Areas › Focus, starting, and ADHD › Treatment and medication
A great many people are diagnosed and then left with a starting dose nobody ever revisited, no reading, no group, nothing else at all. If things have stalled, the first thing to check is whether the treatment was ever actually finished.
Optimising is unglamorous and often the quickest thing available. Was the dose ever adjusted upwards, and on what basis. Does the cover reach the hours that matter most in your house. Has anyone here read anything about ADHD since the appointment. A good number of cases that look treatment resistant turn out to be treatment left half done.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Qur’an and Sunnah
God will find a way out for those who are mindful of Him (Quran 65:2). A stalled treatment is rarely the end of the road, and going back to ask again is part of the way out.
فَإِذَا بَلَغۡنَ أَجَلَهُنَّ فَأَمۡسِكُوهُنَّ بِمَعۡرُوفٍ أَوۡ فَارِقُوهُنَّ بِمَعۡرُوفࣲ وَأَشۡهِدُواْ ذَوَيۡ عَدۡلࣲ مِّنكُمۡ وَأَقِيمُواْ ٱلشَّهَٰدَةَ لِلَّهِۚ ذَٰلِكُمۡ يُوعَظُ بِهِۦ مَن كَانَ يُؤۡمِنُ بِٱللَّهِ وَٱلۡيَوۡمِ ٱلۡأٓخِرِۚ وَمَن يَتَّقِ ٱللَّهَ يَجۡعَل لَّهُۥ مَخۡرَجࣰ ا
When they have completed their appointed term, either keep them honourably, or part with them honourably. Call two just witnesses from your people and establish witness for the sake of God. Anyone who believes in God and the Last Day should heed this: God will find a way out for those who are mindful of Him
Qur’an 65:2read 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 controlled and naturalistic studies found that stimulants are recommended first and do work in the short term, while much less is known about their effect on long term outcomes in adults. So the evidence for setting treatment up is stronger than the evidence for what happens over years, which argues for reviewing it rather than setting it and forgetting it. That is a summary of a literature and not a rule about your particular dose.
Fredriksen M, Halmøy A, Faraone SV, Haavik J. (2013). Long-term efficacy and safety of treatment with stimulants and atomoxetine in adult ADHD: a review of controlled and naturalistic studies.. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
A treatment that was never adjusted has not really been tried yet.
When not to
Changes to dose or to medicine belong with the prescriber rather than with a decision made at home.
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
Two of the three big advances in ADHD over recent decades were not new treatments at all. They were clearer thinking about what the difficulty actually is, and honest accounting of what psychological treatment can and cannot deliver.
Part of why so many adults are coming forward now is that well known people have said out loud that they have this. Seeing someone capable say it makes the asking cost less.
A ramp does nothing for someone's legs, and it gets them into the building. Timers, visible clocks, a shorter task list and a calendar somebody else keeps do the same job here.