Practices

If you want to use herbal remedies, two things carry most of the risk. Make sure whoever prescribes for you knows what you are taking, and buy from a source that has been independently tested.

That is a short list on purpose. Nearly all the harm in this area comes from an interaction nobody knew about or a product that was not what it…

Water, sleep, food and digestion are not the boring preamble to the real work. When those are running badly, everything else you try has less to work with.

It can feel almost insulting to be asked about breakfast when what you carry is so much bigger than breakfast. But a body short of sleep and short of…

If you are testing whether a food affects you or your child, the test has to be complete. Among children with suspected sensitivity to artificial colouring, most reacted to as little as 100 mg, so a bit left in is enough to blur the answer.

What usually happens is that a family removes the obvious sources, misses the ones hidden in medicines, sauces and cereals, sees no change, and…

If you are going to test whether a food matters, work out in advance where the plan will leak. School lunch swaps, a grandparent's biscuit tin, your own memory on a hard week: all of it decides whether the answer means anything.

Change one thing at a time and keep everything else steady, otherwise you cannot tell which change did what. Then be honest about who is running the…

When something has gone wrong across several systems, expecting one treatment to fix it is usually the mistake. Movement, processing what happened, changes to food and work on calming the body tend to add up in a way that none of them manages alone.

This is not an argument for doing everything at once until you are exhausted. It is an argument against giving up on the whole idea when the first…

Four things carry most of the difference within the class: how much it sedates, how much it activates, what it does to weight, and what it does to sex.

Before anything is chosen, write down which of the four you cannot live with. Almost nobody is neutral about all four, and the one you will not…

Match the tablet to the person rather than to the diagnosis. For someone flattened and slowed who has said clearly that they will not accept sexual side effects, paroxetine is close to the worst choice available.

It is the most sedating in the class, the least activating, and carries a high risk of exactly the effect they ruled out, with weight gain and the…

If you are the therapist, hand the prescriber the profile and leave them the pick. What you hold that they do not is what this person is like across a week, and what they will absolutely not tolerate.

So write those two things down and send them: the presentation, in plain description rather than jargon, and the non-negotiables. Not a drug name.…

If a treatment reliably produces strange sensations, describe them beforehand. Expected strangeness is far easier to sit through than strangeness that arrives unannounced.

With esketamine, feeling oddly detached from your body or the room is the drug doing what it does, not a sign of harm, and it usually clears within a…

If you are living on campus, ask the pharmacist to split the month's supply across two labelled bottles. Then whichever one you are carrying has a valid prescription label on it.

Carrying a controlled medicine loose in a bag, or in an unlabelled tin, is a disciplinary and sometimes legal problem quite separate from any medical…

Saying that medication helps is not the same as saying everyone should be on it. If you have walked in braced for a push, it is fine to say so at the start.

Plenty of people do well with sleep, movement, work that suits them and someone in their corner, and plenty of people need all of that and a tablet…

Stimulants have been used for this since 1937. That is a long time for any treatment to survive, and very few do.

Longevity is a different argument from a trial result. It means decades of changing fashion, competing products, repeated safety scares and reviews,…

These medicines do not pour a foreign chemical into you. Mostly they help you hold on to the serotonin your body already makes, so whatever follows is yours.

The worry underneath is usually about authenticity: that any lift will be counterfeit, or that it will not really be you feeling it. Knowing that the…

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.…

Stimulant medication does not install an ability you did not have. It raises how much signal is available at the junctions between nerve cells, so the circuits you already own can hold that signal long enough to use it.

Messages pass between nerve cells across a tiny gap, carried by chemicals that are released and then taken back up again. These medicines mostly slow…

These medicines have been in use since roughly the 1930s, so there is far more accumulated experience with them than with most psychiatric drugs. That does not settle every question, but you are not part of an experiment.

The length of that record is worth having in mind when somebody hands you an alarming claim about what stimulants do across decades. It is also worth…

Worry about height is one of the commonest reasons families hesitate. The answer is to measure: height and weight plotted at every review, so you are watching an actual line rather than guessing at one.

Growth speeds up and slows down for all sorts of reasons during the years a child might be medicated, and one measurement tells you almost nothing. A…

You will hear confident claims in both directions: that stimulants permanently rewire a child's brain, and that they leave nothing behind at all. The honest position sits between the two, and it helps to know which parts are settled.

Well established: the medicines work while they are in the body, and the benefit is real. Not settled: whether long exposure during childhood leaves…

Some long acting tablets are small machines. The coating gives you the first part within about half an hour, then fluid seeps in through a laser drilled hole and pushes the rest out steadily across eight to ten hours.

Knowing this turns a vague pill into something a hesitant person can picture, which is often what they needed. It also explains why the empty shell…

One of these medicines arrives inactive and has to be broken down by your own body before it does anything at all. That design flattens the rise and removes the spike that misuse depends on.

If fear of addiction is what is holding you back, ask your prescriber about this by name, because formulation is one of the levers they have. Taken…