Loading practices
Loading practices
Areas › Focus, starting, and ADHD › Medication and how it works
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 attention difficulty plus treatments for the anxiety, mood or sleep that came with it. If nobody can say what one of them is doing, that is the one to raise at the next review.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
'Give full measure when you measure, and weigh with accurate scales' (Quran 17:35). Going through a regimen item by item, honestly, is that kind of weighing.
الإسراء
وَأَوۡفُواْ ٱلۡكَيۡلَ إِذَا كِلۡتُمۡ وَزِنُواْ بِٱلۡقِسۡطَاسِ ٱلۡمُسۡتَقِيمِۚ ذَٰلِكَ خَيۡرࣱ وَأَحۡسَنُ تَأۡوِيلࣰ ا
Give full measure when you measure, and weigh with accurate scales: that is better and fairer in the end
Qur’an 17:35read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
A randomised trial added cognitive behavioural therapy for adults already taking ADHD medication and found core symptoms improved, while effects on the accompanying problems were mixed. So the difficulties that travel with ADHD are targets in their own right and they do not simply lift once the main treatment works. The trial tested therapy rather than a second drug, though the logic for adding something is the same.
Young S, Khondoker M, Emilsson B, Sigurdsson JF, Philipp-Wiegmann F, Baldursson G, Olafsdottir H, Gudjonsson G. (2015). Cognitive-behavioural therapy in medication-treated adults with attention-deficit/hyperactivity disorder and co-morbid psychopathology: a randomized controlled trial using multi-level analysis.. Psychological medicine doi
Strength of evidence: one line of research. A single study, or a theoretical account.
A long list of medicines makes sense once each one is matched to the problem it was added for.
A synapse is three things rather than one: the end of the cell sending, the gap itself, and the surface of the cell receiving. Ask which of the three a drug acts on and most of its behaviour follows.
The skin patch comes with two things worth knowing before you start. Take it off several hours before bedtime or it keeps delivering and sleep goes, and around one person in six gets a rash bad enough to stop.
You may hear that being treated as a child leaves an advantage that lasts even after you stop. It is a comforting claim and the strongest evidence does not quite bear it out.