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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41 practices

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Difficult things come out more easily when your hands are occupied and you are not looking straight at the other person. Walk side by side, drive somewhere, wash up together, keep the sewing going.

If you are the one listening, offer it first. Most people assume that picking something up would look rude or half interested, so they sit still and…

Twenty minutesSystems for daily lifeMedical and treatmentQur’an 3:159One line of research

If sleep has gone since starting, look at what time the dose is being taken before deciding the medicine is the problem. A long acting dose swallowed at one in the afternoon is still working at bedtime.

Extended release preparations are built to cover eight to twelve hours from whenever they are taken, so a late start pushes the whole thing into the…

A minuteMedication and how it worksMedical and treatmentQur’an 73:20One line of research

Debt, impulsive spending, an account that never quite recovers: this belongs in the conversation about attention rather than in a separate drawer marked shame.

People hide this part longer than anything else, which means it is usually the last thing to get any help. If you are the one struggling, saying it…

Five minutesMedication and how it worksMedical and treatmentQur’an 33:5One line of research

Where anxiety sits alongside the attention difficulty, a non-stimulant is sometimes the better first choice. Stimulants sharpen anxiety in some people, and that is a hard trade to live with.

The same holds when blood pressure rises on a stimulant that is otherwise working, since adding an alpha-2 agent can make it possible to keep the…

Five minutesMedication and how it works

There is more about focus, starting, and adhd than the practices: the focus, starting, and adhd area has the themes and the courses too.

Medical and treatment

Qur’an 21:83

One 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 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

Waking your child at six to give the tablet so it has taken hold by breakfast, then letting them fall back to sleep, is not a strange thing you invented because you are failing. It is a reasonable answer to a real gap in how the medicine works.

Families quietly carry a lot of these. The early alarm, the switch to a faster product, the parent who does the whole morning alone because it goes…

Five minutesMedication and how it worksMedical and treatmentQur’an 9:91One line of research

Doing badly on one long acting product does not mean the medicine inside it was wrong for you. The same molecule in a different capsule can behave differently enough to be worth trying before anyone gives up on it.

What gets described as the medicine not working is often the shape of the day being wrong: too slow to start, too abrupt at the end, strongest at the…

Five minutesMedication and how it worksMedical and treatmentQur’an 33:5One line of research

People usually stop for one of three reasons: the side effects are not worth it, the price is too high, or the dose was never raised far enough to do anything. The last one is the saddest, because it makes a workable medicine look useless.

If a trial ended with the words nothing happened, it is worth going back over what dose was actually reached and for how long it was held there. A…

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

Before anyone concludes that medication does not work for you, check what dose was actually reached. Doses in general practice often stay lower than a specialist would use, and a fair share of so called non responders respond once the dose goes up.

You are allowed to ask this, gently and without any accusation in it: what was the highest dose tried, and how long did it stay there? A trial that…

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

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.

Stopping after a single class is one of the commonest routes to believing that nothing helps. Trying the second one is a normal next step rather than…

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

For someone who cannot swallow tablets, or whose mornings fall apart long before the tablet gets taken, patches exist that release medicine slowly through the skin over hours.

Going through the skin skips the first pass through the liver and smooths out the peak, which changes the timing and sometimes how well it is…

Five minutesMedication and how it worksMedical and treatmentQur’an 5:6One line of research

Much of the progress in these medicines over the past twenty years has been in how the drug is delivered rather than in new molecules. So if one version did not suit you, another form of the same drug can still be worth a try.

People often conclude that a whole class has failed them when what failed was one release pattern: too sharp, too short, too much at once. That is a…

Five minutesMedication and how it worksMedical and treatmentQur’an 33:5One 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

Medication treats the attention difficulty. It does not teach reading, lift a depression, or repair a household that has been fighting for years.

Those things need treatment of their own, and they are often what the family actually came about. Treating the attention difficulty well can stop…

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

Smoking runs high in ADHD, and nicotine genuinely does something for attention. It helps to treat that as self-medication rather than as one more impulsive habit.

It changes what a conversation about stopping looks like. If a cigarette is doing a job, taking it away and leaving the job undone is a plan that…

Twenty minutesMedication and how it worksMedical and treatmentQur’an 39:53One line of research

With many of these medicines the unpleasant part turns up on day one and the good part takes weeks. Knowing that in advance is most of what carries people across the gap.

The first fortnight can feel like a bad bargain, because it is one: you pay now for something that arrives later. Put a date in the diary two to four…

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

Treat the first fortnight as a stretch that needs contact rather than silence. Say plainly that things may feel worse before they feel better, and arrange to hear from the person during that window instead of after it.

This is when most people quietly stop. Somebody who has been warned experiences a rough two weeks as expected; somebody who has not experiences it as…

Twenty minutesMedication and how it worksMedical and treatmentQur’an 3:159One line of research

Being in recovery is not a reason to leave an attention difficulty untreated. The restlessness that made a substance useful is still there once the substance goes.

Clinicians often hold back here, uneasy about a stimulant for someone with a history, and that caution is understandable. The other choice carries a…

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