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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An untreated attention difficulty rarely stays a blank space. People tend to find something that steadies them, and what they find is not always kind.

Nicotine, coffee at strange hours, cannabis in the evening, a bit of somebody else's prescription: these are often attempts at self correction rather…

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

Conversations about alcohol and cannabis tend to be timed for the child you expect to have at fourteen. With an attention difficulty in the picture, start them earlier and keep them light.

Early does not mean heavy. It means the subject is already open, so the first offer is not the first mention. Keep the tone curious rather than…

Five minutesMedication and how it worksMedical and treatmentQur’an 16:43One 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 4:28One line of research

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

In simulator work the biggest improvements on medication show up in the drivers who were worst without it: stopping properly, slowing for an amber, actually looking around.

That pattern is quietly reassuring. A drug that made everyone sharper would lift the good drivers as well, and this does not look like that. It looks…

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

When you are weighing up whether a teenager is ready for something, it helps to think in two thirds. A fifteen year old may be handling responsibility more like a twelve or thirteen year old.

This is not an insult and it should never be delivered as one. It is a way of explaining why a privilege arrives later here than for their friends,…

Five minutesMedication and how it worksMedical and treatmentQur’an 2:286One line of research

Offered ten pounds now or twenty in an hour, plenty of people with attention difficulties take the ten and know while they are doing it that it makes no sense. The pull towards now is not a flaw of character.

It shows up in a laboratory and it shows up on a bank statement. Naming it helps, because a thing with a name can be planned around: money moved by…

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

Before you explain anything about medication, ask what the person already believes about it. You cannot correct a worry that has never been said out loud.

Most people arrive carrying something: a cousin who could not sleep, a headline, a parent with a strong view. Lead with your own information and you…

Five minutesMedication and how it worksMedical and treatmentQur’an 42:38One 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

In practice the non-stimulants turn up more often as an addition than on their own. A stimulant in the morning with guanfacine alongside it is a common shape.

The two act at different points of the same circuit, so they tend to complement rather than repeat each other, and the blood pressure effect of one…

Five minutesMedication and how it worksMedical and treatmentQur’an 42:38One 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

A small short-acting dose in the afternoon, on top of the long-acting one, is ordinary practice rather than a special case. Homework and the evening drive often fall outside what the morning dose still reaches.

The hours when you most need to hold back are frequently the hours the medicine has stopped covering. Raising the morning dose to solve an early…

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

Skipping weekends, holidays and summers is a common suggestion and mostly it is the wrong call. The difficulty does not take a holiday when school does.

Unstructured time asks more of planning and self-regulation rather than less: whole days to fill, everyone at home, no timetable holding the shape of…

Five minutesMedication and how it worksMedical and treatmentQur’an 13:28One 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

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

Parents and teachers warm to a plan that includes something they do, rather than a prescription on its own. That is not a scientific argument and it still matters.

People stay with treatment they believe in, and belief rises when they have a part in it. So offering the behavioural piece is doing two jobs at…

Five minutesMedication and how it worksMedical and treatmentQur’an 3:159One 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

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