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As the authors explain, these factors are quite important in chronic diseases like diabetes, in which trajectories and therapeutic responses vary

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If you're on a stable ADHD stimulant dose and starting a GLP-1: → Continue current ADHD medication without changes → Track daily protein intake for the first 4 weeks (target minimum 0.8 g/kg body weight) → Set meal-time reminders if appetite becomes too suppressed → If you cannot meet 1,000 calories per day for more than 3 consecutive days, contact your provider to discuss GLP-1 dose reduction → If weight loss exceeds 2% per week for 2 consecutive weeks, contact your provider If you're on a GLP-1 and considering starting ADHD medication: → Discuss the additive appetite suppression risk with your prescriber → Consider starting with a non-stimulant ADHD medication (Strattera, Qelbree) first → If stimulant is necessary, start at the lowest therapeutic dose → Delay GLP-1 dose escalation until you've been stable on the ADHD medication for 4 weeks → Track weight and protein intake weekly If you're on both and experiencing excessive appetite suppression: → First step: reduce GLP-1 dose (easier to titrate than stimulant dose) → If ADHD symptoms are well-controlled at current stimulant dose, consider switching to a shorter-acting formulation so appetite returns in the evening → If ADHD symptoms require current stimulant dose, consider taking a "drug holiday" from the stimulant on weekends to allow appetite recovery → If neither medication can be adjusted without losing therapeutic benefit, structured meal timing plus liquid nutrition is mandatory If you're on both and planning to discontinue one: → Discontinuing the GLP-1 while continuing the stimulant: expect appetite to return to stimulant-suppressed baseline within 4 to 8 weeks → Discontinuing the stimulant while continuing the GLP-1: taper stimulant over 4 weeks to minimize rebound hunger

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