Areas › Focus, starting, and ADHD › Medication and how it works
Writing 'do not substitute' on a prescription tells the pharmacist what to hand over. It does not tell an insurer to pay for it, and that surprise at the counter is where a lot of prescriptions quietly get abandoned.
If a particular brand is being chosen for a reason, say out loud what it might cost and what the fallback is if the price turns out to be impossible. People are far more likely to ring back and ask when they have been warned it could happen. A prescription nobody collects helps nobody, however well it was chosen.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Qur’an and Sunnah
Jacob told his sons 'do not enter all by one gate, use different gates' (Quran 12:67). Sensible precaution taken in advance is not a failure of trust, and naming the likely obstacle before it arrives is that kind of precaution.
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 systematic review of economic evaluations of ADHD medicines generally found them cost effective, while noting wide variation in the assumptions behind the models. Those are health system sums rather than household ones. Something affordable for a service can still be out of reach at a counter in a particular week, so the household figure is worth asking about directly rather than inferring.
Wu EQ, Hodgkins P, Ben-Hamadi R, Setyawan J, Xie J, Sikirica V, Du EX, Yan SY, Erder MH. (2012). Cost effectiveness of pharmacotherapies for attention-deficit hyperactivity disorder: a systematic literature review.. CNS drugs doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
A cost somebody was not expecting feels like a closed door, and most people walk away from a closed door rather than knock.
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
For a family stuck on whether to medicate at all, the comparison with diabetes often unlocks something. Nobody manages diabetes on diet alone, and nobody calls insulin a moral failure.
If a young driver in your house takes medication, the dose and the car keys belong together. Driving is the everyday task where one lost second costs the most.
In simulator work the biggest improvements on medication show up in the drivers who were worst without it: stopping properly, slowing for an amber, actually looking around.