The Optimization Blueprint — the algorithm Jonathan Murphy, PMHNP-BC, uses to find the right medication and the right dose for adults with ADHD.

This episode is for two audiences simultaneously: clinicians refining their adult ADHD prescribing practice and patients trying to understand whether their current treatment is optimized.

This episode covers:

• The three medication categories: methylphenidate, amphetamine, and non-stimulant
• Why extended-release stimulants are first-line and why the "controlled substance" framing misleads prescribers
• The standard adult starting doses for the major medications
• The response and toleration framework for assessing the first prescription
• When to start with amphetamine versus methylphenidate based on presentation
• Why methylphenidate is often the better starting point despite being less culturally familiar
• What "optimized" actually means: all good, no bad, no side effects, works like a vitamin
• The risk of dysfunctional medication relationships and how they form
• Why providers who haven't developed comfort with adult ADHD prescribing should consider referring out rather than under-treating

This is the second episode in the sequence covering the optimization process from the book The Process: An Adult's Guide to ADHD Medication, available on Amazon: https://www.amazon.com/dp/B0H2Z6PM4T

Find the YouTube channel Focus Path | PMHNP-BC for the full clinical education catalog.

For educational purposes only. Not medical advice. Consult your own provider for clinical decisions.

The first episode of Actually ADHD.

Jonathan Murphy, PMHNP-BC, board-certified psychiatric nurse practitioner with 20,000+ clinical hours specializing in adult ADHD, opens the show with the conversation the internet hasn't been having.

This episode covers:

• Why the book The Process: An Adult's Guide to ADHD Medication exists and why the field needed it
• The clinical history of ADHD from 18th-century behavioral observations to the modern DSM
• Charles Bradley's 1937 discovery at the Emma Pendleton Bradley Home that changed the field
• The pharmacology evolution from immediate-release amphetamine to modern extended-release formulations
• Why adult ADHD treatment is in some ways newer than the patients in it
• The personal story of becoming the ADHD clinician
• Why most prescribers in primary care and general psychiatry struggle with optimization
• What "Actually ADHD" actually means

The book The Process: An Adult's Guide to ADHD Medication is available on Amazon: https://www.amazon.com/dp/B0H2Z6PM4T

Find the YouTube channel Focus Path | PMHNP-BC for full clinical education content.

For educational purposes only. Not medical advice. Consult your own provider for clinical decisions.