What should I expect when my child starts ADHD medication?
Starting ADHD medication involves a baseline assessment, specialist-led titration and planned monitoring. Here is what to clarify before the first prescription.
The short answer
Before ADHD medication starts, NICE recommends a baseline assessment that includes the continuing need for treatment, other health and social factors, current medicines, height, weight, pulse, blood pressure and a cardiovascular assessment. Medication is initiated by a healthcare professional with relevant ADHD expertise. During titration, intended benefits, daily-life impact and adverse effects are recorded at baseline and at each dose change, with regular specialist review. Agree what your child wants help with, what you will record, who to contact and who currently prescribes.
What helps, in short
- Agree the specific situations your child wants help with and how change will be recognised.
- NICE recommends a full baseline assessment before ADHD medication starts.
- ADHD medication is initiated by a healthcare professional with training and expertise in ADHD.
- Titration compares symptoms, daily-life impact and adverse effects at baseline and after each change.
- Ask who prescribes, who monitors and what should prompt contact before the next review.
- Use the instructions for the exact medicine and ask before making any change.
Starting ADHD medication is a planned clinical process, not one decision followed by a long wait to see what happens. The useful preparation is to know what your child wants help with, what will be checked before treatment, what you will record and who you can contact between reviews.
This article explains the shape of that process. It cannot tell you whether medication is right for your child or which medicine should be considered.
Before the first prescription
NICE recommends a baseline assessment before ADHD medication begins. This includes confirming the continuing need for treatment, reviewing mental health, social circumstances, other neurodevelopmental conditions and current medicines, and recording height, weight, pulse and blood pressure. It also includes a cardiovascular assessment [1].
Take an accurate list of medicines, supplements, allergies and relevant health history. Tell the clinician about anything your child finds difficult about swallowing medicine, eating with it or taking it at school.
Ask your child two questions:
- What would you most like to become easier?
- What are you worried the medicine might change?
NICE says children and young people should be encouraged to give their own account and that preferences and concerns should be recorded in the treatment plan [1].
Agree what you are looking for
Choose two or three observable situations. For example, "begin independent work after the teacher's explanation" is easier to review than "focus better". Include support already in place, because medication does not replace teaching, environmental changes or other care.
Record a short baseline:
| Area | What happens now | Source |
|---|---|---|
| Child's priority | ||
| Target situation one | ||
| Target situation two | ||
| Appetite and eating | ||
| Sleep | ||
| Mood and physical health |
What titration means
Titration is the period in which a specialist adjusts medication against ADHD symptoms, daily-life impairment and adverse effects. NICE recommends recording these at baseline and at each dose change, with information from parents and teachers and regular specialist review [1].
There is no single number of weeks that applies to every child. The medicine, response, other health conditions and service plan all matter. Ask:
- Who is leading titration?
- When and how will progress be reviewed?
- Who will collect information from school or another setting?
- Which changes should be reported before the next appointment?
- What is the urgent contact route?
- Who will issue the next prescription?
What to record at home
Keep notes brief enough to sustain. Include the child's view, the agreed target situations, possible benefits, unwanted changes and the time and setting.
Write what happened rather than deciding why:
K ate two bites at lunch on Monday and said they felt sick. This began three days after the latest prescription change. They ate their usual evening meal. School also reported a headache after lunch.
That is more useful than "the medication has ruined K's appetite" because it gives the prescriber detail to interpret.
Use the information supplied with the exact medicine. Formulations and brands can have different instructions. Ask the prescriber or pharmacist before changing how or when it is taken.
Who prescribes after titration?
NICE recommends shared-care arrangements with primary care after titration and dose stabilisation [1]. This requires an agreed protocol. It does not mean that responsibility automatically moves to the GP.
Before the next prescription is due, confirm:
- who currently prescribes;
- who completes each monitoring check;
- who decides clinical changes;
- when the specialist will review the treatment;
- who handles adverse effects or supply problems.
The understanding ADHD medication guide includes a one-page review note and fuller questions about monitoring and shared care.
When something worries you
Follow the leaflet and contact instructions for the exact medicine and symptom. Do not wait for a planned review if those instructions call for earlier help. If someone's life is at risk or you cannot keep them or somebody else safe, call 999 or go to A&E.
Sources and further reading
- [1] NICE. Attention deficit hyperactivity disorder: diagnosis and management. NG87 (accessed 3 August 2026).
- [2] NHS. ADHD in children and young people (accessed 3 August 2026).
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