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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  ADDWindows 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 performance.

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.

  1. Is there an AM onset, - and
  2. how long does it last in the PM? 

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.

Three Brain Function Problems occur with ADD:

  1. Acting without thinking
  2. Thinking without acting
  3. Avoidance: not thinking or acting

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.

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