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ADHD drug treatment and risk of negative events and outcomes

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

#261

Post by kstrauser »

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.…

The analogy I've given is having an asthma clinic at the top of Mt. Everest. If I could freaking get there, I probably wouldn't need it.

A friend referred me to a telehealth clinic where I could get in quickly instead of waiting for 6 months. They're dialed in to their patient care, too: I get a string of email and text reminders that I have an upcoming appointment. And contrary to some of the horror stories, my doc spent a couple of hours with me on the first appointment before coming up with a treatment plan. It wasn't a 5 minute visit where they through pills at me, but an actual genuine doctor's appointment with someone doing due diligence and customizing a care plan specific to me, with alternatives to try if my insurance didn't cover the first line of meds.

I feel so lucky that I got connected with the right people, after a series of PCP visits and a psychiatrist referral who diagnosed me as having anxiety. Oh, you think? Yeah, I'm feeling pretty anxious that my boss is annoyed at me for having all the signs and symptoms of ADHD and how it affects my work.

Life is easier now, I tell ya.

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

#262

Post by thisislife2 »

ttul wrote: post #244
homefree wrote: post #133

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…

> "high quality scientific evidence"

Mostly, unfortunately, funded by Pharmaceutical companies - ADHD Nation: Children, Doctors, Big Pharma, and the Making of an American Epidemic ( https://www.amazon.com/ADHD-Nation-Children-American-Epidemi... ):

> More than 1 in 7 American children get diagnosed with ADHD—three times what experts have said is appropriate—meaning that millions of kids are misdiagnosed and taking medications such as Adderall or Concerta for a psychiatric condition they probably do not have. The numbers rise every year. And still, many experts and drug companies deny any cause for concern. In fact, they say that adults and the rest of the world should embrace ADHD and that its medications will transform their lives.

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

#263

Post by lysp »

mandevil wrote: post #185
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…

The DEA put Adderall on its list of the most abused medication, and limits production of it and investigates doctors who prescribe too much of it. This is a response to the problems with the abuse of legal opiates a decade ago- the DEA now takes potential abuse of legal drugs much more seriously and adderall (an amphetamine- it's a cousin of meth) is at a high risk of abuse. Your psychiatrist is trying to deal with t…

> The DEA put Adderall on its list of the most abused medication, and limits production of it and investigates doctors who prescribe too much of it.

The other thing on top of limiting its production, it's not just for the US, it's worldwide.

Australia has a shortage of various types of ADHD medication due to this DEA production limit too.

https://www.tga.gov.au/safety/shortages/information-about-ma...

Also, the Australian Government requested increased production to cover these shortages, and the DEA rejected that request.

So those limitations have a worldwide effect due to the US being one of only a few countries that produce these drugs.

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

#264

Post by aidenn0 »

DrewADesign wrote: post #58
schlauerfox wrote: post #41

The youtube channel of ADHD science researcher Russell Barkley gave me the push to get diagnosis in my last year of undergrad and It was like lightning to see all my symptoms laid out since childhood in context of the underlying brain science. He does a lot of debunking of bad research too. Great channel.

In addition to confirming and quantifying my more obvious and problematic symptoms, the reaction time tests clearly showed my very mild impulsivity. Nobody I know would call me impulsive, and in the questionnaires I’d have said I wasn’t impulsive, even though I had a sense I was subconsciously resisting that tendency. The tests were too quick for my usual masking reflex, and while I was still ultimately diagnosed wit…

I'd like to see some research, but anecdotally the reaction time tests are overperformed on by people who are serious gamers.

I am absolutely wildly impulsive (and was even more so when I was younger), but when I took the reaction time test in college, I was playing counterstrike multiple hours a day. I tested in whatever the "in between" area was on that for impulsivity. None of the people I knew that played twitch games a lot got a positive result on that test.

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

#265

Post by impure-aqua »

hinkley wrote: post #186
pesus wrote: post #140

Earlier quoted context omitted.

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.

The extended release means you only have to remember to take the medication once a day instead of twice. What we need is for these pills to be compounded the way they do opioids: the wax granules are arranged to attempt to keep you from getting a burst dose by crushing the pills. The same process that makes crushing work makes splitting not work. So if you make split pills still time release, no problem. But not for…

Vyvanse is biochemically rate-limited rather than mechanically, so it is ideal for this; there is not really an alteration to the absorption properties no matter what you do.

