Areas › Focus, starting, and ADHD › Medication and how it works
To find out whether treatment is helping, ask the people who live with the person. One parent who stopped her medication for a family holiday remembered a lovely trip, while her children remembered running it.
Two teenagers had packed for her, fetched what she forgot, and kept an eye on the airport clock. She had no idea any of it happened. There is no blame in this, and it is the reason to ask more than one person before concluding that a medicine makes no difference. Children will usually answer honestly if they are asked gently and not in front of everybody.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Qur’an and Sunnah
'Consult with them about matters' (Quran 3:159). Asking the household what they have noticed is consultation of the most ordinary kind.
فَبِمَا رَحۡمَةࣲ مِّنَ ٱللَّهِ لِنتَ لَهُمۡۖ وَلَوۡ كُنتَ فَظًّا غَلِيظَ ٱلۡقَلۡبِ لَٱنفَضُّواْ مِنۡ حَوۡلِكَۖ فَٱعۡفُ عَنۡهُمۡ وَٱسۡتَغۡفِرۡ لَهُمۡ وَشَاوِرۡهُمۡ فِي ٱلۡأَمۡرِۖ فَإِذَا عَزَمۡتَ فَتَوَكَّلۡ عَلَى ٱللَّهِۚ إِنَّ ٱللَّهَ يُحِبُّ ٱلۡمُتَوَكِّلِينَ
By an act of mercy from God, you [Prophet] were gentle in your dealings with them- had you been harsh, or hard-hearted, they would have dispersed and left you- so pardon them and ask forgiveness for them. Consult with them about matters, then, when you have decided on a course of action, put your trust in God: God loves those who put their trust in Him
Qur’an 3:159read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
In a study of over three hundred children taking methylphenidate, poor adherence was linked with maternal distress and with strain in the parent and child relationship rather than with symptom severity alone. It looked at children on medication rather than at parents, and which way the influence runs is not settled. What it does establish is that treatment and family life move together, so the household is a fair place to look for evidence.
Gau SS, Shen HY, Chou MC, Tang CS, Chiu YN, Gau CS. (2006). Determinants of adherence to methylphenidate and the impact of poor adherence on maternal and family measures.. Journal of child and adolescent psychopharmacology doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
The person whose attention is affected is the least placed to notice what their attention missed.
When not to
Ask children what they have noticed, never to referee whether their parent should take a medicine.
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
There is now a version taken in the evening that only switches on around nine hours later, so it is already working when you wake. The point of it is the morning, not the night.
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.
Canada once pulled a stimulant from the market after four cardiac deaths, then reversed the decision. Three of the four had heart abnormalities from birth and the fourth had been hiking in desert heat without water.