Ladder

Titration & PK dosing, embeddable.

A pharmacokinetic titration engine for stimulants and non-stimulants. Eight drugs, six PGx genes, forty CPIC reference cards, SMART-on-FHIR ready — build it into your EHR.

Open Ladder How it works

LadderPrecision · Dosing

Get the dose right — with less trial and more evidence.

Titration is where ADHD treatment often stalls. Too fast, and side effects erode trust. Too slow, and the family loses months waiting for a fair test. Too cautious, and the patient never reaches an effective dose. The evidence for how to titrate exists — it's just scattered across textbooks, CPIC guidelines, and individual prescribers' experience.

Ladder brings that evidence into the workflow: pharmacokinetic models for the drugs that matter, pharmacogenomic-aware rules where the genotype is known, and forty CPIC reference cards a click away. It runs as its own tool today, with SMART-on-FHIR embedding built and waiting on a live EHR pilot. Clinicians reach the right dose faster because the reasoning is right there.

Features

The titration reasoning that used to live in someone's head.

8 drugs modelled

Stimulants and non-stimulants — the ADHD formulary a general clinician actually reaches for.

PGx-aware

CYP2D6, CYP3A4, CYP2B6, CYP1A2, and CES1 — genotype-aware rules where the patient's PGx is on file.

40 CPIC reference cards

Guideline cards at the point of decision — searchable, printable, always current.

SMART-on-FHIR

Built to embed inside Epic, Cerner, and other SMART-on-FHIR EHRs. The OAuth2 launch flow is implemented; a live pilot against a host sandbox is the next gate.

Open Ladder

One cockpit — run it standalone or embedded.

Ladder is a single workspace. Use it directly, or embed it inside your EHR via SMART-on-FHIR.

Side A

Open Ladder

The cockpit — titration workflow, dose calculators, and PGx reference cards. Sign in with your clinic account today; EHR-embedded launch via SMART-on-FHIR is pilot-pending.

Open the cockpit

Ladder is one of the research tools built inside the Synapse Spark Foundation. Everything we make is part of the same mission — understanding neurodivergent minds and supporting the researchers advancing the science.

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