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ADHD drug treatment and risk of negative events and outcomes

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381–390 of 537 posts

Re: ADHD drug treatment and risk of negative events and outcomes

#381
post #244

My hypothesis about this for a long time has been stimulants help everyone be more productive (with some tradeoffs) and ADHD is kind of a weakly differentiated diagnosis that could apply to most people. Probably something like this was lost when people stopped smoking, obviously beneficial for health - but a huge amount of the public was taking stimulants regularly via nicotine until relatively recently.

Your hypothesis is contracted by mountains of high quality scientific evidence. ADHD is a well-defined condition and there is an accepted way of diagnosing someone with it that effectively divides those with the condition from those without it. Stimulant medications may help many people to feel and be more productive, but that does not imply that people who meet the criteria for ADHD do not represent an identifiable…

Which part of the disgnosis do you find objective measures? There isnt a single scientific one

Take a look at studying looking at the consensus on diagnosis. Even among psychatrists the same patient gets diagnosed with different things.

Re: ADHD drug treatment and risk of negative events and outcomes

#382
post #378

Earlier quoted context omitted.

> It would be weird if stimulants only had an effect of ADHD patients One example of this actually happening is the concept of a "stimulant nap" in people with ADHD, where stimulants actually make them sleepier. Also manifesting as "I tried coke once, it didn't do anything, I just felt sleepy" Terrible source but it's a pretty common thing: https://www.reddit.com/r/ADHD/comments/hkkyjl/you_know_your_...

I find the claim (repeated verbatim in some of the comments here) that people with ADHD process stimulants differently particularly specious. Are there any medical studies/not-reddit threads that suggest anything like this?

Essentially the idea is that there is an "optimal" amount of alertness (inverted U curve). People with ADHD start below the optimal point, and stimulants move them up towards the optimal point. People without ADHD are typically closer to the optimal point, and stimulants move them past it.

Someone with ADHD taking a large dose will therefore feel the same as someone without ADHD taking a small(er) dose.

Methylphenidate improves sleep in people with ADHD: https://pmc.ncbi.nlm.nih.gov/articles/PMC2276739/

> Compared to [non-adhd] controls untreated [adhd] patients showed increased nocturnal activity, reduced sleep efficiency, more nocturnal awakenings and reduced percentage of REM sleep. Treatment [of those with adhd] with methylphenidate resulted in increased sleep efficiency as well as a subjective feeling of improved restorative value of sleep.

I can't find a corresponding paper studying the effect of stimulants on sleep in healthy adults. I would assume it hasn't been studied because it's common knowledge and it's not worth the risk of making healthy people take stimulants. I also don't think that's the part you were disputing.

Re: ADHD drug treatment and risk of negative events and outcomes

#383
post #292

Earlier quoted context omitted.

There are non-stimulant ADHD meds as well. Most of us don't get a chance to try all of them. In fact, I was surprised to learn that Adderall is highly illegal in many countries, including Japan and South Korea( ), both of which have a higher standard of healthcare, and a much longer life expectancy, than the US does. In other words, they're not anti-health. ( ) In theory, you can bring Adderall into South Korea with…

I’m using Wellbrutin, which is a NDRI (norepinephrine–dopamine reuptake inhibitor) antidepressant. The main reason for this is because I’m also bipolar. First-line stimulants for ADHD cause manic episodes.

Wellbrutin is not dispensed in the UK except for quitting tobacco. Annoying because it seems like a very useful antidepressant.

Re: ADHD drug treatment and risk of negative events and outcomes

#384

The irony about getting treatment for ADHD is that medical providers make it very hard to get the proper medication and treatment. People with ADHD are horrible at following through and handle rejection poorly. So the worse the ADHD is, the less likely somebody will be able to actually get treatment for it. A lot of people suffer because doctors fear losing their license like so many did during the pain pill debacle.…

I agree, except I've been much happier with Wellbutrin. After getting through the initial insomnia a few years ago and switching to normal release, not extended, I have good focus and don't have tremors or back pain like I did with stimulants.

Re: ADHD drug treatment and risk of negative events and outcomes

#385

This was an observational study, not a randomized control trial. Access to care is one plausible confounder. Individuals who receive treatment may differ systematically in socioeconomic status, healthcare access, parental advocacy, comorbidities—from those who do not, affecting outcomes.

Haven't read the study yet, though I've been associated with research at the same department. Usually the study design is using matched controls which negates the effect of the parameters you mention. Sweden basically has free healthcare so there is not much difference in access to care, and controlling for the potential residual factors makes studies results quite stable.

Re: ADHD drug treatment and risk of negative events and outcomes

#387

Earlier quoted context omitted.

> I still struggle to see how it's used recreationally. - Adderall keeps you awake. Some people use that to be awake for very long periods of time. Long drives, marathons, etc. - Adderall can make boring tasks seem engaging, so it can be used, for example, to help a student study. Combining that with no need to sleep that night, can become a bit of an unfair advantage. - Adderall can cause a high, even though I've on…

That's not recreationally. That's actually a good, useful drug effect (even if not specifically for ADHD). I'm more than a little pissed that governments don't let us use drugs like this responsibly.

Governments treat their citizens like children to be watched over, not like adults capable of making decisions. Until that changes, expect to be pissed off.

Re: ADHD drug treatment and risk of negative events and outcomes

#388
post #285

Earlier quoted context omitted.

- Supply chains - Skilled workforce - Risk capital - Regulatory overhead

Other drugs are made outside the USA, what is so special about adderal (besides us regulations which other countries dont have to listen to)

Nothing is special about it. Lots of drug manufacturing is low-risk low-reward but setup costs are high so nobody thinks it's worth the investment.

Re: ADHD drug treatment and risk of negative events and outcomes

#389

My $0.02 as a response to several comments I read in this thread: I was diagnosed with ADHD in my 40s and got Concerta. My belief is that ADHD is not a disease, nor a disability (even though it acts like one very frequently) and in fact there is evidence that ADHD is an important part of our evolution as a species. The problem(s) mostly relies with the modern way of life and what is expected from the society at large…

This is a common belief people have, especially those with mild ADHD or those who wish to be dismissive of the disorder. Unfortunately, in reality while there are some very limited advantages, as a whole ADHD is a whole-brain dysfunction where your neurons are literally incapable of maintaining their level of operation as long as in a healthy person, with ALL of your executive functions - all self-regulation, plannin…

> People also like to claim we'd be better as lookouts or sentries but this isn't true. People with ADHD don't pay more attention to a broader range of things

Have to disagree. Noticing every small noise a neurotypical Brain filters out makes you a good canary.

Re: ADHD drug treatment and risk of negative events and outcomes

#390

The irony about getting treatment for ADHD is that medical providers make it very hard to get the proper medication and treatment. People with ADHD are horrible at following through and handle rejection poorly. So the worse the ADHD is, the less likely somebody will be able to actually get treatment for it. A lot of people suffer because doctors fear losing their license like so many did during the pain pill debacle.…

The system isn't built for people who need it to be a little easier
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