A Therapy Center for Autistic Girls & Women
She Rocks the Spectrum
Tracking a Medication Trial
Finding the right medication and dose is usually a process of small, monitored adjustments — not a single perfect prescription. A simple log turns 'I think it helped?' into real data your prescriber can use.
Educational, not medical advice: This worksheet helps you prepare and reflect — it doesn't give medical advice or replace your prescriber. Any decision about medication is between you and a qualified professional who knows your history.
What we're watching
With your prescriber, note the target symptoms you're hoping to shift and any side effects to keep an eye on.
Target symptoms and side effects to track
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Daily log
Fill one row a day. Focus and mood on a 1–5 scale; keep it quick.
Daily medication log
Row 1
- Date: ____________________
- Dose: ____________________
- Focus (1-5): ____________________
- Mood: ____________________
- Sleep: ____________________
- Appetite: ____________________
- Notes: ____________________
Row 2
- Date: ____________________
- Dose: ____________________
- Focus (1-5): ____________________
- Mood: ____________________
- Sleep: ____________________
- Appetite: ____________________
- Notes: ____________________
Row 3
- Date: ____________________
- Dose: ____________________
- Focus (1-5): ____________________
- Mood: ____________________
- Sleep: ____________________
- Appetite: ____________________
- Notes: ____________________
Row 4
- Date: ____________________
- Dose: ____________________
- Focus (1-5): ____________________
- Mood: ____________________
- Sleep: ____________________
- Appetite: ____________________
- Notes: ____________________
Row 5
- Date: ____________________
- Dose: ____________________
- Focus (1-5): ____________________
- Mood: ____________________
- Sleep: ____________________
- Appetite: ____________________
- Notes: ____________________
Row 6
- Date: ____________________
- Dose: ____________________
- Focus (1-5): ____________________
- Mood: ____________________
- Sleep: ____________________
- Appetite: ____________________
- Notes: ____________________
Row 7
- Date: ____________________
- Dose: ____________________
- Focus (1-5): ____________________
- Mood: ____________________
- Sleep: ____________________
- Appetite: ____________________
- Notes: ____________________
Patterns I'm noticing
Trends over the days
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Questions this raises
Things to ask at my next appointment
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Review, don't self-adjust: Bring this to your prescriber and change nothing on your own. The log is for the conversation; the dosing decisions stay with them.
