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ADD-ADHD Medication Treatment – 7 Overview Tips For Stimulant Dosage With the Therapeutic Window

Contributed by: Dr. Charles Parker

Use Therapeutic Window and Correct Medication Dosage – Brief Summary

If you simply pay attention to these simple details the possibility of the biggest two problems with ADD/ADHD medications are almost naturally corrected – no more frustration, no more fear of adverse effects. This article is a summary of three other articles here at EzineArticles with greater details.

7 Therapeutic Window Tips to find the right dosage and the right medication – it’s easy if you have basic guidelines.

  1. The Entire Problem with Stimulant Meds can be summarized in two ways- Too Much, or Not Enough – the Therapeutic Window is the correct dosage, not too much, not too little, lasting exactly the right duration through the day. Stimulant meds don’t last all day, thus the problem with timing. Everybody is built different metabolically, thus the problems with dosage.
  2. The Therapeutic Window is specific for each individual adult or child, not based on your mother, father, sister, brother, or great aunt experience with medications in general or stimulants specifically. Yes, some families have medication sensitivities which appear genetically related, but don’t necessary exclude a low dose careful trial.
  3. Stay away from the Top of the Window: The dosage is too high and side effects occur such as feeling overfocused, agitated or stoned, If your sleep is significantly disturbed or your appetite is gone, the dose of the medications or the medication itself is simply incorrect – and I always look the dosage carefully first. Start low, go slow, don’t increase more than weekly or every other week.
  4. Watch for the Bottom of the Therapeutic Window: At the outset and during the treatment the meds often need adjustment upwards, especially the MPH [methylphenidate-Ritalin like meds] and AMP [dextroamphetamine – Adderall like meds]. Vyvanse often needs little titration – it remains quite stable in dosage over time.
  5. Watch for the Sides to find the DOE, Duration of Effectiveness: Each stimulant medication lasts only a specific duration. If you are under that expected duration and the sides do not cover it properly as noted in the “Sides” article, you are underdosed. If you go past that expected DOE, you are on too much.
  6. Drug Interactions do occur and cause unpredictable problems if they are ignored. This caution involves drugs that interact with the stimulants. The two most seriously interactive meds are Paxil and Prozac, seen over years of long term use of medications. No, these interactions aren’t in the literature yet, but these potential interactions do live on the package inserts of these two products. With managed care and money a problem, these problems are on the rise, not diminishing. More later on 2D6, an important metabolic pathway.
  7. Denial of the Importance of the Window: If you don’t think about it, if you don’t know it’s there, you simply cannot target it. If you don’t target the ‘Window’ you are either shooting geese at night, or simply throwing cans of paint at the barn door. Without clear visualization of the target, without paying attention to the details and the edges, the job will be predictably less than quality.

Bottom Line
By following simple guidelines and the metaphor of the ‘Therapeutic Window’ you will be more able to adjust dosing correctly, and effectively – so you and yours don’t feel like treatment failures. I invite you to sign up now for the early bird special set of gifts for my new book “Fixing the ADD Madness: A Patient’s Guide to Stimulant Medication Details,” over at – And enjoy the bonus gift on the thank you page for signing up early — simply to express your interest in the book: a 1200 word article on The 10 Biggest Problems With ADD/ADHD Medications, and a 17 min audio review of the article. At CorePsychBlog you can also sign up to keep posted on upcoming ADD/ADHD teleseminars and other training opportunities to further understand ADD medication challenges.

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Posted on November 22, 2008