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

#266

Post by intended »

alaithea wrote: post #169
bluefirebrand wrote: post #13

I was diagnosed with ADHD in my early 30s and prescribed Concerta to help manage it For a few years being medicated for ADHD was a godsend. I was finally able to be more productive and focus on work, my career took off in a huge way, I've literally tripled my income since I started medication Now I'm incredibly burned out, I've been having pretty severe memory problems, I'm on medical leave from my job to try and cou…

I feel this. It's so very hard to manage one's medicated-ADHD productivity in a way that feels useful but doesn't burn like a white-hot flame. My boss has been supportive and really helped me see the ways in which I was causing myself burnout, encouraging me (as a senior tech IC) to write things down, do more knowledge and skill transfer, and delegate more. That helped me a lot. What I used to think of as "autonomy,"…

> I also had to privately learn how to pace myself, setting realistic, appropriate and prioritized daily goals (nevermind the arm's-long TODO list). Checking myself against those, aiming for better goal-setting each day. Being able to close the laptop when it's done. I never really had a sense of "done" before, I had a lifetime of feeling always-behind. There's this peace, though, that comes with realizing that you _can_ prioritize effectively, do the things, then rest. That peace can become its own reward, which is bananas to me, because my unmedicated brain would never have felt that.

This is pretty much what I am working on, and I too have had followed the “burn out after getting diagnosed and medicated” arc.

Being able to set realistic, appropriate, and prioritized daily goals, and aiming for better goal-setting each day. Sounds like a good thing to aim for.,

I still don’t have a sense of “done”, and struggle to achieve that, even though I know I managed to move the needle a bit.

How long did it take you to get to this point? And how do you deal/ identify/ know you are “done”?

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

#267

Post by jrflowers »

arcfour wrote: post #182
Spooky23 wrote: post #106

Earlier quoted context omitted.

They issue licenses for making the drugs and getting the raw materials to make them. The process is inflexible at best and if manufacturer A hits their quota, they can’t get additional raw materials, even if manufacturer B has excess. Like most things associated with drug criminality, the rules are stupid and capricious.

And this has nothing to do with insurance, but does have to do with government bureaucracy negatively impacting people getting treatment for an illness.

I like that you’re posting “check and mate the DEA doesn’t do health insurance” as a gotcha when nobody in this entire thread has at any point said that the DEA is directly involved in health insurance. It is like loudly claiming victory that you have established that doctors aren’t in charge of trimming the hedges in your neighborhood

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

#268

Post by bawolff »

hnthrowaway847 wrote: post #226
mandevil wrote: post #185

Earlier quoted context omitted.

The DEA put Adderall on its list of the most abused medication, and limits production of it and investigates doctors who prescribe too much of it. This is a response to the problems with the abuse of legal opiates a decade ago- the DEA now takes potential abuse of legal drugs much more seriously and adderall (an amphetamine- it's a cousin of meth) is at a high risk of abuse. Your psychiatrist is trying to deal with t…

I wouldn’t be surprised if this study were funded by some pharmaceutical lobbying shell organization. I was on various forms of prescribed amphetimines for years and developed paranoia. It took me a few years to somewhat recover. My family has PTSD about that period of my life. I can’t think or communicate well anymore. Fuck that industry.

Afaict the study was not looking at the risk of that type of side effects.

In any case, paranoia is a known potential (but rare) side effect, its not like pharma companies were keeping this a secret.

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

#269

Post by bawolff »

lysp wrote: post #263
mandevil wrote: post #185

Earlier quoted context omitted.

The DEA put Adderall on its list of the most abused medication, and limits production of it and investigates doctors who prescribe too much of it. This is a response to the problems with the abuse of legal opiates a decade ago- the DEA now takes potential abuse of legal drugs much more seriously and adderall (an amphetamine- it's a cousin of meth) is at a high risk of abuse. Your psychiatrist is trying to deal with t…

> The DEA put Adderall on its list of the most abused medication, and limits production of it and investigates doctors who prescribe too much of it. The other thing on top of limiting its production, it's not just for the US, it's worldwide. Australia has a shortage of various types of ADHD medication due to this DEA production limit too. https://www.tga.gov.au/safety/shortages/information-about-ma... Also, the Austr…

Is there something stopping other countries from spinning up a factory?

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

#270

Post by astrange »

hnthrowaway847 wrote: post #226
mandevil wrote: post #185

Earlier quoted context omitted.

The DEA put Adderall on its list of the most abused medication, and limits production of it and investigates doctors who prescribe too much of it. This is a response to the problems with the abuse of legal opiates a decade ago- the DEA now takes potential abuse of legal drugs much more seriously and adderall (an amphetamine- it's a cousin of meth) is at a high risk of abuse. Your psychiatrist is trying to deal with t…

I wouldn’t be surprised if this study were funded by some pharmaceutical lobbying shell organization. I was on various forms of prescribed amphetimines for years and developed paranoia. It took me a few years to somewhat recover. My family has PTSD about that period of my life. I can’t think or communicate well anymore. Fuck that industry.

It doesn't matter who funds a study if it's properly designed. You see this kind of dismissal on /r/science all the time and it's always just evidence that they're not qualified to actually read the study.
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