Areas › Focus, starting, and ADHD › Medication and how it works
The message is not made fresh each time it is needed. It sits ready in small sacs at the end of the cell, waiting to be tipped out into the gap.
That storeroom is itself a place drugs act. Some work by emptying the store rather than by slowing the clean up, and that is one real difference between the two families of stimulant. Worth knowing when somebody tells you the two are interchangeable, because they reach a similar end by different roads and can feel quite different on the way.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Qur’an and Sunnah
'God has set a due measure for everything' (Quran 65:3). A store kept ready and released in measure is how the body was arranged to work.
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 meta-analysis pooling double blind placebo controlled trials found amphetamine formulations somewhat more effective on average than methylphenidate in children and adolescents, while noting that direct head to head trials remain scarce. Somewhat and scarce are both carrying weight in that sentence. An average across groups still says very little about which one suits a particular person.
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 drug that empties the store behaves differently from one that only slows the tidying away.
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
When you pass on the long term brain findings to a family, call it a hypothesis out loud. The study that would settle it, years of random assignment to a real drug or a dummy one, could not ethically be run.
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.
Skipping weekends, holidays and summers is a common suggestion and mostly it is the wrong call. The difficulty does not take a holiday when school does.