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Areas › Focus, starting, and ADHD › Medication and how it works
This comes up in waiting rooms and family group chats and it causes real alarm about being on a lot. The number on the box only means something beside the usual range for that particular drug. If the size of your dose is worrying you, ask where it sits within that range, which is the version of the question that has an answer.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
God has set a due measure for everything (Quran 65:3). Each thing having its own measure is a neat description of why one number cannot be read across to another.
الطلاق
وَيَرۡزُقۡهُ مِنۡ حَيۡثُ لَا يَحۡتَسِبُۚ وَمَن يَتَوَكَّلۡ عَلَى ٱللَّهِ فَهُوَ حَسۡبُهُۥٓۚ إِنَّ ٱللَّهَ بَٰلِغُ أَمۡرِهِۦۚ قَدۡ جَعَلَ ٱللَّهُ لِكُلِّ شَيۡءࣲ قَدۡرࣰ ا
and will provide for them from an unexpected source; God will be enough for those who put their trust in Him. God achieves His purpose; God has set a due measure for everything
Qur’an 65:3read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
Comparing drugs properly is hard work. A meta-analysis pooling placebo controlled trials found amphetamine formulations showed somewhat larger effects than methylphenidate in children and adolescents, while noting that direct head to head trials are scarce. A separate systematic review had to compare medications for adults indirectly for exactly that reason. If specialists need methods like these to compare two drugs, a comparison of milligram counts between friends will not tell you much.
Faraone SV, Buitelaar J. (2010). Comparing the efficacy of stimulants for ADHD in children and adolescents using meta-analysis.. European child & adolescent psychiatry doi
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.
Each molecule has its own strength, so a count of milligrams says nothing on its own.
Nobody is sitting in the passenger seat handing out rewards for safe driving. Medication is the part of treatment that is present when no adult is.
For a family stuck on whether to medicate at all, the comparison with diabetes often unlocks something. Nobody manages diabetes on diet alone, and nobody calls insulin a moral failure.
The growth effect is usually small: something like a couple of pounds and a centimetre or two less than expected in the first year or two, with most children catching up afterwards. Knowing the size of it helps, because both blank reassurance and quiet dread are worse than the actual number.