). Cognitive-behavioural therapy in medication-treated adults with attention-deficit/hyperactivity disorder and co-morbid psychopathology: a randomized controlled trial using multi-level analysis.. Psychological medicine doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Remembering to do a thing at a particular time is the weak point, so the reminder has to sit outside you.
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
The most useful question about a dose is whether the person can tell. A shrug and 'I think it sort of helps a bit' usually means it is not yet doing its job.
One question is worth asking before choosing between products: which part of the day actually goes wrong? Bead type capsules tend to give more early on, while the pump type keeps more back for the afternoon.
A child who has spent years being told they are careless will often say yes to whoever finally seems glad of them. Work on how they see themselves is not a soft extra to the clinical work.