Adults with ADHD show decreased function in brain dopamine reward pathway (2010) • Hacker News Board

Re: Adults with ADHD show decreased function in brain dopamine reward pathway (2010)

#81

Post by Zenbit_UX » Sat, Oct 03, 2020, 4:53 PM UTC

treeman79 wrote: post #20

_dibly wrote: post #7

This was an interesting read but, as an adult with ADHD, all I get out of this is that medication is even more of a benefit to those with real difficulties coping with their ADHD. I've always been one to 'just deal with it' but after a few years of working through school and seeing my younger brothers go through the same thing with medication, I realized that I was essentially just handicapping myself. Now I take med…

Took adderal for year. Completely life changing. My focus and energy level were on par with a normal persons. Unfortunately it was far too hard on the body. Started stroking out on it. Plus it interacted with almost every Medicane I’ve been prescribed. Tried vyvanse. Only one side effect. The deepest most profound sadness imaginable. Would sit for hours just “sad”. Nothing was bothering me. Worked fine aside from tha…

You can get a genetic test to see which adhd medication works best with your DNA and is least likely to give undesirable side effects.

Re: Adults with ADHD show decreased function in brain dopamine reward pathway (2010)

#82

Post by Zenbit_UX » Sat, Oct 03, 2020, 4:55 PM UTC

pen2l wrote: post #10

zarkov99 wrote: post #8

Earlier quoted context omitted.

What medication do you take now? Did you take anything while growing up?

I take concerta, 18mg, and it works wonders. The only small negative is the its life is a little too long... even if I take it at 7am, I find I have difficulty getting to sleep sometimes up till 3am... and then my whole sleep schedule gets shifted and it’s damn difficult to get it back to a proper rhythm. That aside, I _so_ agree with grandparent post about the negative stigma associated with medication for adhd. I’m…

Try dexedrine imo, I had what you're describing with XR pills like vyvance and if I ever woke up late I knew I couldn't take the pill without having an all-nighter.

5mg of dexedrine at 8am gets me til 5-6pm and no crash afterwards.

Re: Adults with ADHD show decreased function in brain dopamine reward pathway (2010)

#83

Post by __blockcipher__ » Sat, Oct 03, 2020, 4:55 PM UTC

haneefmubarak wrote: post #73

_dibly wrote: post #7

This was an interesting read but, as an adult with ADHD, all I get out of this is that medication is even more of a benefit to those with real difficulties coping with their ADHD. I've always been one to 'just deal with it' but after a few years of working through school and seeing my younger brothers go through the same thing with medication, I realized that I was essentially just handicapping myself. Now I take med…

What's a more modern medicine in this context?

I would guess Vyvanse, it’s dextroamphetamine bound to a lysine molecule. Your liver must cleave the lysine before the d-amp is released giving a smooth release, taking ~3.5 hours till you hit max blood concentration.

Fun fact: Methamphetamine naturally takes 3-3.5 hours to hit peak so Vyvanse has a more “meth-like” concentration curve as opposed to raw d-amp (or adderal which is 75% d-amp 25% l-amp) which hits way sooner. As an aside, Meth is very misunderstood and is in many ways a more ideal ADHD drug than normal amphetamine; and indeed it can be prescribed under the brand name Desoxyn. Methamphetamine when taken in low-moderate oral doses is completey safe and less jittery than amphetamine, but if abused (say, smoking 100mg d-meth) it becomes far more neurotoxic.

Understanding enantiomers (left-handed vs right-handed molecules in this case) is really important. For amp / methamp, the d enantiomer is 3-4x more powerful by weight yet is more cerebral as opposed to causing peripheral (body) stimulation. So d is almost always superior, although with adderall it has been found that the 75/25 d/l formula synergizes and has a bit longer half life

Re: Adults with ADHD show decreased function in brain dopamine reward pathway (2010)

#84

Post by saeranv » Sat, Oct 03, 2020, 4:56 PM UTC

TheLegace wrote: post #45

cbluth wrote: post #3

i have severe ADD, and i dont have the patience with myself to read enough of this article to benefit my understanding of it.

