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ADHD drug treatment and risk of negative events and outcomes

bmj.com

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

#341

Post by isodude »

mockingloris wrote: post #192

As someone from Nigeria who's self-diagnosed with ADHD (my brain switches gears on the spectrum, and I've learned to cope without formal help), reading this thread hits different. Here, access to stimulants like Adderall or alternatives are expensive to be viable to the average household (if there is fore-knowledge, which is undocumented), doctors rarely diagnose ADHD in adults (that kind of access is on the premium…

From the West here, but anyway.

> But the cultural stigma? Folks just call it laziness or blame "village people" (supernatural enemies).

Funny, my daughter just stops my explanations after circa one minute, abruptly, saying that her brain just does not listen anymore and there is no reason for me to continue. Which is blunt, but kind. I understand and stop talking, that's that. We can do that since we know our limits, I would assume that Africa in general is more attuned to accepting people as they are? For my daughter it makes a world of difference that she can communicate her ADHD symptoms. The medication are there to make ADHD people behave like "normal" people, but acceptance in the other direction could quite helpful as well.

With some luck and effort you can have some effect with diet. It would be nice to see a graph between the rise of white flour and the amount of ADHD in the world. I would love to step off medication, but it's not doable without switching to sufficient combination training and good diet, I have neither now :) As they point out in the article it can be great to find out your vitamin levels to address shortage.

> These types of complex carbohydrates are less likely to spike your blood sugar levels and help keep you feeling fuller for longer, which may help improve your focus and attention.

> By avoiding simple carbohydrates, like sugar and white flour, you may reduce specific ADHD symptoms. [0]

I just finished fixing my bike (Suntour Perfect) and have started taking it on smaller trips, hopefully that will be _my_ way to a more stable day to day. [1]

[0] https://add.org/adhd-diet/

[1] https://i.ebayimg.com/images/g/NxQAAeSwpg1odZbS/s-l1600.jpg (about the same bike)

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

#342

Post by bratwurst3000 »

astrange wrote: post #272
idiotsecant wrote: post #253

Earlier quoted context omitted.

Yes. Some brains react to some stimulants differently. That's the whole reason ADHD can be treated with Adderall.

This isn't true, it affects everyone the same way. But you could say the optimal dosage is different for different people. I think people just like saying this because they're afraid stimulants will get banned otherwise.

this is true. Regular people get hyperfocus and adhd people get focus. real adhd is a neurologic disorder. its an instability in the flow of dopamin. so adderall puts dopamin flow on 200% and suddenly there is a steady flow for adhd people.

there are maybe 10% of people getting not focused and awake of adderal.

But "adhd brain reacts different then regular brain" is not true. For both its 20x dopamin release in 8 hours.

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

#343

Post by rcxdude »

jasonfarnon wrote: post #188
Nikolas0 wrote: post #168

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…

"The problem(s) mostly relies with the modern way of life and what is expected from the society at large." I assumed not just ADHD but a number of other psychological conditions are more about reconciling some individuals to this particular society. It seems baked into a lot of their diagnostic criteria, like how well one "functions" at school or work. Surely ADHD would not be cognizable where people don't have to sp…

The line is indeed, fuzzy. The basic definition of a disorder is very much dependent on context, because in general it requires that the behavior or thought pattern is causing distress or danger to the patient or those around them. There are many facets of the human mind which have a substantial variation among the population, where some range is adaptive to certain situations and some part becomes a problem, and where exactly that flips will depend on the individual and the context they are in. But I think it's unhelpful to claim that because this line is contextual, it means there isn't really a problem. It's a problem because that individual is in that context (and often it's preferable to address the behaviour or thought patterns than the context), and there are individuals where it would be a problem in basically any context.

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

#344

Post by Arcanum-XIII »

astrange wrote: post #272
idiotsecant wrote: post #253

Earlier quoted context omitted.

Yes. Some brains react to some stimulants differently. That's the whole reason ADHD can be treated with Adderall.

This isn't true, it affects everyone the same way. But you could say the optimal dosage is different for different people. I think people just like saying this because they're afraid stimulants will get banned otherwise.

I’ve seen friends with stimulant and can say with full confidence they are not reacting to them the way I am. They’re « high », ideas everywhere and nowhere, acting like their overstimulated, full of energy… when I’m quieter, energy level normal, can think at one thing at a time without switching… and sleeping under the effect is not an issue. I a have great nap.

