ADHD drug treatment and risk of negative events and outcomes • Hacker News Board

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

#131

Post by kanbara » Fri, Aug 15, 2025, 9:28 PM UTC

klipklop wrote: post #77

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.…

funnily, i had zero issue getting vyvanse after a nearly 20 year medication gap, and being hugely successful by most metrics. i went to a psych, did an eval, and got medication. i know there are issues, but it’s interesting how different people’s outcomes are

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

#132

Post by mh- » Fri, Aug 15, 2025, 9:28 PM UTC

yesco wrote: post #105

diob wrote: post #86

Earlier quoted context omitted.

Yeah, the journey to stimulants for me was long and painful, with a lot of procrastination on my part. And now even having them prescribed it is a pain dealing with the bureaucratic / expensive nightmare of USA health insurance.

I just go through GoodRx now, makes it like $20 per month for my prescription. You don't even need to make an account with them, it's like coupon you don't even need to print out. Just tell the pharmacist you are going to use GoodRx and you are done. My work insurance seems to change all the time, and while going through GoodRx doesn't count towards my deductible, I prefer the price stability. Not fun when I'm random…

GoodRx is genuinely a good deal. There's a paid offering (called Gold, I think?) that makes things cheaper, but whether it pays for itself will depend on what you're filling.

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

#133

Post by homefree » Fri, Aug 15, 2025, 9:28 PM UTC

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.

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

#134

Post by baby_souffle » Fri, Aug 15, 2025, 9:29 PM UTC

llbbdd wrote: post #121

mithametacs wrote: post #101

Earlier quoted context omitted.

I literally did the thing you’re not supposed to do. my psych kept giving me everything by Adderall. So I went to one of those online doctors and got Adderall through her. Then I just told my psychiatrist that I have Adderall prescription and she took it over. For the record, she’s actually really reasonable and I like her but very conservative about the stimulants. Which when I finally got them were a revelation. Me…

Which online doctor? I've had the same frustrating experience with "real" psychiatrists but didn't know you could arbitrage the prescription like that.

> Which online doctor? I've had the same frustrating experience with "real" psychiatrists but didn't know you could arbitrage the prescription like that.

There are a few providers out there. The DEA is cracking down on them (they call them "pill mills") and that crackdown is - depending on who you ask - partially/fully responsible for the stimulant shortages the past few years. The /r/ADHD sub has some good discussion(s) from time to time on the latest action(s) taken by the DEA.

---

When I was seeing medical help to confirm or refine my suspected/self-diagnosed ADHD, it was a _pain_ to jump through all the hoops. I was nervous getting my first Rx filled but oh my god was it a night and day difference. Within 45 min, it was _clear_ that the medication was working ... exactly how it's supposed to for people with ADHD. That "validation" was my prize for attempting to navigate the american health care system.

If I could have replaced dozens of hours / 6+ months of phone-tag/paperwork/assessments for a monthly subscription and a 30 min video call, I'd have jumped at the chance.

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

#135

Post by nkingsy » Fri, Aug 15, 2025, 9:34 PM UTC

kstrauser wrote: post #104

TrackerFF wrote: post #99

I'm on Ritalin - which works for me. Where I'm from (Norway), getting a diagnosis is no walk in the park. Very extensive process, if you're adult. At least the doctors I've seen, have all been very precautious in prescribing anything other than the basics. If Ritalin doesn't work for you, they'll obviously try something other...but my doctor told be straight up that it is a red flag when some patients will ask specif…

That's interesting. I'm in the US and my doctor prescribed Adderall for me. While I'd obviously never argue that a drug can't be abused, for me personally, I can't imagine abusing Adderall more than, say, ibuprofen. It's not that it's unpleasant to take it, but that it has zero pleasant qualities, either, except that now I can pay attention to things that don't fascinate me. It doesn't feel good. It doesn't (seem to)…

I’ve only taken it once.

I woke up feeling sick, stiff, and lethargic while staying with a friend in NYC in 2008. My friend said “I’ve got just the thing” and gave me one of his adderall.

20 minutes later I was feeling better than I’ve ever felt in my life. We had one of the most exciting, memorable days in my life, just pinging all over the city. That night we went out to a club, where I somehow charmed a girl way out of my league.

We met up the next day and she was very disappointed.

That is to say, it was quite pleasant for me.

I sometimes think I have undiagnosed ADHD (my daughter has it), but this would seem like evidence against it, as it was undeniably stimulating.

