> While at the same time despite being a controlled substance because they're supposedly so addictive people with ADHD forget to take adderall and with normal use you don't take it every day.
This is incorrect: Normal use of stimulant medication is to take it regularly every day.
We also have evidence from studies showing that the brain adapts to consistent dosing in order to counter some of the damaging oxidative effects of amphetamine. Inconsistent dosing could undermine this adaptation and does not mirror the dosing protocol used in studies to determine long term safety. Sporadic dosing is also known to cause sensitization effects in studies, which can sensitize people to the negative side effects of a drug or exaggerate cravings.
Some people do take medication holidays as recommended by doctors, but even those should be done on a pre-determined schedule.
People get themselves into trouble when they start treating Adderall like an ad-hoc drug that they can take more or less of depending on how they feel that day or how much work they need to get done. This not only leaves the brain in a constant and unpredictable state of flux, it creates an association between “I need to do work” and “I need more Adderall”. Patients who go down this path often end up escalating doses, playing games with saving up pills to take more, or trying to talk their prescribers into extra dosages beyond what they need. It ultimately ends with higher tolerance and reduce effectiveness.
> If you don't refill your Rx of antidepressants your doctor will be notified and reach out to you because stopping has such pronounced effects.
This also isn’t true. There are many medications with withdrawal symptoms far worse than antidepressants. Some drugs can be potentially fatal if discontinued abruptly. Pharmacies don’t generally hunt down doctors when a patient doesn’t get a refill.
Antidepressant withdrawal (without taper) can be difficult for some, but so can withdrawing from Adderall. There are entire subreddits acting as support groups for people tapering down Adderall and trying to get back to feeling normal after taking Adderall for years.
Stimulants are definitely habit-forming and have a high abuse potential. Let’s not downplay it.