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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

#371

Post by StevenWaterman »

thirdacc wrote: post #217
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.

>My hypothesis about this for a long time has been stimulants help everyone be more productive (with some tradeoffs) Of course they do. They're stimulants, that's what they do. Some people just need them to be closer to normal, or whatever's considered normal in post-Industrial society. Modafinil promotes wakefulness in everyone, not just narcolpetics. Anxiolytics calm down everyone, not just the anxious, and psilocy…

> It would be weird if stimulants only had an effect of ADHD patients

One example of this actually happening is the concept of a "stimulant nap" in people with ADHD, where stimulants actually make them sleepier. Also manifesting as "I tried coke once, it didn't do anything, I just felt sleepy"

Terrible source but it's a pretty common thing: https://www.reddit.com/r/ADHD/comments/hkkyjl/you_know_your_...

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

#372

Post by homefree »

enneff wrote: post #176
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.

The science doesn’t support your hypothesis btw.

I’m willing to update, but a lot of “science” is bullshit.

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

#373

Post by StevenWaterman »

hombre_fatal wrote: post #151
nkingsy wrote: post #135

Earlier quoted context omitted.

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 o…

An untrained dose of amphetamine will hit you hard even if you have ADHD, especially if it’s higher than the entry level dose, so I would say it gives you zero information about whether you have the condition. Funny story though. I have a similar story after my friend walked up to me in a club with a line of coke on his hand. Then I proceeded to charm the girl that became my next girlfriend.

You see this in ADHD groups where someone will start stimulant medication for the first time and say "This is incredible. I can't believe this is what everyone else feels like all the time"

And the crowd emerges to reinforce that, no, you're euphoric, this isn't normal, after about a week it'll go away and you'll just feel normal but more productive and have better executive function.

And that's on a starter dose, the parent commenter probably took 2-3x that

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

#374

Post by al_borland »

fragmede wrote: post #287
al_borland wrote: post #102

Earlier quoted context omitted.

How do you feel after those drives of a few hours? I have driven up to 6 hours at a time, but I'm in hyper-focus mode the whole time and it takes everything I have to stay locked into that focus so I don't die. I think all the time about moving somewhere where I don't need a car. I hate driving and always have. I recently found out I have ADHD. I haven't tried meds yet (but am having my first meeting with someone tom…

I bought a new-to-me car that supports Comma.ai. It's not full self driving, but it handles the boring parts sitting on the freeway for me. it's the best purchase I've made in recent memory because holy shit sitting there on the freeway forever is the worst.

I tried this, not with comma.ai, but had a VW with lane keeping, adaptive cruise, etc. The first time I did a 6 hour drive with it, it felt like magic. I was essentially on one road the whole time, there was very little traffic, and I didn’t touch the pedals, or really even steer much for 95% of the drive. Just at the start and end when off the expressway.

However, as I made that drive more, it got worse. Traffic was usually heavier, and things didn’t go as well with a lot of traffic. Some of it was how it acted, and some of it were trust issues with it. When traffic picked up or other cars did things around me, I’d switch back to manual control. After a while, I was using manual control the whole time… and then eventually just took the train, because I couldn’t tolerate driving myself anymore.

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

#375

Post by bratwurst3000 »

adastra22 wrote: post #340
bratwurst3000 wrote: post #338

Earlier quoted context omitted.

i dont think thats true. I have ADHD and get amphetamine as medication. I gave it some friends and it had similiar effect as with me. they where hyper focused and aware. I think its what amphetamine does with every human. Regular humans have more focus and adhd people have suddenly focus but netherless same.

Focus is the same. It's the euphoric high and increased hyperactivity in neurotypicals which is the divergent response.

thats where i have to disagree. if I give anyone 5mg dexteoamphetamin they would be less hyperactive and more focused on one thing. If you do too much it doesnt matter if you are regular brain or not. 80mg of dextroamphetamin would make everyone look like a speed freak.

If it would make people hyperactive it wouldnt be used for learning and sitting there 16h hyperfocused.

IMHO

edit: to explain better. imagine a adhd brain having dopamin swings between -1 and +1. While there are those swings people cant execute their plans and cant focus on one goal. when you give them adderal or similar they get a powerboost to blasting +2 dopamin lvl and can keep that for hours.

so if you give a regular human beeing the same amount of adderall it will blast its brain on +2lvl dopamin also.

so adhd people and regular people behave the samw on adderall.

the thing with adhd it is not a lack of dopamin but an iregular flow of dopamin that is the problem. The solution is to hypercharge the brain with dopamin to get constant lvl.