So no. Maybe if I try a récréative drug will I have my adhd multiplied, but here it’s not. I think it should have been fun while younger discovering that amphetamine could quiet me when everyone was dancing under the influence.

It’s not perfect. No medication are. If you abuse it, take it without need… yeah it can be abused. Don’t try heart medication either. Or lithium for kicks. Or…

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

#345

Post by jakkos »

mrlongroots wrote: post #238
jakkos wrote: post #219

Earlier quoted context omitted.

> ADHD is kind of a weakly differentiated diagnosis that could apply to most people I don't think this hypothesis would survive a look through the literature on google scholar. ADHD is associated with huge increases in risks of suicide, substance abuse, homelessness, accidents, crime, autoimmune disease, etc etc etc. It's not just "damn I find it hard to focus sometimes".

I have diagnosed ADHD and I agree largely with the person you are responding to. The claim is not that ADHD is not a set of people with real psychiatric disorders, but it is a loose umbrella for what are actually disparate problems. I recently learned that my symptoms, to a large extent, can be explained more accurately as POTS or something adjacent, and the meds I guided my psychiatrist towards were far more helpful…

> a loose umbrella for what are actually disparate problems

For me, the DSM-V & DIVA criteria are eerily accurate. I was diagnosed as an adult and it felt like a cruel cosmic joke reading through the psychiatrist report and realizing that most of my past and present issues were repeatedly-documented commonalities of a single condition. It was as if my life had just been playing out from a predetermined script.

I fully agree that that many distinct conditions are incorrectly swept under the "ADHD umbrella", but ADHD is not in any way a "loose" description of me.

> more helpful than the stimulants

My currently prescribed stimulants have been the only thing to ever make me feel consistently "okay", after having previously given up on medications ever helping. I'm sure they also enable me to write a few more lines of code per day, but I'd still be taking them even if they made me significantly worse at doing so.

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

#346

Post by [deleted] »

Llamamoe wrote: post #304
Nikolas0 wrote: post #168

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…

[deleted]

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

#347

Post by astrange »

will_e wrote: post #320
astrange wrote: post #270

Earlier quoted context omitted.

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.

Respectfully disagree. I knew someone that worked for the tobacco industry where they had labs that constantly were looking for reasons that tobacco was good for you. It meets your qualifications for properly designed studies, but it was purely about trying to convince convinced others that a known addictive substance that caused emphysema and lung cancer was beneficial to your health. Something similar happened in t…

> I knew someone that worked for the tobacco industry where they had labs that constantly were looking for reasons that tobacco was good for you.

If you're implying publication bias, that's addressed by preregistration, though you either have to be careful about looking it up or else rely on meta-analysis.

Otherwise if they're publishing true results then there you go. Nicotine does have some benefits; it's basically the only effective nootropic and it's pretty effective for schizophrenia which is why almost all schizophrenic people are smokers. Of course the problem is it's super addictive and all the ways of taking it give you cancer.

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

#348

Post by [deleted] »

jasonfarnon wrote: post #189
enneff wrote: post #176

Earlier quoted context omitted.

The science doesn’t support your hypothesis btw.

Meaning what? All those college kids who took a friend's ritalin prescription to complete a term paper could have done just as well without it? I'm skeptical. Some of us wouldn't have even done the term paper without it, or would have mailed it in. I tend to think of it as little different than steroids. Maybe there's a bigger boost for some individuals than others, but the boost is probably across the board.

[deleted]

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

#349

Post by kruffalon »

Nikolas0 wrote: post #168

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…

Isn't one of the criteria for something to be a disability that it makes it harder to function in the world you are in?

So it has to do with the mismatch between yourself (including the accommodations in place for you), the world and whatever is considered a reasonable life for a person in that world.

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

#350

Post by roody15 »

My experience with ADHD medication now going on over 2 years has been mostly positive.

I am much more effective at getting things done at work and in this regard has been quite positive.

Negative and positive on a personal relationship level. I have much better awareness of conversation dynamics and am more focused and able to listen much better. The downside would be the impact on existing relationships. The medication has an impact on personality and emotional dynamics that have been hard to navigate. With more awareness and focus in existing relationships in some ways has provided insight into unhealthy relationship dynamics and re-negotiating these is not easy.

In short if you change you vibe this has a ripple effect in other areas of your life. My experience at least.

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