Starting ADHD medication in the UK means entering a process called titration, where your prescriber gradually adjusts your dose to find what works for you. This guide covers what to expect week by week, what's worth tracking, and how to make the most of your review appointments.
Titration is the process of starting at a low dose and increasing it gradually until your prescriber finds the balance between effective symptom management and tolerable side effects. It is not a one-appointment process. In the UK, titration typically takes two to four months, sometimes longer depending on how you respond and how often you can be reviewed.
The starting dose is deliberately low. If you feel very little on your first day, that is expected. Your prescriber is not looking for a dramatic change at this stage. They are establishing a baseline and watching for how your body responds before adjusting.
The specific titration path depends on which medication you are prescribed. Elvanse typically starts at 30mg and steps up to 50mg, then 70mg. Concerta XL starts at 18mg and moves through 27mg, 36mg, and 54mg. Ritalin starts at 5mg two or three times daily. Your prescriber will explain your specific path.
You may notice a clear effect on your first day, or you may feel very little. Both are normal at a starting dose. Common early experiences include improved focus, reduced mental noise, suppressed appetite, dry mouth, and difficulty sleeping. Some of these are side effects that often settle within the first one to two weeks.
What matters most this week: notice when the medication seems to start working, when it seems to fade, and whether anything feels uncomfortable. You do not need to draw conclusions yet. If you are using ADHDose, the concentration curve shows this visually from your very first dose.
Initial side effects like appetite suppression and sleep disruption typically begin to settle by the end of the second week, though they do not always disappear entirely. You may start to notice a more consistent pattern: a window during the day when you feel most focused, and a point where things begin to fade.
If you are on a long-acting medication like Elvanse or Concerta XL, the point where the afternoon decline begins is one of the most useful things you can bring to your first review. ADHDose shows you exactly when this happens on your curve each day.
Your first review appointment usually happens around two to four weeks after starting. Your prescriber will ask how you are finding the medication, whether side effects are manageable, and whether the dose seems sufficient. Based on your answers, they may increase the dose, keep it the same for another cycle, or consider a different medication.
This is the appointment where having data matters most. Your prescriber needs to know when your medication kicks in, when it fades, how your sleep has been, and what side effects you have experienced. ADHDose captures all of this as you log through the day, and the Clinician Summary gives you an appointment-ready overview.
The recall problem. ADHD itself makes it harder to remember how the past few weeks went. By the time you sit in front of your prescriber, you are reconstructing weeks of lived experience from memory, under time pressure. This is exactly the skill ADHD affects most. Tracking daily, even briefly, means you arrive with a record rather than an impression.
Your prescriber will want to know about dose timing, when the effect started and faded, how your sleep was affected, your general daily experience, and any side effects. These are the variables that inform their decisions about dose adjustments.
The challenge is that ADHD makes it harder to recall and summarise this information accurately, especially under the time pressure of a short appointment. Most people arrive with a vague impression rather than a clear record.
ADHDose logs this automatically. When you log your dose and check in through the day, the app captures your timing, focus, sleep, and side effects in one place. The Clinician Summary feature generates an appointment-ready overview of your data, so you arrive with facts rather than guesswork.
Whether your appointment is 15 minutes or an hour, the challenge is the same: summarising weeks of experience in a way your prescriber can act on. A few things that help:
Lead with the most important thing. If sleep has been a problem, say that first. If you are not feeling any benefit, say that first. Do not wait for them to ask the right question.
Bring a summary, not a diary. Your prescriber does not need to read 30 daily entries. They need to know: how many good days versus difficult days, when your medication seems to wear off, what side effects have persisted, and whether sleep has been affected. The ADHDose Clinician Summary generates exactly this from your logged data.
Know what you want to ask. Write your questions down before the appointment. The most common ones at a first review: should the dose go up, is this side effect expected to settle, and what should I watch for at the next dose level.
This is the question everyone asks, and the answer is less dramatic than you might expect. For most people, effective medication does not feel like a switch being flipped. It feels like the things that were hard before are slightly less hard. Tasks get started more easily. Conversations are easier to follow. The afternoon is not as much of a write-off.
The absence of symptoms is harder to notice than their presence. You may not feel a dramatic "this is working" moment. You may instead notice that you got through a day without the usual difficulty, and only realise in the evening that something was different.
This is where tracking with ADHDose makes the difference. The daily data makes the change visible over time in a way that memory alone cannot. After 14 days, the Insights tab shows you whether your medication is actually shifting your focus, sleep, and daily experience compared to your baseline.
ADHDose shows you your medication level through the day from your very first dose. Log once, see everything.
Download free →This article is for informational purposes only. ADHDose is not a medical device and does not provide medical advice, diagnosis, or treatment. Always consult your prescribing doctor or specialist before making changes to your medication.