Areas › Focus, starting, and ADHD › Treatment and medication
If the prescriber, coach or therapist is not delivering much, say so and ask for someone else. Working around poor care quietly is the thing that convinces a couple this is simply as good as it gets.
A dose never revisited, or a therapist who has never worked with ADHD, sets a low ceiling. The trouble is that the ceiling gets read as the person: this is what he can manage, this is how much she is capable of. Changing the care changes that belief too, which is often the more important repair. Asking for a second opinion is an ordinary request, not a complaint about anyone.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Qur’an and Sunnah
Do not despair of God's mercy (Quran 12:87). A ceiling set by treatment that was never finished is not a verdict on either of you.
يَٰبَنِيَّ ٱذۡهَبُواْ فَتَحَسَّسُواْ مِن يُوسُفَ وَأَخِيهِ وَلَا تَاْيۡـَٔسُواْ مِن رَّوۡحِ ٱللَّهِۖ إِنَّهُۥ لَا يَاْيۡـَٔسُ مِن رَّوۡحِ ٱللَّهِ إِلَّا ٱلۡقَوۡمُ ٱلۡكَٰفِرُونَ
My sons, go and seek news of Joseph and his brother and do not despair of God’s mercy- only disbelievers despair of God’s mercy.’
Qur’an 12:87read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
An indirect comparison meta-analysis of competing medications for adult ADHD was carried out precisely because guideline committees disagree about which to prescribe first and few trials compare drugs head to head. That disagreement is worth knowing about as a patient, because what you were started on reflects a genuinely unsettled question rather than a settled answer. It compares medicines indirectly, so it supports asking for a review rather than telling you which one to ask for.
Peterson K, McDonagh MS, Fu R. (2008). Comparative benefits and harms of competing medications for adults with attention-deficit hyperactivity disorder: a systematic review and indirect comparison meta-analysis.. Psychopharmacology doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Poor treatment looks exactly like a low limit, so fixing the treatment is what shows the limit was never real.
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
Said plainly, because it should be: medication is the most effective treatment for ADHD, and by a good margin. Everything else in this area is something you add to that decision, not something that replaces it.
Do not write off simply sitting with someone. When researchers looked into why dummy treatments helped, one of the things they kept finding was half an hour of a person's full attention.
Think of it the way you would think about diabetes. Something to manage with several things at once, most days, for as long as it is there.