Tripsitter ADHD Medication Efficacy Survey
Thank you so much for offering your time and limited executive functioning to fill out this survey!!

You can link to the full article and learn more here: https://tripsitter.com/news/why-your-add-meds-may-not-be-working/
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If you would like to stay anonymous, skip this question. Otherwise a first name to attribute any quotes is good!
What's your age? *
Your sex *
1. What drug were you prescribed?
*
Required
1a. What is your dosage? *
1b. How long have you been on stimulant medication?
*
2. Has your prescription changed in the last three months?
*
2a. If so, what was the cause of the change?
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2b.  When was your last prescription change?
*
3. Has your medication label changed month-to-month?  *
3a. Did the shape/color of the pills change month to month?
*
3b.  Please share the pill stamp (letters/numbers on the pill)   if you have any on hand  *
3c.  Please share the batch number of your current prescription if possible
*
4. Where are you located? (be as broad or specific as you'd like!)
*
5. What Pharmacy Do You Use? *
Required
6. Do you get prescription via Telehealth provider or an in person psychiatrist?
*
7. When you take your medication, how effective is it? *
8. Please select all effects that apply to your experience. *
Never
Rarely
Some Days
Most Days
Every Day
Decreased Executive Function
Decreased Focus
Decreased Mood Stabilization
Decreased Negative Side Effects (jitters, sweatiness, dry mouth)
Racing Thoughts
Headaches
Brain Fog
Fatigue
Increased Appetite
Increased Anxiety
Increased Depression
Increased Irritability
8a. Please share  any details you feel are relevant to your experience not covered in this survey *
9. Do you take tolerance breaks? 
*
9a. If so, when was your last tolerance break? *
9b. Has your prescriber recommended taking tolerance breaks? *
9c. Multiple factors can alter the effect of your medication. Please mark any factors that apply to you: *
Required
10. Have you spoken to your psychiatrist about your experience? *
11. Have you filed a complaint with the FDA at 888-INFO-FDA (888-463-6332)/ the Canadian Health Authority at 866 234-2345? *
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