Your prescriber has 15–30 minutes with you and a clinical decision to make: raise the dose, lower the dose, change timing, switch medication, or stay the course. Everything they decide rests on what you can tell them.
Here are the four patterns that drive that decision — and what to bring so each one is visible at a glance.
1. Onset and offset
The single most actionable thing your prescriber needs is the shape of the medication's effect across the day. Specifically:
- How long after dosing did you feel it kick in? 30 minutes? 90 minutes? Never?
- How long did the effect hold? Until 2pm? All afternoon? Crashed at 4pm?
- Was there a clear "off" point? A noticeable drop in focus or mood?
If your dose is wearing off at 2pm and you have a 9–5 job, the answer might be a longer-acting formulation, a small booster dose, or a different med — not just "more of the same." Onset/offset patterns make that decision visible.
What to log: time of dose, time you noticed effect, time it tapered off. Even rough estimates help.
2. The focus trend (not the focus number)
Single-day focus ratings are noisy — sleep, stress, illness, what you ate, weather, what tasks you actually had to do. Any one day means little.
What your prescriber looks at instead: the rolling trend over 2–4 weeks.
- Trending up over weeks 1–4? Probably the right direction; consider holding the dose.
- Trending up then plateauing at "okay"? Time to discuss dose increase or alternate med.
- High-variance week-to-week, no trend? Suggests the medication isn't doing much; sleep or other variables are dominating.
- Trending down? Tolerance, side effects, or wrong medication.
The chart on the tracker shows this trend automatically — the line matters more than any single dot.
3. Side effects, severity, and trajectory
Most stimulant side effects (appetite suppression, dry mouth, mild anxiety, sleep delay) improve over the first 1–2 weeks as your body adjusts. A few don't, and your prescriber needs to know which is which.
- Improving over time → usually fine, keep going.
- Stable but tolerable → may indicate the dose is correct.
- Stable and intolerable → dose change or medication switch.
- Getting worse → escalate, may need urgent contact.
What to log: short keyword + intensity word ("dry mouth, mild" / "jaw clenching, frequent" / "rebound fatigue, severe").
4. Functional outcomes — what changed in your life
The number that actually matters is whether your life is working better. Self-reported focus is a proxy. The real proxies are:
- Did you complete your most important task today, this week?
- Are you missing fewer meetings / appointments / deadlines?
- Are conversations less fragmented? Are you finishing thoughts you start?
- Is your relationship with your partner / kids / coworkers easier?
- Is your sleep, mood, eating reasonably stable?
Bring 2–3 specific functional examples to your visit. "I finished the project I'd been avoiding for two months last Wednesday" is more useful to your prescriber than "focus is maybe a 6.5 average."
What to actually print and bring
- One-page summary table: date, time of dose, dose, focus rating, sleep, side effects.
- The 30-day trend chart.
- 2–3 short bullet points of functional outcomes.
- Any specific question you have ("can we try splitting the dose?", "I'm worried about appetite — should we add anything?").
The trackadhd.org export contains the first two. Print, write the bullets at the bottom, walk in.