Areas › Focus, starting, and ADHD › Medication and how it works
Offered ten pounds now or twenty in an hour, plenty of people with attention difficulties take the ten and know while they are doing it that it makes no sense. The pull towards now is not a flaw of character.
It shows up in a laboratory and it shows up on a bank statement. Naming it helps, because a thing with a name can be planned around: money moved by standing order before you see it, a rule that anything over a set amount waits until tomorrow, the card left at home on a bad day. You are not trying to become patient by force. You are removing the moment where the choice gets made.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Qur’an and Sunnah
'God will be enough for those who put their trust in Him' (Quran 65:3), and He has set a due measure for everything. Trusting that what is due to you will reach you makes waiting feel less like losing.
وَيَرۡزُقۡهُ مِنۡ حَيۡثُ لَا يَحۡتَسِبُۚ وَمَن يَتَوَكَّلۡ عَلَى ٱللَّهِ فَهُوَ حَسۡبُهُۥٓۚ إِنَّ ٱللَّهَ بَٰلِغُ أَمۡرِهِۦۚ قَدۡ جَعَلَ ٱللَّهُ لِكُلِّ شَيۡءࣲ قَدۡرࣰ ا
and will provide for them from an unexpected source; God will be enough for those who put their trust in Him. God achieves His purpose; God has set a due measure for everything
Qur’an 65:3read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
A randomised trial compared methylphenidate's effects on the human dopamine system in younger and in adult patients and found they differed by age, which leaves open questions about lasting effects. It measured brain chemistry rather than choices about money, so it does not show that medication makes anyone more patient. What it does is place these choices in a system that medication acts on rather than in someone's character.
Schrantee A, Tamminga HG, Bouziane C, Bottelier MA, Bron EE, Mutsaerts HJ, Zwinderman AH, Groote IR, Rombouts SA, Lindauer RJ, Klein S, Niessen WJ, Opmeer BC, Boer F, Lucassen PJ, Andersen SL, Geurts HM, Reneman L. (2016). Age-Dependent Effects of Methylphenidate on the Human Dopaminergic System in Young vs Adult Patients With Attention-Deficit/Hyperactivity Disorder: A Randomized Clinical Trial.. JAMA psychiatry doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
The value of a reward drops away steeply with waiting here, so the decision is easier to avoid than to win.
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
Blood pressure on a stimulant is an individual matter. For most people it is a non-event, and where it does rise the answer is often a different stimulant rather than none at all.
When somebody decides against medication, respect the decision and then say the rest plainly. Some of the struggle will stay, and no amount of therapy or another clever app will fully close that gap.
Where anxiety sits alongside the attention difficulty, a non-stimulant is sometimes the better first choice. Stimulants sharpen anxiety in some people, and that is a hard trade to live with.