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Quiz: Medication

Test your understanding of how ADHD medications work, what to expect during titration, and how to make an informed medication decision with these review questions.

1. What are the two classes of stimulant medications for ADHD?

  1. SSRIs and SNRIs
  2. Beta blockers and antihistamines
  3. Methylphenidate and amphetamine medications
  4. Sedatives and antipsychotics
Show Answer

The correct answer is C. The chapter names exactly two stimulant classes — methylphenidate (Ritalin, Concerta) and amphetamine medications (Adderall, Vyvanse) — as close cousins with slightly different mechanisms. Options A, B, and D name unrelated medication categories not used as first-line ADHD stimulant treatments.

Concept Tested: Stimulant Medications

See: Chapter 7

2. What is titration, as this chapter defines it?

  1. The deliberate process of finding the right medication and dose by starting low and adjusting stepwise while measuring response
  2. A one-time test that determines a person's exact lifelong dose
  3. A surgical procedure used to treat severe ADHD
  4. The process of switching entirely from medication to therapy
Show Answer

The correct answer is A. Titration is the stepwise process of starting low and adjusting medication and dose while measuring response, since the effective dose can only be found empirically for each individual nervous system. Option B wrongly treats it as a single test rather than an ongoing process. Option C misdescribes it as surgery. Option D confuses it with an unrelated treatment switch.

Concept Tested: Titration

See: Chapter 7

3. What does this chapter mean by "pills don't build skills"?

  1. Medication has no effect on ADHD symptoms whatsoever
  2. Only non-stimulant medications are effective; stimulants are placebo
  3. Skills-based treatment always works better than medication
  4. Medication can improve executive functioning for some hours a day, but it doesn't install routines, teach planning, or organize a backpack — systems and skills still need to be built separately
Show Answer

The correct answer is D. The chapter is clear that medication can improve steerable attention for part of the day, but it doesn't teach planning or build routines — those come from the systems in later chapters, working alongside medication rather than being replaced by it. Option A contradicts the chapter's strong evidence base for medication's effect. Option B misrepresents stimulants as ineffective. Option C makes an unsupported ranking claim the chapter never makes.

Concept Tested: Medication Overview

See: Chapter 7

4. How do stimulant medications work in the brain, according to this chapter?

  1. They sedate the brain broadly, reducing all activity equally
  2. They mainly block dopamine (and norepinephrine) reuptake, or boost release, strengthening signaling in prefrontal and reward circuits that under-serve regulation
  3. They permanently rewire neural pathways within a single dose
  4. They work by suppressing appetite, which indirectly improves focus
Show Answer

The correct answer is B. The chapter explains that methylphenidate blocks dopamine and norepinephrine reuptake while amphetamines also boost release, both strengthening signaling in the prefrontal and reward circuits Chapter 2 identified as under-serving regulation. Option A misdescribes stimulants as sedating rather than improving steering. Option C overstates a same-day chemical effect as permanent rewiring. Option D reverses cause and effect; appetite suppression is a side effect, not the mechanism of action.

Concept Tested: How Stimulants Work

See: Chapter 7

  1. The claim is entirely accurate and families should be alarmed
  2. Stimulant medications contain no similar compounds to any illegal drug
  3. The molecules are related, but medical formulations, doses, and delivery are engineered exactly opposite to abuse pharmacology, with slow delivery as a safety feature
  4. This concern only applies to non-stimulant medications
Show Answer

The correct answer is C. The chapter acknowledges the molecules are related but explains that medical dosing and slow-delivery formulations are engineered specifically to avoid abuse pharmacology, which is itself a safety feature. Option A overstates the concern as fully valid. Option B denies a chemical relationship the chapter acknowledges. Option D misapplies a stimulant-specific misconception to non-stimulants, which aren't controlled substances at all.

Concept Tested: Stimulant Misconceptions

See: Chapter 7

6. Why does a disappointing first trial of one stimulant class mean less than families often fear, according to this chapter?

