How about making it available for adults first?
ADHD Pill Faces High Hurdle in Europe as Stigma Persists
11–20 of 95 posts
Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists
#12I posted this in a HN thread about therapeutic uses of nicotine a week ago, but it's even more relevant here: > A friend of mine is a psychiatrist who specializes in treating ADHD. She told me about a conference she went to recently, where someone presented an interesting paper. > Apparently, there was an amazing study done relatively recently (last five years), in which they demonstrated that, in mice, exposure to n…
> "Vyvanse is just a more concentrated version of the d-enantiomer"
Not at all; it's a prodrug that is converted into the d-enantiomer by your liver, at whatever your xenobiotic-metabolic speed is.
The major result of this has nothing to do with how safe a regular pill-dose of Vyvanse is vs. Adderall (or, equivalently, Strattera vs. Ritalin.) Instead, the effect is that you can't convert Vyvanse into an injectable or smokable form to make it absorb faster. There's no simple physical process you can put prodrugs through to turn them into something that will get you high; they need the full biological environment of your liver to be "unlocked", and it will only do so at a rate safe for you. (Or it'll create cytotoxins if you overload it, but this still won't get you high.)
And because of this, it's much safer statistically to prescribe it; with Adderall/Ritalin, there is a high chance that any voluntary self-diagnosed case will turn out to be a junkie/drug-seeker/drug-seller. With Vyvanse/Strattera, that potential for "malicious use" doesn't exist[1]. There are still all the same medical dangers, to be judged by doctors on an individual basis -- but there's a far lower worst-case downside in prescription.
(Further, prodrugs aren't addictive when taken at recommended dosages, since addiction is [likely] caused by your brain correlating spikes in its chemistry with recent memories, and prodrugs aren't "spiky" in the way their raw agonist or reuptake-inhibitor forms are.)
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[1] Well, it does, but only in the nootropic/"study drug" market; not on the street.
Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists
#13ADHD is defiantly a real thing, but I don't think we should drug it out of them. We should make sure they go into suitable jobs/schools, where adhd would have advantages as opposed to disadvantages.
Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists
#14I posted this in a HN thread about therapeutic uses of nicotine a week ago, but it's even more relevant here: > A friend of mine is a psychiatrist who specializes in treating ADHD. She told me about a conference she went to recently, where someone presented an interesting paper. > Apparently, there was an amazing study done relatively recently (last five years), in which they demonstrated that, in mice, exposure to n…
> "Vyvanse is just a more concentrated version of the d-enantiomer" Not at all; it's a prodrug that is converted into the d-enantiomer by your liver, at whatever your xenobiotic-metabolic speed is. The major result of this has nothing to do with how safe a regular pill-dose of Vyvanse is vs. Adderall (or, equivalently, Strattera vs. Ritalin.) Instead, the effect is that you can't convert Vyvanse into an injectable or…
> There's no simple physical process you can put prodrugs through to turn them into something that will get you high;
The fact that Vyvanse is a prodrug is emphasized heavily in its marketing, but the anti-abuse potential is overstated, IMHO. Even some very cursory searching on Bluelight, et. al. will yield a dozen ways to either magnify or dampen the effects of Vyvanse using common foods, etc.
> with Adderall/Ritalin, there is a high chance that any voluntary self-diagnosed case will turn out to be a junkie/drug-seeker/drug-seller.
Well, we can't prescribe any psychiatric medication, addictive or not, to people who are "self-diagnosed".
Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists
#15> “There’s been a great deal of resistance to even believing there is a disease,” said Mary Baker, president of the European Brain Council, a Brussels-based non-profit representing doctors, patients and companies including Shire that work on neurology and psychiatry issues. Here's a PDF of funding for the European Brain Council. ( http://www.europeanbraincouncil.org/pdfs/Publications_/EBC%2... )
Novartis and Jannsen are on that list, and they make Ritalin and Concerta, respectively.
Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists
#16Earlier quoted context omitted.
> "Vyvanse is just a more concentrated version of the d-enantiomer" Not at all; it's a prodrug that is converted into the d-enantiomer by your liver, at whatever your xenobiotic-metabolic speed is. The major result of this has nothing to do with how safe a regular pill-dose of Vyvanse is vs. Adderall (or, equivalently, Strattera vs. Ritalin.) Instead, the effect is that you can't convert Vyvanse into an injectable or…
> There's no simple physical process you can put prodrugs through to turn them into something that will get you high; The fact that Vyvanse is a prodrug is emphasized heavily in its marketing, but the anti-abuse potential is overstated, IMHO. Even some very cursory searching on Bluelight, et. al. will yield a dozen ways to either magnify or dampen the effects of Vyvanse using common foods, etc. > with Adderall/Ritali…
> Well, we can't prescribe any psychiatric medication, addictive or not, to people who are "self-diagnosed".
I meant "self-diagnosed" as in "books an appointment with a therapist because they think they have X, whereupon the therapist tests them for X, and then sends them to a psychiatrist who tests them more carefully for X and, finding that they do have X, prescribes them medication for X."
Junkies can and do game this by looking up the tests online (which are, if you didn't know, just battery self-assessments of correlated behaviors.) But the only way to prevent this (besides coming up with objective measures for ADHD involving fMRI scans, like they've done for depression) would be to only prescribe neuroaffective medications to people whose lives take such a bad turn that they end up talking to a psychiatrist involuntarily (i.e. in a mental ward), thus preventing anyone who is self-aware-enough to notice that they have a problem from solving it.
Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists
#17Earlier quoted context omitted.
Of note: Adderall is by far not the only drug available for ADHD, and considering its addictive nature, should not be the first on you try.
What could be wrong with dosing children with amphetamines every day for years?
ADHD is not just a problem for children.
Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists
#18Earlier quoted context omitted.
What could be wrong with dosing children with amphetamines every day for years?
What do you suspect?
Nothing at all. Methamphetamine, which is not very different than the dextroamphetamine in Adderal, has proven to be a remarkably safe substance and in general, society benefits a great deal when people ingest methamphetamine. I'm sure schoolchildren being prescribed dextroamphetamine to take every single day for years is a very good idea as well.
Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists
#19Vyvanse is a prodrug of dextroamphetamine, which means that it turns into that in the body. The advantage allegedly is that it's less prone to abuse but the real reason it exists is that dextroamphetamine entered the market in 1937 and so its patent has long since run out. Dextroamphetamine in turn is just amphetamine with the left-handed isomer removed. This left-handed isomer is less potent than the right, but both promote higher concentrations in the brain of the same chemicals norepinephrine and dopamine.
Amphetamine you may know better under its colloquial name -- speed. That's right, Shire Pharmaceticals is upset that European doctors and parents aren't rushing to give children fancy, expensive, speed.
Re: ADHD Pill Faces High Hurdle in Europe as Stigma Persists
#20Given there are non-stimulant alternatives available at this point, one would hope they would be tried first with children.
Among other things, Ritalin and friends used to completely suppress my appetite, which while it may sound cool, is really "not great".