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Areas › Focus, starting, and ADHD › Medication and how it works
So somebody who says their generic feels different is not being fanciful, and is not usually being cheated either. Tablets are held to a band rather than to an exact figure, and the fillers carrying the drug affect how it dissolves. If a switch really did change things for you, say which pharmacy and which manufacturer, because that is what makes it fixable. Say it without the conspiracy, since the boring explanation is nearly always the true one.
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). Honest measure is the standard, and knowing how wide the permitted band is belongs to honesty too.
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.
Delivery is a real variable rather than a technicality. A randomised crossover trial found a once daily long acting methylphenidate matched the same drug given three times a day, in a laboratory and in ordinary settings, which is a comparison of delivery rather than of molecules. On the money side, a systematic review of economic evaluations generally found ADHD drug treatments cost effective, while noting wide variation in the assumptions behind the models. Neither of them settles what any one switch will feel like to you.
William E. Pelham; Elizabeth M. Gnagy; Lisa Burrows-MacLean; Andy Williams; Gregory A. Fabiano; Sean M. Morrisey (2001). Once-a-Day Concerta Methylphenidate Versus Three-Times-Daily Methylphenidate in Laboratory and Natural Settings. PEDIATRICS doi
Wu EQ, Hodgkins P, Ben-Hamadi R, Setyawan J, Xie J, Sikirica V, Du EX, Yan SY, Erder MH. (2012). Cost effectiveness of pharmacotherapies for attention-deficit hyperactivity disorder: a systematic literature review.. CNS drugs doi
Strength of evidence: one line of research. A single study, or a theoretical account.
The molecule is identical and the delivery of it is where the variation lives.
If a switch has clearly changed how you are, raise it with the prescriber or pharmacist rather than adjusting how much you take.
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 one family of stimulant did nothing, or felt awful, that tells you very little about the other. Methylphenidate and amphetamine work in overlapping but different ways, and plenty of people who do badly on one do well on the other.
A medicine can give you back some energy. It cannot turn a bad situation into a good one, and it helps to be clear which of the two you are hoping for.