Every signal we track has a published reason behind it.

01

Writing it down changes how you notice it

In self-monitoring studies, people who tracked a behaviour changed it, and digital self-monitoring CBT shows moderate to large effects on symptoms and quality of life.^{1, 2, 3}

For Titrate: The effect fades when tracking stops, so a log works best with a purpose, such as a clinic visit.

02

Short check-ins get finished

In ADHD research, people complete about 84% of brief momentary check-ins when the burden is low. Completion falls as the check-in gets longer.⁴

For Titrate: That is why Titrate's check-ins are meant to take under two minutes.

03

Timing matters more than the dose alone

Different ADHD medicines start, peak and wear off at different times. Immediate-release formulations often wear off sooner and can produce a crash in the afternoon, which clinical sources describe.^{7, 8, 9, 10}

For Titrate: Titrate's curve is a predicted average. It is not fitted to you, and it is not a dosing guide.

04

Guidelines ask for records at each change

NICE guidance says symptoms and side effects should be recorded at baseline and at each dose change, on standard scales. Titration usually moves in steps over several weeks.^{5, 6, 11}

05

A checklist catches more than an open question

A structured side-effect checklist, modelled on the Barkley Side Effects Rating Scale, catches more side effects than a general "how are you?" question. Symptoms such as chest pain, palpitations and fainting show a message to contact your prescriber or seek urgent care.^{12, 13}

For Titrate: Safety-critical symptoms show a message to contact your doctor or urgent care. Titrate does not advise on them.

06

Validated scales that are free to use

The ASRS v1.1 is a WHO adult self-report screener, free to use with attribution. WFIRS measures how ADHD affects work, family, life skills and more. Prescribers judge a medication by function as well as symptom scores.^{14, 15, 16, 17, 18}

For Titrate: Titrate does not use the CAARS or BAARS-IV, which require paid licences.

07

Sleep is part of the picture

Most studies find sleep disturbance in a large share of adults with ADHD, and the link runs both ways: poor sleep worsens ADHD symptoms, and ADHD worsens sleep.^{19, 20}

08

Mood and co-occurring conditions

Emotional dysregulation is common in adults with ADHD, and anxiety and depression often occur alongside it. Tracking mood and these signals gives a fuller picture for a prescriber.^{21, 22, 23, 24}

09

Hormonal cycles can change medication response

Emerging research links estradiol drops in the luteal phase to worse attention and reduced medication response. Titrate does not track menstrual cycles yet.²⁵

For Titrate: This is an emerging finding and a reason to ask your prescriber, not a rule.

10

Peer support helps, though the evidence is qualitative

Online ADHD peer groups provide information, emotional support and less isolation. The studies are mostly qualitative, not randomised trials.²⁶

For Titrate: Community is support, not treatment, and it is not a substitute for care.

11

Few apps are built on the evidence

A 2025 systematic review found almost no overlap between published ADHD app evidence and the apps on the stores. Titrate starts from the evidence and works outward.^{27, 28, 29}