Knowing if the medication works

Jan 4, 2018

I just read an article from ADDitude's Research Digest:

It relates the results of a small study of teens. They were given different amounts of medication, including placebo and asked to rate their effectiveness everyday. Even though their efficacy was clearly influenced by the medication, they reported not feeling a difference. The conclusion was that teens have difficulty telling if the medication works. 

The first question that came to my mind was, "compared to whom?" I would argue that teens, kids, and adults all vary widely in their ability to be able to tell if the meds are working. As a coach, my impression is that self awareness is one key to treatment. Some of us are born with more of it than others. But it is important to cultivate self awareness in regards to any treatment plan. I'm just not sure it it is an age related thing. 

I've know eight-year olds who can clearly articulate that the medication helps. I know that I could feel its effects very clearly at age 10 or 11 when I first started. In fact my doctor trusted me enough to allow me to decide how much I needed for a given activity at a very young age. School, baseball, and homework were 20 mg Ritalin tasks. Playing with friends or going to a birthday party might be 10 or 15 mg Ritalin activities. I knew what I needed. 

On the flip side, I also have adult clients who have no idea that the meds are working. I had one client who started over the weekend and we talked on Monday. He said that he couldn't tell if it was working. I asked him what his weekend was like. He told me that he finally did that project around the house that he'd been trying to get to, and that he actually put all of his tools away afterwards for the first time in his life. Coincidence? I think not. That's the medication doing its job.

Of course, the modern delivery systems of things like Concerta and Vyvanse are designed to be gentler on the system. I alway say that the best case scenario is that you are more focused and productive but don't "feel" any different. That's a good thing. So, if you or your teen are having trouble telling if the meds are working, take a look at what you are able to accomplish and how challenging it was to get it done. Is there a difference with the meds?

Another piece to consider is the dosage. Some people need more than others. Many times doctors aren't aggressive enough with the dosing to get their patients to the level where the meds will work. I particularly see this issue in teens because, often, doctors forget to reevaluate the dosing of stimulants that a kids has been taking for many years. A 150 lb. high school freshman full of hormones is not going to be effectively medicated on the same dose he/she took as a 50 lb. 3rd grader. There was actually another article in the Research Digest about undermedication. 

Lastly, teens are by their very nature, difficult. I very much believe in the conclusion of the first article. "The best way to sell medication is with honest." I would also add that honesty depends on education. Teach your teen about ADHD and what the medication does. They are much more likely to choose to take it in that scenario. 

Standard Disclaimer:  In an effort to foil my own perfectionist tendencies, I do not edit my posts much… if at all. Please and typos, mistakes, grammatical errors, or awkward phrasing. I focus on getting my content down. An imperfect post completed is better than a perfect post that goes unposted.

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