ADD – ADHD Medication Treatment – 7 Tips for Finding the Challenging Sides of the Therapeutic Window

The sides of the window are puzzling and require a few more questions in the office. The reason for asking the questions is simple: we want to know exactly how the drug is working in the context of the time of day, duration of effectiveness, and predictable expectations of the specific drug in question.

All these questions arise from the essential philosophical description of drug delivery systems: if you know the science and have clear goals, you can measure the treatment result objectively and correctly adjust the drugs according to the biochemical and metabolic individuality of each. specific individual. Measure that ‘Window’ to get predictable results.

The simplified version of that statement: The cookie cutter drug based on weight, age, body size is out of date and simply ineffective. – So let’s get the details right every time, starting from the same place using the same predictable grid to measure effectiveness. These 7 tips for the sides of the therapy window, along with the measurements from my other articles here on 7 tips from the top and bottom of the therapy window, will outline the precise goals of treatment. I have been using these ‘Window Strategies’ with thousands of patients for over 12 years, and I can assure you that they work like a correctly timed clock. Predictable results should be the standard of care.

The 7 Tips for Therapeutic Window Sides for Stimulant Medications.

1. The sides of the window are based on time: the expected DOE: duration of effectiveness of that specific drug for that specific person’s metabolic rate, and should be tailored for each person from the beginning and for the duration of treatment. Each person burns medications at different rates that cannot be predicted by superficial appearances of weight or size. I have an ex-navy [Nuclear] The commander who is about 6’6 “and hovering over me has to duck when he walks in the door, he only takes Adderall 10mg XR and the DOE is a reasonable 10 hours. We want to have a specific match between expected duration Y clinically effective duration.
2. Know the DOE’s Drug Expectations Early: Authorities and studies disagree on some of the following points about specific drugs that I am about to discuss. Pharmaceutical companies have done their homework and are focused on these same DOE goals. I simply disagree with some of your DOE findings based on my extensive experience in the office. Many studies span the thousands of patient hours over years of treatment using a particular approach in this ‘Window’ grid. See the 7 tips for the article at the top of the window for more details on specific medications.
3. Get to work – accurately measure DOE time at every meeting: Easy Questions: “When did you take it and when does it stop working?” If it is taken at 7 a. M. And it lasts until 3 p.m. M., That’s the DOE. The math is simple: 5 hours in the morning% 2B 3 in the afternoon = 8 hours. A drug can work for 8 hours, but still keep the person out of the top of the window if the IR is pushed too high.
4. The first secondary objective – AM Onset: All medications should be working in 30-45 minutes. after taking the medication. GO [Immediate Release] The tablets have a quick start, but the sides of the window are too narrow and the DOE [Duration of Effectiveness] It comes out too fast, which means it just lasts for a small part of the day. IR medications need dosing 2-3 times a day because the DOE is too short. If the start of the morning is more than 45 min, the dose is or very little, is not working at all, or it may be too much – see point 4 of the 7 tips for the top.
5. Regulation of the start of the morning: breakfast is essential, protein breakfast works better more often: With drugs, since we are now paying attention to the rate of metabolism, the DOE, we are much more interested in the “steps that limit the rate.” Breakfast is an imperative speed-limiting step and essential for all psychiatric medications to prevent irritation of the gastric mucosa. [stomach lining]. With breakfast, that early side of the ‘Window’ is smoother and less involved with uncomfortable spikes from over-medication.
6. The second side objective: the PM launch: when they stop working: Concerta to Adderall XR extended release capsules are all mechanically released and have unpredictable release times based on acid-base variables in the stomach and intestine, and transit time of intestinal contents. Prolonged transit time often means increased sensitivity to drugs and a relative accumulation of drugs over time, with a narrowing of the ‘Window’. Metabolic challenges with bowel function almost always change the release time of PM, when medications stop working. Vyvanse is not as vulnerable to speed changes based on acid / base balance or transit time.
7. The Mysterious Objective: Launching PM with Vyvanse: Vyvanse deserves its own advice because it is so effective, with a DOE of 12-14 hours so excellent and predictable. Think about this simple point when measuring DOE with Vyvanse: the metabolically released stimulant is so different that many “don’t feel it working” and are therefore lost when it “stops working.” Remember with Vyvanse: look for the original “mental” cognitive targets, not the somatic and buzzing effects. When Vyvanse retires in PM, the ability to finish tasks disappears.