Practices
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Theme · Medication and how it works
Put today next to the night before it, out loud and often. How did today go after seven hours of sleep, next to the day that followed staying up until three?
ADHD makes it hard to link a consequence back to a choice made hours or days earlier, so the link has to be supplied from outside until it starts…
Plenty of children on a stimulant are taking something else as well, most often an antidepressant. That second medicine is usually there for a second problem rather than for the attention itself.
It is a useful lens when a regimen has grown complicated. Ask what each item is for, and the list generally resolves into a treatment for the…
To find out whether treatment is helping, ask the people who live with the person. One parent who stopped her medication for a family holiday remembered a lovely trip, while her children remembered running it.
Two teenagers had packed for her, fetched what she forgot, and kept an eye on the airport clock. She had no idea any of it happened. There is no…
The old argument about medication against behaviour therapy was set down years ago. The useful question now is what each one covers.
They work by different routes and they reach different hours of the day, so putting them in a single contest was never going to tell anyone much.…
Adding psychosocial work to medication buys something extra, and less than people hope. The extra tends to arrive in the places medication was never going to reach.
Homework routines, the temperature of arguments at home, how a teacher speaks to a child, the hours after a dose has worn off: that is where the…
Doing the behavioural work alongside a medicine can mean managing on less of it. That matters most for the side effects that follow the size of the dose.
Appetite, sleep and irritability all tend to scale with how much is being taken. Where part of the load is carried by routines, by support at school,…
Medication treats the attention difficulty. It does not teach reading, lift a depression, or repair a household that has been fighting for years.
Those things need treatment of their own, and they are often what the family actually came about. Treating the attention difficulty well can stop…
Smoking runs high in ADHD, and nicotine genuinely does something for attention. It helps to treat that as self-medication rather than as one more impulsive habit.
It changes what a conversation about stopping looks like. If a cigarette is doing a job, taking it away and leaving the job undone is a plan that…
Stopping medication rises sharply in the early teenage years. If that is where you are, it helps to know this is the usual pattern rather than a sign that something has gone wrong with your child.
The pull is understandable: wanting to be in charge of your own body, hating being the one who is different, and a parent no longer standing over the…
When a medicine seems to be underperforming, look at what else is in the room before reaching for a higher dose. Anxiety, low mood and a wrecked sleep pattern can each blunt a good response or imitate a poor one.
Otherwise the dose climbs while the real driver goes untreated, and the side effects arrive without the benefit. Ask what a bad night actually looks…
Blood pressure on a stimulant is an individual matter. For most people it is a non-event, and where it does rise the answer is often a different stimulant rather than none at all.
No blood test or cheek swab will tell you in advance which one suits you. Finding out means trying, measuring and being willing to change, which is…
If the first medicine disappoints, that is information about the first medicine. Plenty of people who get nothing from one class do well on another.
Methylphenidate and amphetamine are not the same drug at different strengths. They work by partly different routes, so a poor result on one says…
Finding the dose is a search rather than a calculation. It goes up in small steps until either the effect you want turns up, or the side effects get annoying enough that you come back down a step and settle there.
There is no way to work the right dose out from body weight or from how bad things look, which surprises people who expect medicine to be more exact…
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