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Areas › Focus, starting, and ADHD › Treatment and medication
Decent sleep, ordinary good food and keeping screens within reason sit underneath all of it as support rather than treatment, and a sleep study is worth asking for if snoring or exhaustion is in the picture. Notice where accommodations sit, since changing what a day asks of someone tends to work better than trying to change the person, and it usually costs nothing. Nobody has to take the whole list. It is a running order to choose from, not a prescription.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Follow the ways made easy for you by your Lord (Quran 16:69). Taking the route that has been made workable is presented as the sensible thing, not the lazy one.
النحل
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.
A systematic review with network meta-analyses compared drug, psychological and complementary treatments for ADHD in children and adolescents against each other, and a separate indirect comparison did the same for adult medications, undertaken because guideline committees disagree about what to prescribe first. Comparisons like these are what any ranking rests on. They give averages across groups, and the fact that experts still disagree about the order should keep anyone from stating it too flatly.
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
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.
Knowing which options do the most lets you spend limited time and money at the top of the list rather than the bottom.
Which of these fits a particular person is a decision for them and their prescriber, since age, other conditions and history all change the order.
The therapy that helps adult ADHD is not really about arguing with your thoughts. It is practical work on how your week is built, and it works because you are the one who can go and rebuild it.
Coaching for adult ADHD comes down mostly to one thing: a standing appointment with somebody who will ask how it went. That sounds thin until you have tried keeping a plan alive entirely on your own.
Think of ADHD as sitting at the centre of an onion. Poor sleep, sleep apnoea, low vitamin levels, allergy, ongoing pain, untreated anxiety or low mood all sit in layers around it, and each one makes the centre look worse than it is.