Take a look at this new treatment(neurofeedback)[1]. It changed my life. Instead of changing brain chemically you can change the structure of your brain. It's not ADHD that's the problem, its the focus networks in the brain not being trained properly. ADHD becomes a gift when you can focus and the brain just naturally learns, and memorizes very well. I went from being incapable of anything to being really great at an…

This is really fascinating. I just sent them an email to see if I could participate (diagnosed with ADHD 6 months ago at age 33, feeling pretty depressed that all the years of struggling/setbacks were to some degree unnecessary).

May I ask how long have you been participating in the training?

Re: Adults with ADHD show decreased function in brain dopamine reward pathway (2010)

#85

Post by whimsicalism » Sat, Oct 03, 2020, 4:58 PM UTC

dx87 wrote: post #18

_dibly wrote: post #7

This was an interesting read but, as an adult with ADHD, all I get out of this is that medication is even more of a benefit to those with real difficulties coping with their ADHD. I've always been one to 'just deal with it' but after a few years of working through school and seeing my younger brothers go through the same thing with medication, I realized that I was essentially just handicapping myself. Now I take med…

Yeah, the stigma against the medication, and the people who casually say "omg, I'm like, so ADD" really hurt the people who have actually been diagnosed with it. Depending on where you live, it can be difficult to find a psychiatrist willing to see you for a diagnoses and subsequent prescription because they think that you're a college kid wanting to abuse it or sell it. I had to call 4-5 different offices until I fo…

From my perspective, the thing that has hurt the credibility around ADHD diagnoses is the pretty blatant use by affluent parents to get diagnoses so they can get test-time extensions for their kids.

ADHD diagnosis is much more strongly correlated with affluence than many other mental illnesses.

Eliminating the 504 accommodation would be beneficial in my view.

Re: Adults with ADHD show decreased function in brain dopamine reward pathway (2010)

#86

Post by treeman79 » Sat, Oct 03, 2020, 4:58 PM UTC

Zenbit_UX wrote: post #81

treeman79 wrote: post #20

Earlier quoted context omitted.

Took adderal for year. Completely life changing. My focus and energy level were on par with a normal persons. Unfortunately it was far too hard on the body. Started stroking out on it. Plus it interacted with almost every Medicane I’ve been prescribed. Tried vyvanse. Only one side effect. The deepest most profound sadness imaginable. Would sit for hours just “sad”. Nothing was bothering me. Worked fine aside from tha…

You can get a genetic test to see which adhd medication works best with your DNA and is least likely to give undesirable side effects.

I did not know this.

Biab

Re: Adults with ADHD show decreased function in brain dopamine reward pathway (2010)

#87

Post by jdavis703 » Sat, Oct 03, 2020, 5:00 PM UTC

Zenbit_UX wrote: post #81

treeman79 wrote: post #20

Earlier quoted context omitted.

Took adderal for year. Completely life changing. My focus and energy level were on par with a normal persons. Unfortunately it was far too hard on the body. Started stroking out on it. Plus it interacted with almost every Medicane I’ve been prescribed. Tried vyvanse. Only one side effect. The deepest most profound sadness imaginable. Would sit for hours just “sad”. Nothing was bothering me. Worked fine aside from tha…

You can get a genetic test to see which adhd medication works best with your DNA and is least likely to give undesirable side effects.

From my understanding the verdict is still out on these. What test are you referencing and is it an FDA approved test?

Re: Adults with ADHD show decreased function in brain dopamine reward pathway (2010)

#88

Post by Zenbit_UX » Sat, Oct 03, 2020, 5:01 PM UTC

sergiomattei wrote: post #62

I recently started atomoxetine for my ADHD and had to completely stop it. Side effects were killing me. After I stopped, I was more hyperactive and less focused... Yet the hyperactivity compensated for the "less focused" part, and I finished a week's work in a day. That's my experience with meds so far. They completely eliminate my anxiety and make me feel in control of my emotions. Yet they make me less productive t…

I said this somewhere else in the thread already but it sound like it could help you, get a genetic compatibility test for adhd meds, my doctor gave me a referral for one and it gave clear recommendations on which medications would likely be fine and which would have chances of negative side effects. Even without the referral I'm sure you can get a test like this privately for reasonable price.