  1. Because response is individual by class, and a person who responds poorly to one class quite often does well on the other — trying the other class is a standard next step
  2. Because medication never actually works for ADHD
  3. Because all stimulants are chemically identical regardless of class
  4. Because a disappointing trial always means the diagnosis was wrong
Show Answer

The correct answer is A. The chapter states that response is individual by class, so a poor result on one class often doesn't predict the other, making "try the other class" a standard, low-stakes next move. Option B contradicts the chapter's strong evidence base for stimulant effectiveness. Option C is factually wrong; the two classes work through related but distinct mechanisms. Option D wrongly ties medication response to diagnostic accuracy, which the chapter treats as separate questions.

Concept Tested: Finding The Right Dose

See: Chapter 7

7. A father notices his daughter becomes irritable and flat every day right around 5 pm, and assumes she's "reverting to her old self." Based on this chapter, what is the more accurate explanation?

  1. She is choosing to misbehave on purpose each evening
  2. Her ADHD diagnosis must have been incorrect
  3. The medication is permanently changing her personality
  4. This is likely end-of-dose rebound or wear-off, a predictable pharmacokinetic event tied to when the medication exits her system, not a character reversion
Show Answer

The correct answer is D. The chapter explicitly names the "5 pm cliff" as end-of-dose rebound — a real, schedulable pharmacokinetic event, not a character reversion. Option A misreads a physiological pattern as intentional behavior. Option B conflates a dosing effect with diagnostic accuracy. Option C overstates a temporary daily pattern as a permanent personality change.

Concept Tested: Medication Onset And Duration

See: Chapter 7

8. A family repeatedly struggles because their teen's stimulant prescription can't be refilled early and requires a new prescription every month with ID checks at the pharmacy. Which approach does this chapter recommend?

  1. Ask the pharmacy to bend the rules as a one-time favor each month
  2. Treat the refill logistics as a system to design around from day one — calendar alarms for reorder day, pharmacy apps, and an agreed family reminder protocol
  3. Switch to an unregulated substitute purchased without a prescription
  4. Give up on the medication because the rules are too burdensome to manage
Show Answer

The correct answer is B. The chapter recommends treating Schedule II refill logistics as a system to build from day one, including calendar alarms and an agreed family reminder protocol, since the rules demand exactly the executive function ADHD makes hard. Option A is not a realistic or recommended workaround. Option C is unsafe and never suggested. Option D abandons a working treatment over a solvable logistics problem.

Concept Tested: Controlled Substance Rules

See: Chapter 7

  1. Stop the medication immediately and never revisit medication as an option
  2. Ignore the flatness and appetite changes since the homework result alone proves success
  3. Record all the changes with times of day, report them fully to the prescriber, and let the titration process adjust the dose or timing rather than ending the trial early
  4. Double the dose immediately to see if the homework improvement gets even stronger
Show Answer

The correct answer is C. The chapter treats every symptom in this scenario as a titration signal — recorded with times of day and reported to the prescriber, so the process can adjust dose or timing rather than the trial being abandoned or escalated unilaterally. Option A discards real target-symptom progress unnecessarily. Option B ignores side effects the chapter treats as significant. Option D is a unilateral dose change that should go through the prescriber, not the family.

Concept Tested: Tracking Medication Response

See: Chapter 7

10. A family weighing whether to try medication worries that starting it means committing to a permanent, irreversible path. Using this chapter's framing, how should they best analyze this concern?

  1. A stimulant trial is closer to a reversible experiment than a permanent life choice, since same-day pharmacology means stopping returns the person to baseline, and the real comparison is medication versus the costs of the status quo, not medication versus nothing
  2. The concern is accurate; once started, stimulant medication cannot be stopped
  3. Medication decisions, once made, should never be revisited at any later life stage
  4. The only responsible choice is to avoid medication entirely to prevent any risk
Show Answer

The correct answer is A. The chapter reframes the decision three ways: a stimulant trial is reversible because effects don't accumulate day to day, the real comparison is against the status quo's own costs (burnout, chronic stress), and the decision is renewable at every life stage. Option B and C both wrongly treat the decision as permanent and unrevisitable, which the chapter directly rejects. Option D swaps one blanket answer for another instead of weighing the actual trade-offs.

Concept Tested: Deciding About Medication

See: Chapter 7