Titration & monitoring
Titration is the process of adjusting treatment while tracking benefit, side effects and physical observations.
The goal is not simply to reach a high dose. It is to find an effective, tolerated regimen for the individual.
The treatment journey
Relevant history, current medicines and physical observations are reviewed before starting medication.
A specialist initiates an appropriate treatment according to the clinical plan.
Dose or formulation is adjusted while symptoms, function and adverse effects are reviewed.
A regimen is considered stable when benefit and tolerability are acceptable and monitoring is satisfactory.
Ongoing monitoring and at least annual medication review remain important.
What gets monitored
Monitoring can include symptom improvement, functional change, adverse effects, blood pressure, pulse, weight and other measures depending on age, medicine and clinical circumstances. NICE and SPS also emphasise ongoing review rather than leaving treatment unchanged indefinitely.
NICE NG87 – ADHD: diagnosis and management ↗ · NHS SPS – modified-release methylphenidate ↗
What happens after stabilisation?
Some people continue under the specialist. In other cases, a shared-care arrangement may be proposed so that primary care takes on agreed prescribing and monitoring responsibilities while specialist oversight continues.
Shared care explained →