A prescription stimulant keeping the brain's alertness and reward chemicals active longer. Its clearest effect: less inattention, restlessness and impulsive action in people meeting diagnostic criteria, with matching gains in daily functioning. Adults without the diagnosis gain less: better recall, steadier attention, tighter impulse control. Costs are consistent: slower sleep onset, blunted appetite, headache, faster pulse, higher blood pressure. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Resting pulse | 50–70 beats per minute | Tracks the drug's direct cardiac load |
| Blood pressure | Below 120/80 mmHg | Detects the pressor effect and long-term hypertension risk |
| Body weight | Within 2 kg of pre-treatment baseline | Appetite suppression is the commonest cause of unintended loss |
| Sleep latency and total sleep | Latency below 20 minutes; 7–9 hours total | Quantifies the dominant adverse effect |
| Ferritin | 50–100 ng/mL | Iron limits the enzyme that makes dopamine; low stores blunt response |
| Thyroid-stimulating hormone | 0.5–2.0 mIU/L | Untreated overactive thyroid mimics and amplifies stimulant effects |
| Fasting glucose | 75–86 mg/dL | Stimulant-driven stress hormones oppose insulin action |
| Electrocardiogram | No established numeric target; sinus rhythm, corrected QT below 450 ms in men, 460 ms in women | Screens for the arrhythmia risk that turns a pressor effect into an event |
| Full blood count | No established target; track change from own baseline | Labels list rare suppression of blood cell counts with long-term use |
Cadence: Blood pressure, pulse and weight at one week, four weeks, three months and then every six months, and one week after every dose change; the blood panel at six months and then annually.