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ADHD drug treatment and risk of negative events and outcomes

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421–430 of 537 posts

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

#421

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…

I sympathize with this point of view but I disagree. I’m not sure if I’m ADHD, but I’m autistic. I’ve been diagnosed as ADHD in the past, I’m just not sure how useful it is as a diagnosis for me. I have enormous problems with focus and executive functioning. For large portions of my life I’ve been seriously disabled, unable to work or support myself. There are times where I’m unable to talk. And I still don’t see autism as inherently dysfunctional.

If you put me in a village in Europe 5000 years ago, I’d be fine. I’d be better than fine. I’d be the guy in the hunting part who could smell the fresh scat from 50 yards away. I’d be the guy who could remember all the fucking barks and plants and mushrooms that are good for what ails ya. I’d be the guy who knew the story of every god and goddess and why they’re important. Most social situations would involve people I knew very well or people in the same culture, where I could depend on knowing the rules of the culture.

The modern world is full of random noise and stifling bureaucracy. I love being autistic. But it’s awful, truly awful to have this nervous system in this society. The endless stress breaks you down day after day, year after year, and system teaches you to see yourself as inherently broken, when it’s the system that has broken you.

Maybe you’re disabled, but maybe it’s the system that did it to you.

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

#422

Canadian here. ADHD diagnosis is one of the few non-socialized parts of our medical system. Because of the abuse potential they charge a fairly steep fee (cad $3k+, with a $2k+ autism assessment addon) to even attempt diagnosis (after screening by your GP — referral required). The intake paperwork alone was perhaps 100 pages of online questionnaires that lead to interviews where they schedule counselling and evaluati…

Try Frida. Online clinic that can get you from diagnosis to prescription in a few weeks.

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

#423
post #244

Earlier quoted context omitted.

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…

Which part of the disgnosis do you find objective measures? There isnt a single scientific one Take a look at studying looking at the consensus on diagnosis. Even among psychatrists the same patient gets diagnosed with different things.

QbTest [https://www.qbtech.com/adhd-tests/qbtest/]

It measures your ability to focus your attention quite objectively and there's statistically significant differences between neurotypical and adhd performance. This test was used during my own diagnosis.

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

#424

Earlier quoted context omitted.

Eh. When you take it the first time the euphoria is more that you can focus and the mind becomes quieter. It’s not like a party drug

The euphoria from amphetamine (in reasonable doses) is also rather subtle - it's no MDMA where it's very much in your face. But lifted mood and energy is why it's taken recreationally, the euphoria can then come what you make from that.

One neurotypical I know who took 20mg of Adderall IR ended up going into a hyperfocused ‘can’t look away from the road’ 12+ hour road trip without stopping and couldn’t sleep for 3 days afterwards.

An ADHD’er I know who did the same thing, took a nap instead, and then actually started their taxes.

These are not the same thing.

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

#425
post #244

Earlier quoted context omitted.

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…

Which part of the disgnosis do you find objective measures? There isnt a single scientific one Take a look at studying looking at the consensus on diagnosis. Even among psychatrists the same patient gets diagnosed with different things.

You’re right that there isn’t a _single_ “scientific” or purely objective test for ADHD. The consensus statements on ADHD make this explicit: diagnosis is clinical, not biomarker-based [1][2], even though biomarker tests are being developed and this is a promising area of research.

That said, there are structured and semi-objective tools that add quantifiable data to the process, even if they can’t stand alone; and, these tools in combination reveal a very real condition that is also highly treatable once diagnosed:

1. Rating scales (e.g. Vanderbilt, CBCL) use structured questionnaires to quantify symptom frequency. They’re subjective (based on parent/teacher/patient report) but standardized. Many mental health conditions are assessed using standardized rating scales [3].

2. Continuous Performance Tests (CPTs) and objective activity measures can quantify attention lapses and hyperactivity. They’re more “objective,” but consensus statements say they’re insufficient for diagnosis _in isolation_ [4]. I did a CPT test and it lit up for ADHD, which was helpful in ruling out other conditions.

3. Multi-informant reports (parents, teachers, patients) are required in good clinical practice to triangulate symptoms across contexts [5]. As I wrote in my first comment, ADHD exists only when the symptoms affect functioning in many areas of life.

4. Experimental methods (like neuroimaging or computerized neurocognitive tests) show promise but aren’t yet validated for clinical use [6].

The core of diagnosis remains a comprehensive clinical interview and history guided by DSM/ICD criteria. This is where “inter-rater variability” arises: different psychiatrists may weigh the same evidence differently. Consensus statements acknowledge this diagnostic variability, which is a limitation of current psychiatric nosology in general (not just ADHD).

So to answer directly: no, there isn’t a single objective test. But there are quantifiable tools that support diagnosis. The diagnosis itself is still fundamentally consensus- and criteria-driven, not biologically “proven.” But this limitation is minor and is common in psychiatry where many real conditions are diagnosed using a combination of approaches because no single test exists (and may never).

