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Work through interactive clinical case studies, test your reasoning against discussion questions, then review the expert analysis.
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Medication optimisation in a teenager with anxiety
A 15-year-old on methylphenidate with emerging anxiety symptoms and suboptimal response.
Clinical presentation
A 15-year-old girl diagnosed with ADHD 18 months ago is on extended-release methylphenidate 36mg. Her teachers report improved focus but her parents describe increasing irritability, sleep onset difficulty and new anxiety around exams. ADHD rating scales show partial response. She is otherwise well with no comorbidities previously identified.
Discussion questions
1. How would you assess the relationship between medication and anxiety? 2. What adjustments to the treatment plan could be considered? 3. When would you consider switching medication class? 4. What non-pharmacological supports should be offered?