Stimulants

Domain IX · Biomedical, neuro & digital

What it is

Stimulant medicines (methylphenidate and amphetamine-family products such as lisdexamfetamine and dexamfetamine) are prescription medicines used mainly for ADHD; lisdexamfetamine is also licensed in the US for moderate to severe binge eating disorder in adults only, and is "not indicated or…

Format

• Stage A. Assessment and diagnosis (prescriber or specialist team). Goal: confirm the diagnosis and impairment in more than one setting, screen for coexisting emotional, behavioural, developmental and physical conditions (anxiety, depression, substance use, learning disorders, autism, tics, sleep…
• Format: the therapist's work alongside medication is typically ongoing individual, family or group sessions; NICE also mentions brief group support for parents and CBT for young people and adults. Session counts for psychotherapy are not set by the medication sources.

Who practises it, and how they are trained or regulated

• Stage B. Non-drug first steps. NICE: information and support for everyone; environmental modifications before medication; for children under 5 an ADHD-focused group parent-training programme first; for children 5 and over, ADHD-focused information and support for parents and carers (can be as brief as 1–2 sessions), plus parent training if there are oppositional or conduct symptoms. AAP: for ages 4–6, parent…
• Stimulant medicines (methylphenidate and amphetamine-family products such as lisdexamfetamine and dexamfetamine) are prescription medicines used mainly for ADHD; lisdexamfetamine is also licensed in the US for moderate to severe binge eating disorder in adults only, and is "not indicated or recommended for weight loss". They are Schedule II controlled substances in the US. This is a prescriber-delivered treatment,…
• Who prescribes and regulatory status (as sources state):

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Does it involve intense or unusual breathing? Have you been told about the medical conditions for which that is not advised?
• Does it involve fasting, a special diet or 'detox'? Have you discussed this with your doctor?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• loss to follow-up at transitions.
• missed reviews, especially after transfer to shared care with the GP.
• the client minimising side effects for fear the medicine will be stopped.
• stimulant misuse with sleep loss, which can mimic or trigger psychiatric crisis.
• your own urge to reassure; when uncertain, err towards contact with the prescriber.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.