[1] Faraone, S. V., Asherson, P., Banaschewski, T., Biederman, J., Buitelaar, J. K., Ramos-Quiroga, J. A., Rohde, L. A., Sonuga-Barke, E. J., Tannock, R., & Franke, B. (2021). The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder. Neuroscience & Biobehavioral Reviews, 128, 789–818. https://doi.org/10.1016/j.neubiorev.2021.01.022

[2] Kooij, J. J. S., Bijlenga, D., Salerno, L., Jaeschke, R., Bitter, I., Balázs, J., Thome, J., Dom, G., Kasper, S., & Nunes Filipe, C. (2019). Updated European Consensus Statement on diagnosis and treatment of adult ADHD. European Psychiatry, 56, 14–34. https://doi.org/10.1016/j.eurpsy.2018.11.001

[3] Collett, B. R., Ohan, J. L., & Myers, K. M. (2003). Ten-Year Review of Rating Scales. V: Scales Assessing Attention-Deficit/Hyperactivity Disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 42(9), 1015–1037. https://doi.org/10.1097/01.CHI.0000070245.24125.B6

[4] Hall, C. L., Valentine, A. Z., Groom, M. J., Walker, G. M., Sayal, K., Daley, D., & Hollis, C. (2016). The clinical utility of the Continuous Performance Test and Objective Measures of Activity for diagnosing and monitoring ADHD in children: A systematic review. European Child & Adolescent Psychiatry, 25(7), 677–699. https://doi.org/10.1007/s00787-015-0798-x

[5] American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

[6] Cao, Q., Zang, Y., Sun, L., Sui, M., Long, X., Zou, Q., & Wang, Y. (2006). Abnormal neural activity in children with attention deficit hyperactivity disorder: A resting-state functional magnetic resonance imaging study. NeuroReport, 17(10), 1033–1036. https://doi.org/10.1097/01.wnr.0000224769.92454.5d

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

#426

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…

If it's not a disability, then why can't I work on projects that I am excited to work on?

Sure, my ADHD experience is probably the impetus for most of those projects in the first place, but that doesn't help me get anything done, whether I want to or not.

It sounds like what really happened is that you found an appropriate amount/cadence of medication for your body. That's much more difficult than many realize, which is why each stimulant is sold with 5 different delivery methods: immediate release, capsule with drug dust coated in timed digestion substance, capsule with hole to pump via capillary action, skin patch, and the bonus prodrug lisdexamphetamine that metabolizes into amphetamine at the rate of digestion.

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

#427

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…

Framing it as a handicapping disease is not particularly helpful either. ADHD cannot be cured, we have to live with it and cope however we can. Treatment is absolutely an option but we can also change our environment.

People act like ADHD patients are feeble minded and that just isn't the truth. In the right contexts we can also focus quite intensely. Especially with treatment.

It's true that neurotypical people also experience hyperfocus, that's not in dispute. I don't really like these comparisons to be honest. I just think the fact ADHD patients also experience hyperfocus really should make people rethink the pejorative "attention deficit" label.

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

#428
post #30

Conclusion for those who read the title and read it as an implied negative effect on use. > Drug treatment for ADHD was associated with beneficial effects in reducing the risks of suicidal behaviours, substance misuse, transport accidents, and criminality but not accidental injuries when considering first event rate. The risk reductions were more pronounced for recurrent events, with reduced rates for all five outcom…

The study found substantial risk reductions with ADHD medication: 38% for suicidal behaviors, 30% for substance misuse, 28% for criminality, and 20% for transport accidents - with even stronger effects for recurrent events.

[dead]

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

#429

Earlier quoted context omitted.

ADHD isn't a personality quirk and also, it is fundamentally a disorder of regulation not attention. The education system (for all its drawbacks and inflexibility) works for most because they're able to regulate the urge to get up and climb random shit when they can't figure out how to start writing the answer to Q1 on the worksheet.. I also think its cope to take a disorder where a specific part of the brain tasked…

Nowhere did I claim ADHD was a personality quirk. Nowhere did I claim ADHD wasn't real. I'm not disputing the neurodevelopmental pathophysiology of ADHD. I'm questioning the labels society applies to people with such a disorder. I claimed it's not the "attention deficit" people think it is. People with ADHD are clearly able focus when the subject is interesting enough to them. That's a huge contradiction. The truth i…

it's just poorly named; it's an executive function disorder. The hyper focus you described is just as uncontrolled and pathological as lack of attention. I used to hyper focus on StumbleUpon. You think that's evidence I _don't_ have an attention disorder?

Stop spreading medical misinformation. You're extremely uninformed.

Here are some lectures, go educate yourself: https://m.youtube.com/playlist?list=PLKF2Eq0eYbbrNLoJjFpWG_U...

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

#430

Earlier quoted context omitted.

> Adderall keeps you awake For many (not all) ADHD'ers, amphetamine or caffeine makes them sleepy. > Adderall can make boring tasks seem engaging This is true > so it can be used, for example, to help a student study ... can become a bit of an unfair advantage Unfair? This isn't sports. Nobody is being cheated by a study-enhancing drug. > Adderall can cause a high, even though I've only ever experienced that with pur…

> Interesting. FYI ADHD people feel none of that. If anything, the opposite: on stimulants ADHD people feel relaxed and normal, bringing them down from hyperactivity and allowing them to focus on their life. That is common myth. It's a matter of dosage over time. If one takes 120mg of Adderall in one go, then I can assure you they will not be calm nor relaxed. The relaxed feeling comes with a build of tolerance over…

There’s a lot of myth in this myth-correcting post. I’ve doubled dosed by accident and although I felt like my heart was going to explode (and was very anxious over that), I still felt absolutely nothing resembling a euphoric high.

If you have good vision you do not benefit from glasses. In fact it makes things worse, as those with good vision are able to use their eye muscles to adjust focus but the glasses make that harder.

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