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Areas › Focus, starting, and ADHD › Medication and how it works
It is easy to write a whole drug into the allergy box after a bad experience with a patch, and that single line can close off a first choice treatment for years. A reaction where something sat against the skin is a different event from a whole body reaction to a swallowed dose. Ask for what happened to be recorded in words, in detail, rather than as a bare allergy label.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
'do not forbid the good things God has made lawful to you' (Quran 5:87). Ruling out a permitted remedy on a misunderstanding is its own kind of harm.
المائدة
يَٰٓأَيُّهَا ٱلَّذِينَ ءَامَنُواْ لَا تُحَرِّمُواْ طَيِّبَٰتِ مَآ أَحَلَّ ٱللَّهُ لَكُمۡ وَلَا تَعۡتَدُوٓاْۚ إِنَّ ٱللَّهَ لَا يُحِبُّ ٱلۡمُعۡتَدِينَ
You who believe, do not forbid the good things God has made lawful to you- do not exceed the limits: God does not love those who exceed the limits
Qur’an 5:87read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What makes this worth getting right is what would otherwise be lost. An updated systematic review of treatments for adolescents found methylphenidate to be a well established treatment in this age group, while behaviour therapy had only preliminary support for these years. Giving up a well established option over a skin reaction is a costly mistake, even though that review says nothing about patches or rashes itself.
Sibley MH, Kuriyan AB, Evans SW, Waxmonsky JG, Smith BH. (2014). Pharmacological and psychosocial treatments for adolescents with ADHD: an updated systematic review of the literature.. Clinical psychology review doi
Strength of evidence: one line of research. A single study, or a theoretical account.
A reaction in the skin under the patch does not predict how the same medicine behaves once it is absorbed from the gut.
This is a judgement for the prescriber, who needs the details of what the reaction actually looked like.
Breaks from medication at weekends or over the summer are a tool for a particular problem, usually growth, rather than something everyone ought to be doing. Where growth is fine, a holiday tends to cost more than it gains.
Waiting to see how they get on carries a cost that is easy to miss. Every year a child spends behind narrows what is available to them the year after.
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.