ADHD Medication Titration Symptom Tracker — A4 Printable Layout
(Designed for single‑page daily use. You can duplicate for each day.)
Header
ADHD Medication Titration Tracker Date: ______________________ Week of titration: ______________________
Medication: ______________________ Dose: ______________________ Time taken: ______________________
1. Medication Effects Timeline
Onset time: ______________________ Peak time: ______________________ Wear‑off time: ______________________
Notes on timing (optional):
2. Focus & Executive Function (0–10 ratings)
(0 = very difficult, 10 = very easy)
SkillRatingFocus / attention____Task initiation____Sustained attention____Mental clarity____Productivity____Short notes:
3. Mood & Emotional Regulation (0–10 ratings)
(0 = very low, 10 = very stable)
AreaRatingOverall mood____Irritability____Emotional sensitivity____Motivation____Short notes:
4. Physical Side Effects (tick + severity 0–10)
Side EffectTickSeverityAppetite changes☐____Nausea☐____Headache☐____Heart racing / jittery☐____Dry mouth☐____Sleepiness☐____Insomnia☐____Rebound crash☐____Other: __________________☐____Notes:
5. Sleep Tracking
Hours slept last night: ________ Sleep quality (0–10): ________ Difficulty falling asleep: ☐ Yes ☐ No Night waking: ☐ Yes ☐ No
Notes:
6. Daily Functioning Notes
(Context matters — stress, routine changes, food, hydration, hormones, etc.)
7. Optional DSM‑5 Symptom Check (0–3)
(0 = not present, 3 = strongly present)
Inattention
☐ Careless mistakes (0–3): ____ ☐ Difficulty sustaining attention: ____ ☐ Seems not to listen: ____ ☐ Doesn’t follow through: ____ ☐ Disorganised: ____ ☐ Avoids sustained effort: ____ ☐ Loses things: ____ ☐ Easily distracted: ____ ☐ Forgetful: ____
Hyperactivity / Impulsivity
☐ Fidgeting: ____ ☐ Leaving seat: ____ ☐ Restlessness: ____ ☐ Difficulty relaxing: ____ ☐ “On the go” feeling: ____ ☐ Talks excessively: ____ ☐ Blurts out: ____ ☐ Difficulty waiting: ____ ☐ Interrupts: ____
8. End‑of‑Day Summary
Best effect today: ____________________________________________ Most challenging symptom: _____________________________________ Anything to mention to clinician: _______________________________
