ADHD and Medication: Finding the Right Dose

If your child is on stimulant therapy for ADHD, finding the right dose can be difficult. Every child is an individual who will respond physically and mentally to medication in different ways. Even when a dosage has been working well for some time, it will likely need to be adjusted as your child grows and develops. The difference between the correct dose and an incorrect one can make all the difference in your child’s outlook.

Finding a dose that will benefit your child requires a triangular partnership between you as the parent, your child’s pediatrician, and your child’s teacher.

What the Doctor Should Do:

Typically the doctor will begin with a starting dose based on your child’s weight and symptom history. This is an educated guess—a place to begin. The doctor will then need to periodically increase or decrease the dose depending upon the input he receives from you. This is called “titration,” and it’s the same principal used with any other condition requiring medication, such as juvenile diabetes. The doctor will need to know whether improvement has been seen on the current dose, or if any side effects have been observed. A good doctor will ask a lot of questions, and take notes. He or she should approach medication changes cautiously.

What the Teacher Should Do:

Your child’s teacher should be in regular contact with you, via phone calls or private meetings while your child’s dose is in question. The teacher should be making observations about whether your child is able to focus during class time, whether the quality of work is improving or not, and whether any behavior problems are being observed. The teacher should be especially watchful for side effects such as dizziness, tics, abnormal thinking, nervousness, or a “zoned out” appearance. Anything of concern should be reported to you as soon as possible. More subtle changes could be made known to you in a weekly contact. The teacher should also be making classroom adaptations to help your child have the best possible chance for success.

What You Should Do:

It would be an excellent idea for you to keep a written record of your child’s symptoms and your observations. There are many ways you can do this. It’s likely that the brand of medication your child is on will have its own website with a tracking sheet for you to use online. (Such as or If not, you can purchase a small notebook or calendar to write down dates and symptoms observed. If your child has bouts of hyperactivity at certain times of the day, make note of it. If you’re seeing mood swings or erratic behavior after a recent dosage switch, jot it down. This information will be critical to helping your child’s doctor determine whether the dose needs an adjustment. You know your son or daughter better than anyone else. Be your child’s advocate and insist that his or her needs be met.

Kristyn Crow is the author of this blog. Visit her website by clicking here. Some links on this blog may have been generated by outside sources are not necessarily endorsed by Kristyn Crow.

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