Actually ADHD | Medication Strategies & Clinical Wisdom17 Jun

ADHD Medication Optimization for Adults

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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Episoder(25)

Reacting in Real Time to the Lindsay Clancy Medication List | A Prescriber's First Read

Jonathan Murphy, PMHNP-BC, reads through the Lindsay Clancy medication record for the first time on mic, reacting in real time as he goes. No script, no preparation, no edits. Just a psychiatric nurse...

26 Sep 16min

Why the Lindsay Clancy Case Spread Like It Did (It's Not a PSYOP)

People keep asking whether the Lindsay Clancy case is a psyop. Jonathan Murphy, PMHNP-BC, grew up in Duxbury, and his answer is no — it looks organic. What's worth understanding is why a local tragedy...

24 Sep 10min

High Masking Autism: The Most Misunderstood Psychiatric Diagnosis

Autism spectrum disorder is the diagnosis Jonathan Murphy, PMHNP-BC, sees the most confusion around — from patients and clinicians both. People get evaluated, spend a lot of money, and come back witho...

15 Sep 18min

Got Adderall From a Friend? Here's What a Prescriber Wants You to Know

Is it illegal to share ADHD medication? What happens if you got Adderall or Vyvanse from a friend? Jonathan Murphy, PMHNP-BC, answers both the legal question and the one that matters more clinically: ...

10 Sep 11min

Understanding Creativity and Critical Theory

After the Clancy deep dive I was in a bad mood, and the antidote is always nerding out. So I pulled some books, took notes, and thought out loud about why the things we look at run us more than the th...

8 Sep 15min

ADHD and Creativity: Build the Structure First

Creativity can be the difference between depression and feeling motivated for someone with ADHD. It can also blow up your life, because the ADHD brain goes all or nothing and the hobby you barely pick...

5 Sep 14min

Lindsay Clancy DSM 5-TR Deep Dive

Jonathan Murphy, PMHNP-BC, opens the DSM-5-TR and works the Lindsay Clancy case the way a clinician actually works a differential, starting with the forensic cautionary statement at the front of the b...

4 Sep 34min

Media literacy amid true crime mobs and ADHD

Psychiatric nurse practitioner Jonathan Murphy, PMHNP-BC, connects the dots between true crime consumption, mob psychology, and ADHD executive function. In this episode of Actually ADHD, we discuss ho...

1 Sep 21min