171–180 of 327 posts
weird. amphetamine is one of the medications of last resort for debilitating depression
In the case of ADHD, amphetamine helps the dopamine dysfunction which in turns alleviates the depressive symptoms.
This doesn't surprise me. I've been prescribed Ritalin at times both as a child and an adult in small doses. It is a remarkable strong medication, and operates much like I imagine recreational drugs operate - there's a definite strong high, and an equally brutal comedown afterword. I would be extremely cautious about prescribing this to anyone, especially children unless nearly every other kind of intervention has be…
> I would be extremely cautious about prescribing this to anyone, especially children unless nearly every other kind of intervention has been explored. A well-trained psychiatrist can diagnose me in [1] https://chadd.org/about-adhd/myths-and-misunderstandings/
I'm trying, probably somewhat poorly, to make the point that there are a lot of potentially useful things to try in terms of managing ADHD beyond Ritalin (though that can be a very useful tool for some).
This was for ONE adhd medication and the risk was only increased for the initial 90 days... and then went back to baseline.
Should also note that the return to baseline was only after discontinuation of the MPH. Can't really tell if it would return to baseline if the medication was continued without digging into the study more than I have so far. Also worth noting for those less familiar with medication names, methylphenidate is sold under the brand names Ritalin and Concerta.
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One way I try to explain it to people: "We give people insulin because they have diabetes. Diabetes is the disease, but you can cure it through diet and exercise for Type 2 (it's environmental), Type 1 you cannot (it's genetic). Insulin treats the disease, but doesn't cure it" Why is it not the same for ADHD or depression? Type 1 is genetic and Type 2 is environmental. The argument I was attempting to make is differe…
Your analogy fails because type one diabetes also has an causal environmental component: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5571740/
“ In this paper, we discuss candidate triggers of islet autoimmunity and factors thought to promote progression from autoimmunity to overt type 1 diabetes (figure 1). These factors seem to have their effect mainly in the genetically predisposed individuals.” [my emphasis]
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First off, do you are assuming that everyone reacts to drugs in the same way? I was taking 1/5th to 1/10th of a 'normal' dose. Secondly, if you do a few minutes of research online you will find that both issues (the high, and the comedown) is not at all an uncommon complaint. Ritalin is a CNS stimulant. With respect, you are being a bit too condescending relative to the amount of knowledge of the issue you posses.
What do you consider to be a “normal” dose? I’ve heard of people using 60+ mg of Ritalin and thinking that’s normal. Ritalin is a powerful stimulant at 5 or 10mg. You can get lower doses or different formulations - e.g. 5 or 10mg at extended release to last through the day. Extended release is usually preferred by doctors in part because you avoid the highs and lows. Regardless of what “normal” practice is, if you ar…
Hello. That's me. I can sleep on that dose. Is that not normal?
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Same. I've had a low-grade depression for all my adult life, which has worsened in the past 5 years. I got diagnosed with ADHD 5 months ago, started medication 2 months ago, and last week I told my therapist I'm pretty sure my life-long depression is in remission. There's a definite feeling that my life is now in a slight upwards trajectory, even on the worst of days. Life tends to become pretty sad when you have no…
Why is it so strange that an amphetamine would get rid of depression?
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As you pointed out ADHD is a disease, what’s the cause? Do you have adhd, or do the drugs help you focus and you want that? Calling it a disease implies something is wrong, but having trouble focusing isn’t “wrong”. It’s a skill one can acquire and may have a variety of factors impacting it (from genetics to environment to mental management). That’s the issue I personally take with these kind of discussions. Medicati…
Not them, and I don't have ADHD, but I am the parent of a child with ADHD and I know plenty of people with ADHD, and it's not just "having trouble focusing". For a lot of people, it's a complete inability to focus on any one thing for any real amount of time. They can try as hard as they can to force themselves, but become disfocused and distracted despite any effort. It also often involves impulsiveness that is incr…
As an ADHDer, I never understood what it was like for others until I got treatment with stimulants. It's like I can just take this magic pill and for 8 hours I'm "normal."
I wish there was an opposite pill, one which made people inattentive and impulsive. Then everyone else could try it for a day or two and see how debilitating it is. Regular, everyday life is like being falling-down drunk in terms of mental incapacitation, and the pills for the first time let us experience life sober.
Edit: how old is your son now? One thing I worry about as a parent of an ADHDer as well is her eating. I've so far avoided treatment for her because I'm worried she'll eat less and her growth will be stunted. We're cautiously waiting on medication until post-puberty.
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Same. I've had a low-grade depression for all my adult life, which has worsened in the past 5 years. I got diagnosed with ADHD 5 months ago, started medication 2 months ago, and last week I told my therapist I'm pretty sure my life-long depression is in remission. There's a definite feeling that my life is now in a slight upwards trajectory, even on the worst of days. Life tends to become pretty sad when you have no…
Why is it so strange that an amphetamine would get rid of depression?
My point is, of course AMPH helps depression from ADHD, because ADHD is a debilitating disorder. But AMPH probably doesn't help in other types of depression not caused by executive function disorders.
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Why is it so strange that an amphetamine would get rid of depression?
Well, a dose doesn’t last forever. It wouldn’t be surprising if it was a net negative. You tend to feel worse on the comedown for example.
> Well, a dose doesn’t last forever. It wouldn’t be surprising if it was a net negative.
My near-sightedness returns as soon as I put down my prescription glasses. I've had to wear them every single day to be able to function decently. Imagine that.
Anecdata, but I've been on methylphenidate (Concerta) since age 7, and holy cow has it impacted my life in an insanely positive way. 21 years later, I'm still on Concerta, but excelling in my career, spending meaningful time with friends, family, and hobbies, and generally pretty happy with myself. When I tried dropping the meds in college, my life basically fell apart in a matter of months. My then-girlfriend now-wi…
Methylphenidate affects me in fairly subtle ways and I'm constantly wondering whether it's actually working or if it's a placebo effect. However, my general experience when I look at the tracking data I collect in my own life mirrors this sentiment.
Methylphenidate doesn't get rid of my distractability or make it easy for me to focus whenever I want, but it does help with my executive dysfunction just enough that I can now set timers more reliably, I can now use calendars more effectively. It's not that the medication made the problem go away, but it seems to have helped enough that it "unlocked" a bunch of additional coping strategies that I had never been able to access in the past no matter how much I tried.
Definitely not for everyone, but also that's what a psychiatrist is for -- to help you experiment with different medications to see if there is one that will help, and to monitor you to see what the side effects are and what the long-term effects are, and to figure out and advise you on what your risk factors are. For some people it can be life-changing.
I think a lot of people see this as a question of medication vs therapy, but for a lot of people with ADHD the two parts work together -- the medication makes the therapy more effective and more productive.