Use this worksheet to notice what changes during an ADHD medication trial. It is designed to help you bring clearer information to your prescriber—not to decide on your own whether to change a dose, timing, or medication.
Track benefit and cost. A medication can help one part of your day and create a problem somewhere else. Both pieces belong in the review.
Before You Start
Medication:
Dose:
Formulation: ☐ immediate-release ☐ extended-release ☐ not sure
Date started or changed:
Prescriber:
What am I hoping becomes easier?
Choose two or three things that matter in daily life.
Before this medication or dose change
Briefly note your usual pattern so you have something to compare with.
Sleep:
Appetite/eating:
Anxiety/tension:
Mood:
Energy:
Current stress or unusual circumstances:
Daily Medication Check-In
You do not need to fill out every item every day. Use the parts that help you notice a pattern.
What to notice | Today |
Date | |
Time medication taken | |
Food around the dose | |
When I first noticed a useful effect | |
What felt easier? | |
What still felt hard? | |
When did the useful effect seem to fade? | |
What happened as it wore off? | |
Appetite/eating | |
Anxiety, tension, or jitteriness | |
Irritability or emotional changes | |
Headache, stomach symptoms, dry mouth, or other physical effects | |
Sleep that night | |
Anything else that may have affected the day? |
Quick Rating
Use this only if numbers make the pattern easier to see.
0 = none / no change
1 = mild
2 = noticeable
3 = strong
Area | 0 | 1 | 2 | 3 |
Helpful effect | ☐ | ☐ | ☐ | ☐ |
Appetite change | ☐ | ☐ | ☐ | ☐ |
Anxiety/jitteriness | ☐ | ☐ | ☐ | ☐ |
Irritability/rebound | ☐ | ☐ | ☐ | ☐ |
Sleep disruption | ☐ | ☐ | ☐ | ☐ |
Physical side effects | ☐ | ☐ | ☐ | ☐ |
Optional: Menstrual-Cycle Pattern
Use this only if you already suspect that your symptoms or medication response change across the month.
Cycle day or phase, if known:
Period started today? ☐ yes ☐ no
Does the medication feel different from other parts of the month?
Do not change your medication based on cycle phase unless you have a plan with your prescriber.
After Several Days: Look for the Pattern
You are not looking for a perfect score. You are looking for repetition.
What is consistently easier?
What is consistently harder or uncomfortable?
How long does the useful effect usually seem to last?
Is there a predictable wearing-off pattern?
Is the medication helping during the part of the day when I most need support?
What is the medication costing me?
Think about appetite, sleep, mood, anxiety, physical comfort, recovery, or feeling unlike yourself.
Before Your Next Prescriber Visit
Complete these sentences.
The most helpful change has been:
The biggest problem has been:
One thing I am unsure about is:
I want to ask whether the dose, timing, formulation, or medication itself could be contributing to:
A practical barrier affecting treatment is:
☐ cost
☐ pharmacy availability
☐ refill rules
☐ remembering doses
☐ swallowing pills or formulation
☐ eating enough
☐ sleep schedule
☐ another medication or health issue
☐ other:
A Simple Script for the Appointment
“This medication is helping me with [what is easier]. I am also noticing [side effect or problem]. It seems to last about [how long]. I want to review whether the dose, timing, formulation, or another option would fit better.”
Contact Your Prescriber Sooner If
Do not wait for the next routine appointment if you develop a significant or concerning change, including severe mood changes, suicidal thoughts, fainting, chest pain, severe agitation, or another symptom your clinician has told you requires prompt attention.
This worksheet is educational and does not replace medical advice. Do not start, stop, increase, decrease, split, or otherwise change an ADHD medication without following the prescribing plan from your clinician.
Flourishing Women LLC
Kristen McClure, MSW, LCSW