Monitoring & Safety
What monitoring is needed for ADHD medication, what to track at home, and when to contact your clinician.
ADHD medication is safe when properly monitored. Regular monitoring ensures the medication is working well, side effects are identified early, and your child's growth and development are tracked.
You are a key part of monitoring. Your observations at home provide crucial information that clinic appointments alone can't capture.
Baseline checks (before starting)
Height and weight
To track growth over time - stimulants can affect appetite.
Frequency: Before starting, then every 3-6 months.
Heart rate and blood pressure
Stimulants and some non-stimulants can increase these.
Frequency: Before starting, at each dose change, then 6-monthly.
Cardiovascular history
Family history of heart problems or sudden death needs consideration.
Frequency: Before starting, update if family history changes.
Current symptoms
Baseline to compare improvement against.
Frequency: Before starting, often using rating scales.
Side effect screening
Some pre-existing issues (sleep, appetite, mood) need documenting.
Frequency: Before starting.
Ongoing monitoring
| What | How | Frequency |
|---|---|---|
| Symptom tracking | Rating scales from parents and teachers. Your observations. | At each appointment, especially during titration. |
| Side effect monitoring | Specific questions about appetite, sleep, mood, headaches, etc. | Every appointment. |
| Height and weight | Measured and plotted on growth charts. | At least every 6 months. |
| Heart rate and blood pressure | Measured at appointments. | After dose changes, then 6-monthly. |
| Overall wellbeing | How is your child doing overall? School, relationships, mood. | Every appointment. |
Side effects to track at home
- •Not hungry at usual times
- •Skipping meals
- •Weight loss
- •Only hungry when medication wears off
Action: Track what and when they eat. Discuss strategies with clinician.
- •Difficulty falling asleep
- •Waking during night
- •Not feeling rested
- •Taking longer to fall asleep
Action: Note bedtime, sleep time, wake time. Consider medication timing.
- •Irritability (when medication active or wearing off)
- •Tearfulness
- •Flat affect ("zombie-like")
- •Anxiety
- •Low mood
Action: Note timing - is it during medication or wear-off? Report promptly.
- •Headaches
- •Stomach aches
- •Dry mouth
- •Tics (new or worsening)
Action: Track frequency and severity. Most settle; report persistent issues.
When to contact your clinician
- •Chest pain or palpitations
- •Fainting or near-fainting
- •Thoughts of self-harm or suicide
- •Severe mood changes or psychotic symptoms
- •Signs of allergic reaction
- •Persistent or worsening side effects
- •Significant weight loss
- •Mood changes (irritability, low mood)
- •Sleep problems not improving
- •Concerns about effectiveness
- •New tics or worsening of existing tics
- •Questions about medication timing
- •Requests for prescription renewals
- •Updates on how things are going
- •Questions about medication breaks
Typical appointment schedule
Titration (finding right dose)
Adjust dose, monitor response and side effects closely.
Stabilisation
Ensure dose is working well, side effects manageable.
Maintenance
Ongoing monitoring, growth checks, prescription renewal.
Annual review
Comprehensive review - is medication still needed? Working well?
Tips for tracking at home
Keep a medication diary
Note dose timing, effects observed, any side effects, sleep, appetite.
Use rating scales
Your clinician may provide these. Fill them out regularly for comparison.
Note timing of effects
When does medication seem to kick in? When does it wear off? Rebound effects?
Get school feedback
Ask teachers to share observations. Before/after comparison is helpful.
Track growth
Keep your own record of height and weight if concerned.
Note good days and bad days
Patterns can be informative - what's different on harder days?
Monitoring is partnership, not just compliance. Your observations provide information that clinic visits alone can't capture. Good monitoring helps ensure medication is safe, effective, and still needed.
Don't hesitate to contact your clinician between appointments if you have concerns. That's what monitoring is for.