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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1061 practices

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The realistic difficulty with this medicine is not misuse. It is forgetting, since part of what is being treated is the very ability to remember to do something later.

So put the reminder outside your head. A weekly pill organiser sitting on top of whatever you pick up every morning, an alarm with the name of the…

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

A medicine can help some people and still fail to win approval for a condition. Modafinil is the usual example, cleared for a sleep disorder and short of the bar for attention.

Approval turns on trials showing a clear enough average effect for that specific use, and an average can be respectable within a subgroup while…

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

Medication does not simply turn the brain up. On scans the regions that should be busy during a task get busier, and the ones that should stay quiet settle.

That detail matters more than it sounds. It says the trouble is one of aim rather than a shortage of effort, which is the opposite of what many…

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

Watch someone on a laboratory stop task and two things move together on medication: the fidgeting drops and the stopping gets more accurate.

Holding still and holding back turn out to run on the same machinery. That is why inhibition sits underneath so much else, from waiting your turn to…

Five minutesMedication and how it worksMedical and treatmentQur’an 4:28

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

What you are actually defending

Food, caffeine and fuel

Making it stick

Feelings and focus

Breaking the worry loop

Tolerate distress

Reading, numbers and learning differences

When you use something to cope

Self-compassion

Growing empathy

Choosing your response

When everything feels flat

Anger, alcohol and the body

Righteous anger and perfectionism

Facing it a step at a time

Use your strengths

When anger turns to harm

Practising under provocation

Letting it out safely

Shame

Being seen and judged

Getting assessed and diagnosed

Question the thought

The cost of avoiding

Obsessions and compulsions

Feeling from the inside

Living with uncertainty

Rest and pacing

One line of research

You may hear that being treated as a child leaves an advantage that lasts even after you stop. It is a comforting claim and the strongest evidence does not quite bear it out.

The best known childhood trial followed its participants into their twenties. The early advantage of the assigned treatment faded, and the group…

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

Atomoxetine works on noradrenaline alone, which is why it can help genuinely and still feel milder than a stimulant. That is the trade being made rather than a sign it is failing.

Noradrenaline at the front of the brain helps a signal stand out from the background noise, so lifting it steadies working memory and attention.…

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

None of the non-stimulants should be stopped suddenly. Guanfacine and clonidine began life as blood pressure medicines, and taking them away all at once can send blood pressure sharply back up.

Atomoxetine has its own unpleasant discontinuation effects, closer to those of an antidepressant. So a break because a prescription ran out, or…

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

Guanfacine and clonidine arrived here sideways. Both were blood pressure medicines that doctors noticed helped with impulsivity, and the formal approval came long afterwards.

They act on receptors at the front of the brain that support working memory and holding a response back, which is a different route from the reuptake…

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

The stimulant shortage is not your pharmacy being disorganised. Regulators set a fixed annual quota of the raw material, and the ceiling has been too low to cover the prescriptions being written.

Knowing that changes what you do with your energy. Ringing round twenty chemists is exhausting and it creates no supply, so spend the effort on…

Five minutesMedication and how it worksMedical and treatmentQur’an 9:91One 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 treatmentQur’an 20:114One 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

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

Prescribers usually begin below the dose likely to work and build upwards. That means the first weeks can be underwhelming by design, and it is not the moment to decide the whole thing has failed.

Ask at the outset what the plan is: the starting dose, what it is being built towards, how quickly, and what you should be noticing at each step.…

Twenty minutesMedication and how it worksMedical and treatmentQur’an 94:5One line of research

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.

Treatment does not settle a life. What happens is that school reports, friendships and confidence build on one another, so a stretch of doing better…

Twenty minutesMedication and how it worksMedical and treatmentQur’an 21:84One line of research

A pharmacy refusing a valid prescription is often working from a made-up rule or a plain mistake. It can usually be escalated, and it usually resolves fast.

People have been turned away for having a prescriber in the next county, or told the shop does not stock narcotics for a medicine that is not one.…

Twenty minutesMedication and how it worksMedical and treatmentQur’an 5:87One line of research

Some settings simply suit an attention difficulty better. Expectations set out minute by minute, consequences that arrive the same day, a visible ladder to climb: military life often fits for exactly those reasons.

The point carries well beyond the army. When you are helping someone choose work, ask what the day actually looks like rather than what the job is…

Twenty minutesMedication and how it worksMedical and treatmentQur’an 2:185One line of research