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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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…

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

Medication belongs in ordinary treatment here rather than at the end of the queue. Most people with a clear diagnosis will use it at some point.

Strategies and accommodations do real work while somebody is watching, and they fall away in the settings where nobody is. That is most of adult…

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

Nobody is sitting in the passenger seat handing out rewards for safe driving. Medication is the part of treatment that is present when no adult is.

Behavioural plans need somebody to run them. The moments carrying the most risk in adolescence are the ones with nobody there: the drive home, the…

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

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…

Five minutesMedication and how it worksMedical and treatmentQur’an 5:6

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

Growing empathy

Breathing

Shame and stigma

Being seen and judged

Making it stick

Structure and routine

Treatment and medication

Answering bids

Feeling from the inside

What you are actually defending

Breaking the worry loop

When you use something to cope

Emotions as signals

Repair after rupture

Facing it a step at a time

Shared spiritual life

Rebuilding trust

Fondness and admiration

Affection and touch

Obsessions and compulsions

Listening and understanding

Posture and how you carry yourself

Rituals of connection

Righteous anger and perfectionism

Anger, alcohol and the body

The cost of avoiding

Living with uncertainty

Rest and pacing

When you go numb

When anger turns to harm

Letting it out safely

Notice the pattern and flex

Your worth is not conditional

Reading, numbers and learning differences

Get it out of your head

Validate yourself and others

Find meaning

Help someone grieving

Keep the bond

Face it gently

Your window of tolerance

Care for yourself in loss

One line of research

Methylphenidate and amphetamine are not two names for the same thing. One mainly blocks dopamine from being taken back up, and the other does that and pushes more of it out as well.

That extra step is why the amphetamines tend to produce somewhat larger average effects, and why somebody who got nothing from one can do well on the…

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

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…

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

A plain immediate release tablet works for roughly three to five hours, so an ordinary school day needs two or three of them. If the afternoons keep falling apart, that gap is worth naming out loud with the prescriber rather than reading it as failure.

Repeat dosing in the middle of the day asks a lot of everyone. Somebody has to remember, the school office has to hold a controlled drug, and a child…

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

If the patch brings a rash, it is usually a reaction to the medicine passing through the skin rather than to the sticky backing. Worth knowing, because switching brand or trying a kinder tape will not fix it.

Skin has its own way of reacting to something held against it for hours at a time, and that reaction stays local. Saying this early saves a family a…

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

A rash from the patch does not put the same medicine out of reach in tablet form. Plenty of people react to it on the skin and take it by mouth with no trouble at all.

It is easy to write a whole drug into the allergy box after a bad experience with a patch, and that single line can close off a first choice…

Five minutesMedication and how it worksMedical and treatmentQur’an 5:87One 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

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

Capsules are not the only option any more. Long acting liquids and chewable forms exist, so a child who cannot manage a pill does not have to be left with nothing or with a dose that runs out by lunchtime.

Not being able to swallow a capsule stops being a small detail when it is the reason treatment ended. Ask specifically what comes as a liquid or a…

Five minutesMedication and how it worksMedical and treatmentQur’an 2:184One 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