Fine-Tuning Stimulant Dosing to Find Your Treatment Sweet Spot

Stimulants are the first-line treatment for most people with ADHD, yet few clinicians receive training on fine-tuning medications like Adderall, Ritalin, or Vyvanse to achieve the best outcomes.No practical, modern protocol exists regarding how to efficiently adjust stimulants to optimize their performance in managing ADHD symptoms and mitigating side effects.

The only guidance available stems from the Multimodal Treatment of ADHD (MTA) Study, published in 1999, but the MTA’s research methodology often took as long as eight months to determine each subject’s optimal medication and dose.This is completely impractical in the real world, where insurance coverage pays for only two or three sessions of clinical assessment and medication adjustments.

As such, I developed a method for optimizing ADHD stimulant medications that I have used successfully in my own practice for 30 years.Two molecules comprise the first-line stimulants prescribed to most people with ADHD: methylphenidate (brand names include Ritalin and Concerta) and amphetamine (brand names include Vyvanse and Adderall).

More than 39 different brand name medications are made from these two molecules, and they all provide a comparable level of benefits, side effects, and response rates, according to large group studies.