Principles of medication titration

The previous chapter outlined the wide variety of medications used in the treatment of attention deficit hyperactivity disorder (ADHD) and discussed their classification as first or second line agents. This chapter will focus on the clinical use of these medications, particularly the titration of each agent to its optimal dosage for the patient. Here the science of medication treatment, as established by clinical trials of these agents, interacts with the art of clinical care where conclusions from averaged data in studies do not always apply to the individual patient. The physician must be flexible in the dosing strategy used, carefully balancing control of the symptoms of ADHD with minimization of side effects.