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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

#441

Post by matheusmoreira »

dingnuts wrote: post #429
matheusmoreira wrote: post #420

Earlier quoted context omitted.

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=PLKF2Eq0eYbbrNL…

> it's just poorly named; it's an executive function disorder.

That's my point. Labeling people as having "attention deficit" leads to unnecessary stigma and marginalization.

> The hyper focus you described is just as uncontrolled and pathological as lack of attention.

I didn't say it was controlled or healthy. I said it was evidence that people with so called attention deficit were, in fact, capable of paying attention. And it is.

> You think that's evidence I _don't_ have an attention disorder?

Nobody claimed that.

> Stop spreading medical misinformation. You're extremely uninformed.

> Here are some lectures

Refer to lecture "Why is ADHD considered a disorder?".

When does it become a disorder? When it starts causing harm, adverse consequences, for the individual. When the environment starts kicking back.

In other words, if you can adapt the environment so that it doesn't kick back at the patient, harm is mitigated.

In other words, ADHD patients might adapt reasonably well to certain environments and not others, and we can reduce impairment by putting patients in an environment that is stimulating for them.

This logic is not even unique to ADHD. Numerous diseases have adaptation of the environmental as a vital part of the non-pharmacological treatment. For example, adapting the environment is vital for preventing falls in elderly patients.

So I don't see where the lectures disagree with me. I shadowed a neurologist who specialized in ADHD patients, he combined pharmacological treatment with this environmental approach and it was very successful. Schools labeling kids as problematic was a huge problem for us.

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

#442

Post by NegativeK »

autoexec wrote: post #39

Not surprised. ADHD medications save lives, including the lives of others when it comes to things like preventing car accidents. I could even see it being required for driving the way corrective lenses can be.

The World Anti-Doping Agency, who defines what a performance enhancing drug is and if it's banned in sports, grants Therapeutic Use Exemptions for methylphenidate and its siblings. This is despite some countries using other medicines as first-line treatment for ADHD that aren't banned by WADA.

The justification is that treatment for people with ADHD markedly reduces accidents and suicidality, and that banning the drug outright would do more harm than would come from liars getting the drug and harming sports.

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

#443

Post by FreezerburnV »

lazide wrote: post #424
pantalaimon wrote: post #407

Earlier quoted context omitted.

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.

Not doubting you but… how? Adderall leaves your system in like 4 hours. The half life is crazy short and it’s extremely noticeable when it happens. I don’t understand how someone would fail to sleep for 3 days, or even hyper focus for 12 hours, when the drug is going to be completely gone from their system and not affecting them a fraction of the time into that period. Are you sure it wasn’t something else or they didn’t take more doses or other things?

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

#444

Post by NegativeK »

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.

I grew up with this belief (not your belief; it's a common one) and it hindered me from realizing I needed help.

I regularly have people doubt my diagnosis to this day. If we talk about it more, a lot of them _continue_ to doubt me even after I explain masking.

Again, it's not just your belief -- I grew up hearing radio jockeys calling ADHD "bad parenting disease" -- but this belief is harmful. It ostracizes people and discourages help for a disability that causes measurable harm.

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

#445

Post by hirvi74 »

adastra22 wrote: post #430
hirvi74 wrote: post #392

Earlier quoted context omitted.

> 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 tha…

> 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.

Doubling one's dosage does not mean much without stating the prescribed dosage. 5mg => 10mg is much different than 60mg => 120mg.

Also, the euphoric high tends to become lessened the longer one is on stimulants, even if the dosage is increased, due to neuroadaptation, i.e., a decrease in dopamine receptor availability and changes to downstream signaling effects of dopamine transmission.

Increasing the dosage on the second day of medication vs second year of medication may likely have significantly different effects in regards to the presence of euphoria.

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

#446

Post by hirvi74 »

LoganDark wrote: post #405
hirvi74 wrote: post #392

Earlier quoted context omitted.

> 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…

> If one takes 120mg of Adderall in one go, then I can assure you they will not be calm nor relaxed. If one takes 120mg of Adderall in one go, and they don't have a tolerance, I'd be surprised if their heart doesn't explode.

Unless you are a Finnish super solider like Aino Koivunen

https://en.wikipedia.org/wiki/Aimo_Koivunen

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

#447

Post by andoando »

gms7777 wrote: post #88
DrewADesign wrote: post #58

Earlier quoted context omitted.

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 think especially as adults (esp. people that managed to get to adulthood without being diagnosed), a lot of people think they don't have certain symptoms, when really they just have developed elaborate systems for managing those symptoms. I never related to "time blindness" because I was always consistently early for things, but really I was just deeply anxious about being on time for things. I would set like 10 al…

People can develop fears of anything from a multitude of reasons. There is nothing to say there is a singular cause for your behavior.

We may both even have 5 similar symptoms caused by different things

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

#448

Post by tstrimple »

teamonkey wrote: post #399
tstrimple wrote: post #225

Earlier quoted context omitted.

I never got into fighting games outside of Bushido Blade which I think translated quite well in my domination of Souls-like games. Domination is an exaggeration. I don't feel like I'm particularly good at those games, but I don't think they are nearly as difficult as the reputation conveys. It took me fewer than a dozen tries to kill Malenia in Elden Ring and most of the bosses I was able to kill in the first or seco…

That’s interesting, I’m more-or-less the same. I ask because FPS gameplay contains a whole host of different skills, including the precision of your movements, the ability to accurately predict and track the enemy’s position on screen, as well as your reaction times, sequencing movements and so on. Potentially you could be exceptionally good at some of these and unusually bad at others and still emerge as a good FPS…

I wonder now if I tended to avoid those more frenetic fighting games because to your point it becomes reaction, rection, rection. It's almost constant throughout a fight to the point where it looks like button mashing to the uninitiated. If my reaction times are a more limited pool, I could see them getting exhausted in a fast fighting game where as something like Bushido Blade just needs those great reflexes for a couple exchanges. Similar in FPS where you can balance reactions and game sense. Even Elden Ring boss fights aren't as crazy as a Tekken match against a skilled opponent.

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

#449

Post by ACCount37 »

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…

It's copium.

People don't want to think of themselves as of "diseased" or "disabled". So you get this strange phenomenon: people who are completely deaf, or lost an entire limb, and argue quite passionately that they're "not really disabled". Coping.

ADHD screws with executive function, attention and impulse control. All three are incredibly important for a person to function in a modern society. A person with severe untreated ADHD would be unable to hold almost any job. It's a disability.

But admitting that requires the kind of mental fortitude a lot of people simply don't have.

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

#450

Post by lazide »

FreezerburnV wrote: post #443
lazide wrote: post #424

Earlier quoted context omitted.

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.

Not doubting you but… how? Adderall leaves your system in like 4 hours. The half life is crazy short and it’s extremely noticeable when it happens. I don’t understand how someone would fail to sleep for 3 days, or even hyper focus for 12 hours, when the drug is going to be completely gone from their system and not affecting them a fraction of the time into that period. Are you sure it wasn’t something else or they di…

That’s what they described.
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