These medications are serious and side effects can include thoughts of suicide so I'm always shocked when doctors try to wing it and just prescribe whatever and see how it goes. I'm hoping it's because they don't know about the genetic tests yet but some are likely willfully ignorant.

Re: Adults with ADHD show decreased function in brain dopamine reward pathway (2010)

#89

Post by dr_dshiv » Sat, Oct 03, 2020, 5:04 PM UTC

kqr wrote: post #71

dr_dshiv wrote: post #69

Earlier quoted context omitted.

You know what's totally nuts? Taking Amphetamine daily for years in reasonable doses essentially has no long term negative effects. In that way, similar to coffee. When I think about that, it's kind of mind blowing. For that matter, it is also crazy that we don't start giving children coffee at younger ages to help focus — since there are no known negative effects. It's just a cultural trope that it stunts growth, et…

> You know what's totally nuts? Taking Amphetamine daily for years in reasonable doses essentially has no long term negative effects. In that way, similar to coffee. This is a null hypothesis that hasn't been refuted due to lack of evidence, and not an alternative hypothesis that has been proven by evidence, right? I ask because I've been looking into this before, and from what I remember there was virtually no evide…

Well, it's scientifically difficult to randomly assign people and assess effects for multiple decades. So the ideal evidence won't be available.

But if we accept a "nutrition science" level of evidence, then I'd say there is strong evidence showing the naturalistic longterm use of adhd meds is not dangerous. Especially considering our baysian prior: a person off the street would estimate far stronger negative effects of taking speed every single day.

In fact, adhd meds are correlated with healthier outcomes (of course, huge selection effects. Yes, eating kale will be associated with increased health, but it isn't causal)

Here is the best recent review that I know of: https://www.sciencedirect.com/science/article/pii/S0924977X1...

I'd love to know your take.

Re: Adults with ADHD show decreased function in brain dopamine reward pathway (2010)

#90

Post by FooBarBizBazz » Sat, Oct 03, 2020, 5:05 PM UTC

relativeadv wrote: post #27

pastrami_panda wrote: post #15

Earlier quoted context omitted.

Many years ago I read the preface to the behemoth of a book that is Infinite Jest by DFW. I don't remember the wording of the preface, but I recall it arguing that the sheer size of the book could be regarded both as a cultural experience as well as a mental exercise. The author of the preface argued that when (or perhaps if) you finished the book you would feel like you've just run a marathon. You would be highly fi…

This is really insightful, thanks. Makes me want to take another swing at Infinite Jest. With depression, we might take medication to grant us a seat at the table of recovery via a therapist. The hope is to get off of that medication eventually. Perhaps the same holds true with ADD/ADHD? I am not a psychiatrist. I've been wondering about this attention deficit and reading comprehension issue for awhile now. I would l…

> If we're talking about a dysfunctional reward pathway would it not stand to reason that someone's gravitation toward systems who provide thousands of small immediate rewards only reinforce this dysfunction?

This makes perfect sense to me.

But in the longest term, what actually /is/ the point? What is the reward that people are supposed to be pursuing /instead/ of video games, porn, and Instagram? We cannot pursue long-term goals if we don't have any. Where do they come from, those goals, that purpose?

> I feel kind of gross typing that out because it feels like some sort of appeal to nature but I can't shake it.

I wonder what you mean by this.

The apparent grossness of appeals to nature must stem from the fact that they have been used to justify injustice. But every form of argument is used to justify injustice -- so I don't think we should pre-emptively cut away our mind's ability to think naturalistic thoughts, just to avoid error. Maybe we have ignored Mother Nature for too long.

This brings me back to the original question, about purpose. Maybe it comes from Nature. Maybe a failure to enthusiastically perform for society means that the menu of options offered by that society contains nothing compatible with what Nature actually wants for us.

Porn is the best example. Why is it bad? What real thing is it simulating? What should you be doing instead?

Video games are similar: What real thing is being simulated?

You mention the development of competencies as an alternative. I agree that this is better. But what purpose of Nature's is served by the development of skills?

The feeling I can't shake is that addiction is the substitution of the simulated for the real, that increasingly everything is simulated, that the thing we are being distracted from is our own biological reality, and that we are, again artificially, trying to hack our own reward systems to be satisfied with goals that our not in our own Natures.