Areas › Focus, starting, and ADHD › Medication and how it works
Methylphenidate and amphetamine are not two names for the same thing. One mainly blocks dopamine from being taken back up, and the other does that and pushes more of it out as well.
That extra step is why the amphetamines tend to produce somewhat larger average effects, and why somebody who got nothing from one can do well on the other. If a first attempt disappoints, this is the specific question to ask: have we tried the other class, or another version of the same one? Keep the names and doses written down somewhere, because nobody remembers them accurately two years later.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Qur’an and Sunnah
'ask those who have knowledge if you do not know' (Quran 16:43). Which class you have actually tried is exactly the sort of question to put to a prescriber rather than guess at.
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
A meta-analysis pooling double-blind placebo-controlled trials in children and adolescents found amphetamine formulations showed somewhat larger effects than methylphenidate, while noting that direct head-to-head trials remain scarce. Somewhat larger on average says nothing about any individual, and the shortage of direct comparisons is a genuine limit. It is enough to establish that the two are not interchangeable.
Faraone SV, Buitelaar J. (2010). Comparing the efficacy of stimulants for ADHD in children and adolescents using meta-analysis.. European child & adolescent psychiatry doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
A second way of raising the same signal can work where blocking alone did not.
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
Ask for the actual list. Not some side effects, but the specific ones people commonly get in the first week or two, and roughly when they tend to settle.
The old argument about medication against behaviour therapy was set down years ago. The useful question now is what each one covers.
A short acting dose lasts around four to six hours in most people, and bodies vary a great deal around that. Some clear it quickly and feel almost nothing, some clear it slowly and feel every side effect at a small dose.