Adderall Risks: Much More Than You Wanted to Know • Hacker News Board

Re: Adderall Risks: Much More Than You Wanted to Know

#131

Post by Yvain » Sat, Dec 30, 2017, 10:06 PM UTC

Jhsto wrote: post #117

d2kx wrote: post #78

I started taking Modafinil about 4-5 years ago and my only regret is that I didn't start earlier. I live in Europe so you can forget about amphetamines/adderall basically, only thing you'll get here is Ritalin and even that not as easy as you might think. Modafinil is easy to get on the internet though. If I lived in the US, I would likely be on Adderall I'd guess. It helped me so much that I wouldn't have completed…

I feel like comments like yours are one reason doctors don't like prescribing it. I'm glad you are able to be happy on modafinil, but think about what you just commented: (1) alternatives are hard to get, (2) you have to get your substitution from the Internet without a prescription, (3) once you are on the gear you are able to notice the same deficiency in others, (4) you attribute your success to it and (5) "fuck e…

The reason doctors don't like prescribing it is because it's not FDA-approved for ADHD. It's not FDA-approved for ADHD because of bureaucratic/economic reasons, AFAIK.

Re: Adderall Risks: Much More Than You Wanted to Know

#132

Post by Yvain » Sat, Dec 30, 2017, 10:09 PM UTC

chimeracoder wrote: post #93

ynonym00s wrote: post #55

A friend of mine who has ADHD takes Vyvanse instead. Does it have similar risks?

(Disclaimer: I've studied pharmacokinetics, though I'm not a pharmacologist) Vyvanse is a prodrug. That means it metabolizes into the d-enantiomer of amphetamine, whereas Adderall contains a 75-25 mixture of the d- and l-enantiomers. (Enantiomers are like left- and right-handed gloves: they have the same chemical structure, but one is the mirror image of the other. Usually two enantiomers will have similar but slight…

I think another important consideration might be that peak plasma concentrations on Vyvanse would be lower than on Adderall (because it's more spread out over time). Some effects only happen at certain plasma concentrations.

Re: Adderall Risks: Much More Than You Wanted to Know

#133

Post by emodendroket » Sat, Dec 30, 2017, 10:11 PM UTC

xocyabencl wrote: post #127

emodendroket wrote: post #114

Earlier quoted context omitted.

The article talks about people's careers being stymied, or people losing promotions to, colleagues whose attention span is longer because they're abusing Adderall. That's the intro. > The human brain wasn’t built for accounting or software engineering. A few lucky people can do these things ten hours a day, every day, with a smile. The rest of us start fidgeting and checking our cell phone somewhere around the thirty…

Sports is a zero-sum game. Productive labor is not. The mathematician Paul Erdos used amphetamines to make many major breakthroughs. This was a great benefit for society, regardless of whether he perhaps took a professorship that some less productive mathematician would otherwise have obtained.

There is a pretty limited set of fields of endeavor where you could make this argument without it being ridiculous on its face.

Re: Adderall Risks: Much More Than You Wanted to Know

#134

Post by xocyabencl » Sat, Dec 30, 2017, 10:17 PM UTC

emodendroket wrote: post #133

xocyabencl wrote: post #127

Earlier quoted context omitted.

Sports is a zero-sum game. Productive labor is not. The mathematician Paul Erdos used amphetamines to make many major breakthroughs. This was a great benefit for society, regardless of whether he perhaps took a professorship that some less productive mathematician would otherwise have obtained.

There is a pretty limited set of fields of endeavor where you could make this argument without it being ridiculous on its face.

While many industries have an element of zero-sum competition, that's not the default. Whether you're designing a car, doing a surgery, giving a haircut, cooking a hamburger, etc. you are giving something of value to your customers.

Re: Adderall Risks: Much More Than You Wanted to Know

#135

Post by Pica_soO » Sat, Dec 30, 2017, 10:25 PM UTC

leesalminen wrote: post #68

mickronome wrote: post #37

Earlier quoted context omitted.

Maybe everyone will score better, although I don't believe so because the tests are trivial for people without ADHD. In any case they certainly won't have anything like the kind of improvements people with ADHD has, improving from spectacularly bad to (usually) only slightly below normal. It's a common mistake made by both professionals and laypeople that ADHD is a condition with only slight deficiencies in focus, wh…

I’ve long held the belief that ADHD is wildly over diagnosed (in the US, at least). Your anecdote has helped solidify this belief. 8/10 Adderall users I know are able to concentrate and complete complex, intricate tasks without the pills. The pills just put them in jet-speed mode. It sounds like you truly have ADHD and are benefitting from proper medication. I wish nothing but the best for you. However, I also wish t…

Competition, till nothing is left of us. Makes me grateful every day, that brain implants are not yet here. Every day before that is a present, else we would have our heads chopped up on the altar of progress to become twitching, spasming prosthetic gods for the common good, until there was nothing left to ask why we did this to ourselves in the first place.

Re: Adderall Risks: Much More Than You Wanted to Know

#136

Post by Analemma_ » Sat, Dec 30, 2017, 10:28 PM UTC

xocyabencl wrote: post #127

emodendroket wrote: post #114

Earlier quoted context omitted.

