ADD/ADHD: Medication - 1 of 7 Tips on Bottom of the Therapeutic Window
Posted Oct 26 2008 8:54am
Start Every ADD/ADHD Medical Intervention with The Therapeutic Window Objectives
1. The First Problem: Is the stimulant medication working?
The *Therapeutic Window* is simply what it says; the window, is the space, the place in time and symptom correction that the stimulant medication clinically works best,
- the dosage, the effectiveness of that specific product with that
specific person. All stimulant products have characteristic features, they
metabolize, they burn, at different rates of speed in different people.
The way we evaluate that therapeutic window is by recognizing the top, the bottom
and the sides.
We work to make sure all the bases are covered correctly
and the medication is working at it's maximum level of expected
A key point of observation with the Bottom of the Therapeutic Window: the medication is an insufficient dosage. The top is too much, the bottom is not enough.
The first question asked by many: Is it working?
Medications have No Effect: "Below the bottom" the means the medications simply are not working: No effect, no focus or attentional improvement, no delay in
impulsivity, or hyperactivity is running wild, the mind is constantly
worrying, the avoidance and procrastination with projects remains
clearly intact.The Duration of Effectiveness cannot be determined.
Inadequate dosage can be measured at both the end and
beginning of the day.
Is there an AM onset, - and
how long does it last in
If you can't answer either of these questions, then the dose is
most often insufficient. You should actually be able to concentrate, think more clearly.
Surprisingly some don't know what to expect regarding effectiveness, and can't feel, can't recognize, can't understand the expected duration of effectiveness. Often this inability is determined by not setting clear objective of what the problem is in the first place.
These are the three functional subsets of ADD and understanding these, measuring these at the outset will give you a better handle on what to expect. The big question: Are they corrected, and when are they corrected. Already we are looking for the Duration of Effectiveness.
And remember with Vyvanse particularly, you often can't 'feel it' as you did with Adderall XR. More than any other medication Vyvanse has an almost purely cognitive, thinking effect - no buzz, less jittery, no somatic/body feeling.