Practices

These are among the best studied medicines in psychiatry, in use for decades. Most of the hesitancy around them traces back to how they get covered in the press rather than to the safety record.

Saying that is not the same as saying there is nothing to watch. Heart rate and blood pressure shift a little, appetite and sleep often need…

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.

Offered gently it moves the question from what kind of parent am I towards what does this condition need. Played as a trump card it makes people…

There are three families of medicine here: the stimulants, the agents that work on noradrenaline alone, and the alpha-2 drugs that began as blood pressure treatments. Three routes rather than three brands of one thing.

That matters when one of them does not work or cannot be used. A poor response inside one family says little about the others, so a sequence has…

The potential for misuse belongs to one of the three families rather than to ADHD medicines generally. The stimulants reach the reward circuitry and the others do not.

That gives a clear answer where there is a substance history in the house, or a worry about tablets going missing at school. Say plainly that a…

Finding the dose is a search rather than a calculation. It goes up in small steps until either the effect you want turns up, or the side effects get annoying enough that you come back down a step and settle there.

There is no way to work the right dose out from body weight or from how bad things look, which surprises people who expect medicine to be more exact…