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ADHD Medication Optimization for Adults

ADHD Medication Optimization for Adults

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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.

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