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

#136

Post by baby_souffle » Fri, Aug 15, 2025, 9:34 PM UTC

sekh60 wrote: post #130

SubmarineClub wrote: post #82

Earlier quoted context omitted.

Yeah, it's ridiculous. I've been taking medication for ADHD since the 3rd grade. Why in the good goddamn should I have to go in EVERY month for a refill for a medication I've been taking for over 20 years.

Since you may sell them if you get them more frequently. Now here's a pack of 30.

> Since you may sell them if you get them more frequently. Now here's a pack of 30.

But it's already a C/II class medication so the name on the Rx has to match the name on the photo ID and the pharmacy has to keep the records / there are rules for how often C/II medications can be dispensed. If you have a 30d Rx, the soonest you can come back with an Rx for that same medication is ~25d.

Regardless, does it matter if I have to re-fill every 30d or every 90d? As long as I'm only in there every 80d to get my 90d supply topped up, how is that any different from a 2d Rx or a 30d Rx being filled every 1d or every 25d?

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

#137

Post by hombre_fatal » Fri, Aug 15, 2025, 9:37 PM UTC

SubmarineClub wrote: post #82

klipklop wrote: post #77

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.…

Yeah, it's ridiculous. I've been taking medication for ADHD since the 3rd grade. Why in the good goddamn should I have to go in EVERY month for a refill for a medication I've been taking for over 20 years.

I was on a 90 day prescription for ten years (vyvanse) when I told my doctor I was traveling abroad.

Insurance doesn’t cover 90 day bottles so it was $300/mo but worth it.

Nowadays there’s generic Vyvanse which is much cheaper so it probably makes 90 day prescriptions financially viable?

I just moved back to the US and had to find a new local doctor who gives me 30 day scripts so I haven’t asked about 90 day yet. I imagine these pill mills are pretty stingy. It takes a lot of time and calling around to find docs who don’t treat you like a fiend in some way.

But we need to count our blessings. People on pain killers need to put up with crazy shit like getting randomly summoned to the office so they can count your remaining pills.

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

#138

Post by bsimpson » Fri, Aug 15, 2025, 9:38 PM UTC

I've seen so much strongly relatable ADHD content over my life, and had so many close friends get diagnosed, that I've often wondered if I'm in the population, or if it's pathologizing the regular experience of modern humans.

I haven't had mental healthcare, so I don't have much personal insight, but I found this interview with Trevor Noah very interesting. It's the first time I've heard someone who identified with ADHD share his experience, and not have it resonate with mine:

https://youtu.be/SkDvqvpxKBY?si=oszaQx7OOh5G3NXb

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

#139

Post by cardanome » Fri, Aug 15, 2025, 9:39 PM UTC

jackdoe wrote: post #112

klipklop wrote: post #77

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.…

> handle rejection poorly Off-topic but recently I found out about Sensitive Rejection Dysphoria, its not officially recognized as a thing but it is in active study now, and very related to ADHD, and tbh I wish I knew about it sooner

Yes, knowing about RSD was life changing for me.

Before I had my ADHD diagnosis, I just assumed that I have social anxiety and tried to fix it myself by giving me exposure therapy. I would force myself to seek out any social interaction regardless on how I felt.

The result was that I got worse, so much worse because I was basically trained myself to disregard my emotions. Turns out being undiagnosed with ADHD is traumatizing. I did not imagine that people hated me for being different, I never had any phobia. It wasn't "just in my head". The truth is that I am different and lots of people will instinctively hate me for being neurodivergent. I just needed to learn to deal with that.

That is why a correct diagnosis is so important. I despise that people are given generic diagnosis like depression or anxiety instead of digging deeper and trying to find out what actually causes them.

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

#140

Post by pesus » Fri, Aug 15, 2025, 9:41 PM UTC

hinkley wrote: post #107

klipklop wrote: post #77

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've heard it argued that ADHD diagnoses should come with a social worker. Every time I realize it's Friday and I'm gonna run out of medication because I forgot to call in the refill I think about that. Three day weekends are the worst. One workaround I've heard is that you order every 30 days even if you forgot to take your pills one or two times. Any surplus pills go into an old bottle you hide in the back of a dra…

I'm of course not recommending or condoning this, but with instant release it's definitely possible to also get a higher dosage than you actually need and cut the pills up to take the lower dosage you need, and stash the rest to build up a surplus.

Or so I've heard.