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

#376

Post by homefree »

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…

The diagnosis criteria in that consensus is pretty weak imo and part of the subjectivity I’m talking about.

They claim there are observable differences, but none of these alone can be used for diagnosis.

> The diagnosis of ADHD has been criticized as being subjective because it is not based on a biological test. This criticism is unfounded. ADHD meets standard criteria for validity of a mental disorder established by Robins and Guze (Faraone, 2005; 1970). The disorder is considered valid because: 1) well-trained professionals in a variety of settings and cultures agree on its presence or absence using well-defined criteria and 2) the diagnosis is useful for predicting a) additional problems the patient may have (e.g., difficulties learning in school); b) future patient outcomes (e.g., risk for future drug abuse); c) response to treatment (e.g., medications and psychological treatments); and d) features that indicate a consistent set of causes for the disorder (e.g., findings from genetics or brain imaging)

I don’t find this very persuasive and it’s a problem in the field generally.

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

#377

Post by radu_floricica »

LoganDark wrote: post #324
tstrimple wrote: post #247

Earlier quoted context omitted.

> 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. I know that I process Adderall differently having ADHD, but I still struggle to see how it's used recreationally. I took it somewhat consistently for over a year for ADHD treatment until I missed an appointment and couldn't get around to scheduling another before my p…

> I still struggle to see how it's used recreationally. - Adderall keeps you awake. Some people use that to be awake for very long periods of time. Long drives, marathons, etc. - Adderall can make boring tasks seem engaging, so it can be used, for example, to help a student study. Combining that with no need to sleep that night, can become a bit of an unfair advantage. - Adderall can cause a high, even though I've on…

That's not recreationally. That's actually a good, useful drug effect (even if not specifically for ADHD).

I'm more than a little pissed that governments don't let us use drugs like this responsibly.

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

#378

Post by agency »

StevenWaterman wrote: post #371
thirdacc wrote: post #217

Earlier quoted context omitted.

>My hypothesis about this for a long time has been stimulants help everyone be more productive (with some tradeoffs) Of course they do. They're stimulants, that's what they do. Some people just need them to be closer to normal, or whatever's considered normal in post-Industrial society. Modafinil promotes wakefulness in everyone, not just narcolpetics. Anxiolytics calm down everyone, not just the anxious, and psilocy…

> It would be weird if stimulants only had an effect of ADHD patients One example of this actually happening is the concept of a "stimulant nap" in people with ADHD, where stimulants actually make them sleepier. Also manifesting as "I tried coke once, it didn't do anything, I just felt sleepy" Terrible source but it's a pretty common thing: https://www.reddit.com/r/ADHD/comments/hkkyjl/you_know_your_...

I find the claim (repeated verbatim in some of the comments here) that people with ADHD process stimulants differently particularly specious. Are there any medical studies/not-reddit threads that suggest anything like this?

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

#379

Post by replwoacause »

Reading all of these anecdotes about how difficult it is for some people to not only get an ADHD diagnosis but also a prescription for medication makes me feel somewhat guilty. This has not been my experience living in the US. I was diagnosed over 20 years ago and since then have explored the full range of medications with various different doctors in different states. I don’t recall any of them scrutinizing me or being reluctant to prescribe. I just asked and received. And the pharmacy always filled without question. Only in the past 5 years in my state have I had to do a urine test before getting a prescription refill to prove I’m not abusing other drugs, but that’s it. I guess I’ve been lucky. To anyone curious, I recently started taking Zenzedi (which I only take once or twice per week) after reading good things about it on Reddit, and all that took was a simple note to the nurse practitioner (though she needs to have a MD write the script). They didn’t grill me on why I wanted to change from Concerta, and I even suggested my own starting dose of 10mg which she agreed to without hesitation. It’s sad to me that others are having to go through the gauntlet for the exact same thing….finding a med that works.

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

#380

Post by replwoacause »

replwoacause wrote: post #379

Reading all of these anecdotes about how difficult it is for some people to not only get an ADHD diagnosis but also a prescription for medication makes me feel somewhat guilty. This has not been my experience living in the US. I was diagnosed over 20 years ago and since then have explored the full range of medications with various different doctors in different states. I don’t recall any of them scrutinizing me or be…

And to add one more semi-interesting bit to this, I initially received my ADHD diagnosis after participating in a clinical trial I heard about on the radio living in FL in the early aughts. They were thorough in screening but I never did find out what group I was in or whether I was given the medicine or placebo. They were supposed to disclose that to us so many years after the study concluded but when I wrote in to find out, I was told the records were not kept and the clinic that had done the test was no longer operating. So who knows what I took for all those months. Some new experimental medication that never made it to market? Or a sugar pill?
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