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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

#481

Post by homefree »

jakkos wrote: post #475
homefree wrote: post #370

Earlier quoted context omitted.

My criticism is not that the criteria don’t apply or that people don’t think they do - but that most people reading it seem to describe what you’re saying. It seems more like a horoscope to me - everyone can find themselves in the criteria. It’s an observable thing, I’m just not sure I buy its special distinction. People also used to make the claim that the stimulant drugs had special effects (or even opposite effect…

> It seems more like a horoscope to me - everyone can find themselves in the criteria. It’s an observable thing, I’m just not sure I buy its special distinction Do you think the same about conditions like Autism or OCD? People often say they "are a little bit" OCD or autistic, but it's the degree to which those traits are experienced which is the differentiation. There is also no objective test, it's all "soft" scien…

FWIW I don’t think the same about autism and OCD (at least not to the same extent). There are some similar problems with the soft diagnosis, but there is more going on there imo.

They both do have problems with variableness (particularly autism), but it’s more distinct from the general public.

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

#482

Post by lazide »

hirvi74 wrote: post #446
LoganDark wrote: post #405

Earlier quoted context omitted.

> 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

Notably, his heart almost exploded. It was 200bpm a week afterwards, and if not a conditioned soldier he likely would have died a long time before.

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

#483

Post by trogdor »

wheelerwj wrote: post #468
gosub100 wrote: post #440

Earlier quoted context omitted.

If that was true there would be a shortage of pain pills

I haven’t once heard of a person addicted to Adderal outside of a DARE class. Opioids however…

I used to be addicted to Adderall.

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

#484

Post by lazide »

graemep wrote: post #433
adastra22 wrote: post #322

Earlier quoted context omitted.

I didn't realize studying was a crime.

Using controlled substances to study is a crime. Working is not a crime either, but using cocaine to be able to work harder is a crime.

wall street looking around nervously. Oh who am I kidding, no one cares about that one.

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

#485

Post by lazide »

agency wrote: post #378
StevenWaterman wrote: post #371

Earlier quoted context omitted.

> 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?

It’s called the ‘paradoxical calming effect’. Here is a nature article on it [https://www.nature.com/articles/s41598-022-07029-2].

Here is more detailed data [https://www.researchgate.net/publication/45708101_Role_of_Ab...].

It doesn’t happen to everyone with ADHD, but the majority.

The effect itself was prominent/notable as early as WW1, as the drugs were widely used by all parties to help fight fatigue and drowsiness. However, a small percentage of the population would end up with the opposite effect - ending up tired, even sleepy, and often calmer instead of more alert.

It took awhile however, before wider implications of sub-population differences in drug effects like this were studied or applied.

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

#486

Post by justinator »

terminalshort wrote: post #295
justinator wrote: post #248

Earlier quoted context omitted.

Are we talking Adderall? I would be amazed if it still works at all on you. It seems research is showing that stimulants work for ADHD, until it doesn't. If it is Adderall, do you cycle on and off, or what's your protocol? (curious is all)

It's worked for me for 20 years

You never developed a tolerance?

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

#487

Post by andoando »

bruce343434 wrote: post #478
andoando wrote: post #456

Earlier quoted context omitted.

There is no doubt some differences in people who experienced mental problems, and sought or were given a diagnosis, and the general population. QbTest was retroactively designed specifically to target this subjectively diagnosed ADHD group. This may be evidence that an ADHD diagnosis does differentiate populations based on some criteria, but it says nothing to this differentiation being caused by a singular disorder/…

I think if you look hard enough there will always be fuzzy boundaries and overlaps in all the forms of neurodivergence. And yet, stereotypes and categories exist for a reason. Just because diagnosis is not perfect, doesn't mean it isn't good enough to do more good than harm in the world. To your point 1, that's true. When there's ample motivation/inspiration, which is fickle and as far as I can tell not really up for…

What I am trying to say is that the brain is a VERY complex machine, I do not believe there is a singular cause for why people fail to be motivated/alert in their daily lives.

I refuse to call it ADHD, as that implies some known pathology. It is imo a social construction. Categorization can be useful for assessment/treatment but it isnt science. Quite frankly I dont care if people were handed amphetamines simply because they wanted to see if it improved their lives.

I will just say, I am disgnosed and take stims and the best and most motivatrd I ever felt was when I was doing some sort of physical activity almost daily, had a challenging rewarding job and friends. I was completely sober and happy, and completely depressed, ADHD like all the years prior. If youre not exercising regularly I highly suggest you try it

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

#489

Post by pas »

pesus wrote: post #140
hinkley wrote: post #107

Earlier quoted context omitted.

I've heard it argued that ADHD diagnoses should come with a social worker. Every time I realize it's Friday and I'm gonna run out of medication because I forgot to call in the refill I think about that. Three day weekends are the worst. One workaround I've heard is that you order every 30 days even if you forgot to take your pills one or two times. Any surplus pills go into an old bottle you hide in the back of a dra…

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.

you can open the XR/LR capsules too, there's just a bunch of small "grains" inside, with different coatings, and thus they get digested at different rates, and basically it's like eating one instant release and one ~4 hour release capsule. (though there are fancy ones that have ~3 peaks, etc.)

you can simply measure the grains with a scale and separate some fraction.

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

#490

Post by pas »

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.

> that could apply to most people

what does that mean? most people have more than 99% identical genes yet we are not clones.

most people don't have a perfect BMI of 23.5 (or whatever is the middle), yet there are clear pathologies on the BMI spectrum, no?

most people could better manage their lives and emotions but most people don't have that severe problems.

the usual diagnostic criteria simply does not apply for most people. the cutoff is pretty high. (problems in multiple spheres of life present before the age of ~14 -- though there's brain damage induced ADHD too)

but of course most people would benefit from some of the ADHD management strategies (which is better time management, planning, organizing things and consistently putting them into their assigned place, cognitive reframing of pervasive bad thoughts, getting a coach, etc.), but at the same time most people would not benefit from being on the usual ADHD meds (maybe they would benefit from some much smaller doses)

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