The article talks about people's careers being stymied, or people losing promotions to, colleagues whose attention span is longer because they're abusing Adderall. That's the intro. > The human brain wasn’t built for accounting or software engineering. A few lucky people can do these things ten hours a day, every day, with a smile. The rest of us start fidgeting and checking our cell phone somewhere around the thirty…

Sports is a zero-sum game. Productive labor is not. The mathematician Paul Erdos used amphetamines to make many major breakthroughs. This was a great benefit for society, regardless of whether he perhaps took a professorship that some less productive mathematician would otherwise have obtained.

Promotions, and the salary/opportunity increases that come with them, absolutely are a zero-sum game. I’m a little baffled that anyone could think otherwise, actually.

Re: Adderall Risks: Much More Than You Wanted to Know

#137

Post by Analemma_ » Sat, Dec 30, 2017, 10:30 PM UTC

xocyabencl wrote: post #134

emodendroket wrote: post #133

Earlier quoted context omitted.

There is a pretty limited set of fields of endeavor where you could make this argument without it being ridiculous on its face.

While many industries have an element of zero-sum competition, that's not the default. Whether you're designing a car, doing a surgery, giving a haircut, cooking a hamburger, etc. you are giving something of value to your customers.

You’re describing retail jobs, where that might be true. But most white-collar workers never interact directly with customers. They have to demonstrate value to their boss, which does make it a zero-sum situation.

Re: Adderall Risks: Much More Than You Wanted to Know

#138

Post by YeGoblynQueenne » Sat, Dec 30, 2017, 10:46 PM UTC

chimeracoder wrote: post #90

CydeWeys wrote: post #85

Earlier quoted context omitted.

The point of a to-do list (or reminder in Google Calendar) is that it's constantly staring at you until you actually complete it. It sounds like you're using one-off calendar entries. I'm not suggesting that "try not having ADD", just suggesting you use mechanisms to remind you to do stuff that are persistent and thus work.

> The point of a to-do list (or reminder in Google Calendar) is that it's constantly staring at you until you actually complete it. It sounds like you're using one-off calendar entries. I'm not suggesting that "try not having ADD", just suggesting you use mechanisms to remind you to do stuff that are persistent and thus work. No offense, but from what you're saying, it's pretty clear you don't understand how ADHD wor…

>> Hence, that's why OP read your post as "try not having ADD", because you're literally suggesting solutions that presume that they not have ADHD in the first place.

To be fair, the article does make the point pretty strongly that it is very hard to separate ADHD from natural variations of attention, concentration etc:

  But “ability to concentrate” is a normally distributed trait, like IQ. We draw a 
  line at some point on the far left of the bell curve and tell the people on the far 
  side that they’ve “got” “the disease” of “ADHD”. This isn’t just me saying this. 
  It’s the neurostructural literature, the the genetics literature, a bunch of other 
  studies, and the the Consensus Conference On ADHD. This doesn’t mean ADHD is “just 
  laziness” or “isn’t biological” – of course it’s biological! Height is biological! 
  But that doesn’t mean the world is divided into two natural categories of “healthy 
  people” and “people who have Height Deficiency Syndrome“. Attention is the same 
  way. Some people really do have poor concentration, they suffer a lot from it, and 
  it’s not their fault. They just don’t form a discrete population.

Also, if attention etc is a "normally distributed trait", any behavioural intervention that can help someone near the middle of the distribution has a pretty good chance of helping someone near the extremes, also. To take the example of height again, just because someone is short doesn't mean they won't look taller with high heels.

In fact, if you think about it, such interventions are designed exactly to help people with poor executive function, as you say. Assuming that this is basically a description of what ADHD is, I don't see why behavioural interventions can't make a dent in it.

Re: Adderall Risks: Much More Than You Wanted to Know

#139

Post by xocyabencl » Sat, Dec 30, 2017, 10:48 PM UTC

Analemma_ wrote: post #137

xocyabencl wrote: post #134

Earlier quoted context omitted.

While many industries have an element of zero-sum competition, that's not the default. Whether you're designing a car, doing a surgery, giving a haircut, cooking a hamburger, etc. you are giving something of value to your customers.

You’re describing retail jobs, where that might be true. But most white-collar workers never interact directly with customers. They have to demonstrate value to their boss, which does make it a zero-sum situation.

I don't think any of the jobs I listed are retail. I went out of my way to include a variety of industries, including knowledge work. "Demonstrating value to your boss" could include zero-sum bullshit or actual production. As a programmer, I've done both kinds of work.

Re: Adderall Risks: Much More Than You Wanted to Know

#140

Post by chimeracoder » Sat, Dec 30, 2017, 11:09 PM UTC

Yvain wrote: post #132

chimeracoder wrote: post #93

Earlier quoted context omitted.

(Disclaimer: I've studied pharmacokinetics, though I'm not a pharmacologist) Vyvanse is a prodrug. That means it metabolizes into the d-enantiomer of amphetamine, whereas Adderall contains a 75-25 mixture of the d- and l-enantiomers. (Enantiomers are like left- and right-handed gloves: they have the same chemical structure, but one is the mirror image of the other. Usually two enantiomers will have similar but slight…

I think another important consideration might be that peak plasma concentrations on Vyvanse would be lower than on Adderall (because it's more spread out over time). Some effects only happen at certain plasma concentrations.

> I think another important consideration might be that peak plasma concentrations on Vyvanse would be lower than on Adderall (because it's more spread out over time).

Vyvanse is intended to be equivalent to Adderall XR, not IR, so the effects are intended to be spread out in both. If you're comparing to IR, you're no longer really comparing apples to apples anyway.