The evidence base for ADHD pharmacotherapy has answered one question more confidently than any other: whether medications are effective, on average, in reducing core ADHD symptoms. We know that several stimulant and non-stimulant treatments, including methylphenidate, amphetamines, atomoxetine, and guanfacine, improve symptoms at the patient-group level.1 What has remained harder to identify is where titration should stop: the point at which further dose escalation is unlikely to yield meaningful additional benefit and might instead worsen tolerability.

