AreasFocus, starting, and ADHDTreatment and medication

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People who use several kinds of help tend to report more benefit than people relying on one. Medication, therapy, coaching, reading, sleep and movement all seem to add something rather than compete.

That turns a hard conversation into an easier one. Instead of pressing a reluctant partner towards the single thing they least want, you can offer a range and let them start where they are willing. Something usually pulls another thing along with it: better sleep makes the therapy homework possible, medication makes the organising stick. Starting anywhere is far better than the long argument about starting with the right thing.

Before you use this

This explains how treatments work. Never start, stop or change a medication because of something you read here.

Qur’an and Sunnah

Follow the ways made easy for you by your Lord (Quran 16:69). More than one road is provided, and taking the one currently open to you is not a lesser choice.

ثُمَّ كُلِي مِن كُلِّ ٱلثَّمَرَٰتِ فَٱسۡلُكِي سُبُلَ رَبِّكِ ذُلُلࣰ اۚ يَخۡرُجُ مِنۢ بُطُونِهَا شَرَابࣱ مُّخۡتَلِفٌ أَلۡوَٰنُهُۥ فِيهِ شِفَآءࣱ لِّلنَّاسِۚ إِنَّ فِي ذَٰلِكَ لَأٓيَةࣰ لِّقَوۡمࣲ يَتَفَكَّرُونَ

Then feed on all kinds of fruit and follow the ways made easy for you by your Lord.’ From their bellies comes a drink of different colours in which there is healing for people. There truly is a sign in this for those who think

Qur’an 16:69read it in the library

Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.

What the research says

In 124 adults with ADHD, CBT combined with medication was compared with CBT alone across core symptoms, emotional symptoms, self esteem and functioning, which is the clearest test in this bank of whether two things together beat one. Alongside it, a network meta-analysis set pharmacological, psychological and complementary treatments for children and adolescents against each other rather than each against placebo. Neither tested a whole stack of five approaches, so read them as support for combining rather than as a formula for how many.

Pan MR, Huang F, Zhao MJ, Wang YF, Wang YF, Qian QJ. (2019). A comparison of efficacy between cognitive behavioral therapy (CBT) and CBT combined with medication in adults with attention-deficit/hyperactivity disorder (ADHD).. Psychiatry research doi

Catalá-López F, Hutton B, Núñez-Beltrán A, Page MJ, Ridao M, Macías Saint-Gerons D, Catalá MA, Tabarés-Seisdedos R, Moher D. (2017). The pharmacological and non-pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: A systematic review with network meta-analyses of randomised trials.. PloS one doi

Strength of evidence: one line of research. A single study, or a theoretical account.

Why it works

Each kind of help works on a different part of the problem, so they add up rather than repeating each other.

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

More on focus, starting, and adhd

People who use several kinds of help tend to report more benefit than people relying on one. Medication, therapy, coaching, reading, sleep and movement all seem to add something rather than compete · Inshirah