Does needing therapy in addition to medication mean the medication isn't working?

No, needing therapy alongside medication doesn't mean the medication has failed, the two typically address different parts of the picture. Medication targets the underlying neurochemical regulation involved in attention and impulse control, while therapy, particularly CBT adapted for ADHD, helps build skills like planning, emotional regulation, and addressing patterns like procrastination or low self-esteem that often develop over years of unmanaged symptoms. Canadian guidelines specifically recommend combined approaches, medication plus psychosocial support, for many people, precisely because each addresses something the other doesn't reach on its own. If the change is persistent, distressing, or affecting daily functioning, contact your provider through the FasTreat portal rather than changing medication on your own. Related reading: https://www.fastreat.com/en/blogs/cbt-techniques-for-adhd-focus References: https://www.caddra.ca/wp-content/uploads/Canadian-ADHD-Practice-Guidelines-4.1-January-6-2021.pdf

Started therapy about two years after starting medication once the day-to-day symptoms were more manageable and I actually had the bandwidth to work on other patterns. Neither felt like it meant the other was failing. Starting them at different times actually made it easier to tell which changes were coming from which piece of the treatment plan. Made it a lot easier to tell which change was actually helping and how.