Practices

Every practice in the library, in one list. Narrow it by how long you have, who it is written for, and where you are right now.

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When a prescription cannot be filled, you can report it to the medicines regulator's shortage inbox, naming the medication and the pharmacy. Nobody writes back, and people often find their prescription turns up soon afterwards.

The value of this is partly practical and partly in not being stuck. Being told no at a counter, month after month, is what makes people quietly…

Five minutesMedication and how it worksMedical and treatmentQur’an 65:3One line of research

When a dose wears off, things can feel worse than they ever did untreated. A good deal of that is contrast rather than the medicine leaving a debt behind.

You have spent the day at one level and then meet your own baseline without warning, late in the afternoon, usually with something still to do.…

Five minutesMedication and how it worksMedical and treatmentQur’an 55:8One line of research

For a fair share of children, medication does more than take the edges off. Their behaviour in class comes back inside the ordinary range, which few treatments in psychiatry manage.

That matters for reasons past the symptoms themselves. A child who is no longer the one named in every staff meeting gets spoken to differently by…

Five minutesMedication and how it worksMedical and treatmentQur’an 55:8One line of research

The stimulants get described as dopamine drugs, and they touch noradrenaline as well. That second effect is what led to medicines aimed at noradrenaline on its own.

Noradrenaline at the front of the brain helps hold a signal steady against background noise, which is a plain description of what working memory…

Five minutesMedication and how it worksMedical and treatment

Looking for a whole subject rather than a single practice? Start from the nine areas.

Feelings and focus

Practising under provocation

Shame and stigma

Screens and attention

Making it stick

Breathing

What worry does

Treatment and medication

Feeling from the inside

Structure and routine

What you are actually defending

Being seen and judged

Growing empathy

Tolerate distress

When you use something to cope

Remembering to do it

Reading, numbers and learning differences

Breaking the worry loop

Righteous anger and perfectionism

Obsessions and compulsions

Emotions as signals

Self-compassion

Facing it a step at a time

Shame

Posture and how you carry yourself

Question the thought

Anger, alcohol and the body

Use your strengths

When anger turns to harm

Letting it out safely

When you go numb

Living with uncertainty

Rest and pacing

Panic and the body

The cost of avoiding

Qur’an 20:114

One line of research

The alpha-2 medicines work differently again. Picture small ports on the receiving cell that let noise in and let signal leak away, and a medicine that closes them.

Because they act on how clear the signal is rather than on how much transmitter is around, they tend to help most with restlessness, temper and tics,…

Five minutesMedication and how it worksMedical and treatmentQur’an 73:20One line of research

There has been no genuinely new stimulant molecule for decades. What is new is almost always the delivery: how fast it arrives, how long it lasts, whether it can be sprinkled or chewed.

So when something is described as a new medication, the useful question is about its shape across the day rather than a new mechanism. That is no…

Five minutesMedication and how it worksMedical and treatmentQur’an 53:28One line of research

New medicines will probably come from genetics and from the chemistry of the frontal lobes. None of it is close enough to be worth waiting for.

Compounds acting on particular dopamine receptors, on glutamate, and on nicotinic pathways have all been proposed, and the nicotinic route has…

Five minutesMedication and how it worksMedical and treatmentQur’an 12:44One line of research

Some capsules are tiny pumps. A coating of powder gives an early lift, then water seeps in and slowly pushes a gel of medicine out through a laser drilled hole, with a little more strength held back for later in the day.

Knowing this changes what you expect from it. The rise is gentle rather than sudden, the afternoon is deliberately given a slightly stronger push…

Five minutesMedication and how it worksMedical and treatmentQur’an 26:80One line of research

One of the amphetamine medicines arrives switched off. It is bound to a simple building block of protein and only wakes up once the body cuts the two apart, which is why crushing or snorting it gets you nowhere faster.

That was designed in on purpose. Because the gate is an enzyme rather than a coating, there is no way to get in front of it, and the medicine comes…

Five minutesMedication and how it worksMedical and treatmentQur’an 12:67One line of research

That locked design turned out to carry an unplanned kindness: a somewhat longer day, and for many teenagers and adults a softer start and a softer finish, with less jaw clenching and less of the ragged hour when it wears off.

The edges often matter more to the person taking the medicine than the peak does. If you dread the late afternoon drop, or notice your jaw aching by…

Five minutesMedication and how it worksMedical and treatmentQur’an 16:69One line of research

You may hear that staying on stimulant medication for years can shift the structure of the brain itself, not only the day. It is a real line of research and it is still an open question, so hold it lightly.

The work points at a handful of regions involved in attention and movement, and at a minority of people who stayed on treatment for several years.…

Five minutesMedication and how it worksMedical and treatmentQur’an 16:69One line of research

A good response to a stimulant is a piece of information, not a verdict. These drugs sharpen attention in people who do not have ADHD as well, so feeling better on one confirms nothing on its own.

It still counts for something. Set beside a full history it can add weight, particularly where the picture was unclear to begin with. What it cannot…

Five minutesMedication and how it worksMedical and treatmentQur’an 49:6One line of research

It is a fair question to ask of anybody telling you about a medicine: what is their interest in it. Good clinicians answer without flinching, and some have said the unwelcome thing to a room that paid for their flight.

You are not accusing anyone by asking. Talks, printed materials and study days are often funded by the company that makes the drug, and that funding…

Five minutesMedication and how it worksMedical and treatmentQur’an 17:35One line of research

There is an old joke among researchers that you should use a new treatment quickly, while it still appears to work. It is funny because early results really do tend to shrink.

First studies are usually small, run by people who believe in the thing, and more likely to reach print when they come out well. Replication brings…

Five minutesMedication and how it worksMedical and treatmentQur’an 20:114One line of research

A workable rule for anything new: do not be the first to use it, and do not be the last either. Both ends carry a cost.

Being first means carrying the risks nobody has found yet. Being last means somebody waits years for help that was already sitting there. Most…

Five minutesMedication and how it worksMedical and treatmentQur’an 55:8One line of research

The medicine can help you focus. It will not make you want to study. Those are two different jobs and only one of them comes in a tablet.

Expect the difference to show up as an odd hour or two where you can sit still and hold a page, and still do not fancy the page. That is the drug…

Five minutesMedication and how it worksMedical and treatmentQur’an 17:36One line of research

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.

If home has been miserable for two years, feeling steadier may just mean you notice the misery more sharply. People often read that as the medicine…

Five minutesMedication and how it worksMedical and treatmentQur’an 21:83One line of research

A nerve cell spends its life adding up. Signals arrive along its branches, the body of the cell totals them, and at one particular point it either fires or it does not.

That threshold is where the pushing and the holding back meet, and it is roughly the level at which these medicines work. None of them decides…

Five minutesMedication and how it worksMedical and treatmentQur’an 55:8One line of research

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.

Drugs that block the clearing away work on the sending side. Drugs that imitate or block the message work on the receiving side. Drugs that stop the…

Five minutesMedication and how it worksMedical and treatmentQur’an 16:43One line of research

A single nerve cell can be in contact with hundreds of others. That fanning out is the plainest reason side effects exist at all.

A tablet goes into your bloodstream and reaches everywhere the chemical it acts on is used, and these chemicals are used in far more than the circuit…

Five minutesMedication and how it worksMedical and treatmentQur’an 4:28One line of research