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> While these drugs will make healthy people high and overexcited, it will help ADHD patients calm down and focus. And beyond that, this simply is a misconcept

> While these drugs will make healthy people high and overexcited, it will help ADHD patients calm down and focus. And beyond that, this simply is a misconception and myth perpetuated by uneducated people. ADHD patients calm down when they take Adderall because they’ve been on it for years and have a tolerance. That’s just what happens. You don’t get the exact same euphoria that someone who takes it monthly feels. The underlying mechanism of action is the same for all humans.

GuB-42 7y ago
My understanding is that ADHD patients are in a constant unsatisfying "underexcited" state, so they will do anything to find exciting things to do. Amphetamines pulls them up to normal levels. Give the same substance to someone already at a normal level and he will become overexcited. Just like putting weights on a scale can balance an unbalanced scale or unbalance an balanced scale.
- hexscrews 7y ago
  I'm in a weird position of taking both ritalin and celexa. It makes me both anxious and focused.
  - antihero 7y ago
    I had to quit Ritalin in year 11 because the anxiety was completely fucking ruining my social development, regardless of whether it was useful to get good grades. I'm unmedicated now (30) and still in some ways quite a difficult human to deal with due to erractic behaviour and unreliability and disorganisation, however, I don't think I could go back to the ritalin man.
    - kortex 7y ago
      Ritalin (methylphenidate in general) is a rough one, cause of its stupidly short half life (as short as 90min in some). On top of that, most extended release systems for it are garbage. Sure on average, the blood plasma level graph is smooth, but you look at individual profiles, and some individuals have way higher peak amplitudes. In my experience, MPH, even the ER/concerta stuff, thrashes your mental state too much to be productive. I actually had more stability dosing slivers of MPH IR every hour, but man, that's tedious, it's easy to miss, and once you drop, it's not the same, even if you get back to therapeutic range.
- vonseel 7y ago
  I like that explanation especially the first paragraph. I don’t understand pharmacology well enough to really know exactly what’s going on, but I’ve always thought today’s ADHD drugs are extremely broad, perhaps even crude solutions to a poorly-understood condition. Kind of a super broad-spectrum antibiotic versus a narrow-spectrum antibiotic. Today, my (non-medical) understanding is essentially the same as yours, and that we use Adderall and other stimulants to do what you say - push them to the normal side of the spectrum - but at its core it's just messing with dopamine levels. Having ADHD and being medicated for many years, it's not like the feeling of "being on a drug" ever goes away completely. It's not completely benign like, e.g. taking an allergy pill. It still curbs my appetite, so I have to be careful about scheduling doses (always eat before). There's a bunch of personality changes when the drugs are in my system, mostly stuff that makes you want to just work "heads down" and not talk to anyone, sometimes that's great, sometimes it's not. I wonder if I am less emotional and am more selfish because of being on it so long, I can't imagine telling someone "I miss you", for example, that just seems like an overly-sensitive emotion that I'm not capable of producing. Especially not in a world connected by iMessage and the Internet, where everyone seems like they are right beside you, even if they are thousands of miles away. Not sure where I'm going with this, but I guess what I meant by "broad action" is that we are kind of killing one person by carpet-bombing. I wonder if in the future we'll have meds that work much better with less side-effects. Maybe we even have them now in the form of the non-stimulant options, but my doc did not sound enthusiastic about switching from stimulant to non-stimulant ADHD meds.
- thonos 7y ago
  Wow that first paragraph is an explanation I never heard before but nails the concentration part of ADHD
temporaryvector 7y ago
>This simply is a misconception and myth perpetuated by uneducated people I think it's less of a misconception and more of the fact that people whom stimulants noticeably calm down are a lot rarer than people with ADHD, if that makes sense. I know personal anecdotes are not data, and I've not taken Adderall itself, but when I got prescribed Vyvanse (lisdexamfetamine) for the first time, and pretty high dose at that, the difference was immediate and notable. I went from being anxious, waking up a couple of times a night, generally sleeping badly when I did and always feeling tired to getting a full 8 hours of restful sleep and a nap during the day if I wanted (despite taking the strong dose of Vyvanse) and being a lot less shaky during the day. Before that, I had never taken any stimulants besides coffee, which never seemed to do anything for me anyway so I wasn't one of those people who "couldn't function without their morning cup of joe" so I skipped it most days because I wasn't feeling up to breakfast. This has been the greatest change in quality of life for me and if you had told me 5 years earlier that I would feel this way I wouldn't have believed you. Improved quality of sleep aside, I don't really get euphoria when I'm taking stimulants. If I had to compare it to anything, when I started taking ADHD meds (I started with Straterra but it was only partially effective) it was like no longer being drunk.
thonos 7y ago
> And beyond that, this simply is a misconception and myth perpetuated by uneducated people. ADHD patients calm down when they take Adderall because they’ve been on it for years and have a tolerance. Hmm I have to disagree here. Even with my first dosage of Concerta (Methylphenidate) on no tolerance, I started feeling calmer. Like a lot of the chatter in my head got muted and I stopped jumping from thought to thought like a pingpong ball. This experience matches with other friends that have ADHD. On the other hand when I give them out to friends for trying more often the other person ended up not being able to concentrate due to restlessness or wanting to do a lot of things at the same time (kind causing similar things that it gets rid of for me)
Doxin 7y ago
> ADHD patients calm down when they take Adderall because they’ve been on it for years and have a tolerance. Speaking of myths, this is wildly incorrect. I've now been on methylphenidate -- AKA ritalin -- for a couple months. I do not and have not ever experienced a high or otherwise any euphoria. Partially this is indubitably because of the relative low dosage and low bioavailability. But partially it's because ADD makes me react differently to it. There's roughly three effects I experience. Primarily it's way easier to stay focussed. The only side-effects I've been experiencing is some feelings of stress towards the end of the effective time of a dosage and some slight muscle twitching in my leg. Anecdote aside, one of the possible side-effects of these sorts of medication is "a rushed feeling". Most people do not get this side effect, and if they do it's a cause for looking at different medication. It's definitely not the case that that's just something you build a tolerance to. Tolerance building is a thing, but it applies to the beneficial effects just as much as it applies to the side effects.
- OGWhales 7y ago
  Agreed. I have built a tolerance to it before but know that I do not have ADHD. My friend who certainly does reacts to adderall differently than I do. We have discussed it in detail and seem to be effected differently despite taking similar doses daily. This far beyond my understanding, but ADHD patients appear to have an imbalance between dopamine and norepinephrine in the mesocorticolimbic dopamine pathway and the locus coeruleus-noradrenergic system. There is more to this of course and I'm sure I botched even that part. Regardless, the point is that these medications actually treat their underlying issue instead of overdriving the same systems. Tolerance is mostly irrelevant in this regard as people without ADHD do not have these same differences which means they do not react to the drug in the same manner. Simply put, these medications tend to make ADHD patients more calm and focused and normal people tend to feel "tweaked".
  - vonseel 7y ago
    In a way, calm and focus are the same thing as tweaked, but I guess you'd have to be on it to understand what I mean by that.

GuB-42 7y ago

My understanding is that ADHD patients are in a constant unsatisfying "underexcited" state, so they will do anything to find exciting things to do. Amphetamines pulls them up to normal levels. Give the same substance to someone already at a normal level and he will become overexcited. Just like putting weights on a scale can balance an unbalanced scale or unbalance an balanced scale.

hexscrews 7y ago
I'm in a weird position of taking both ritalin and celexa. It makes me both anxious and focused.
- antihero 7y ago
  I had to quit Ritalin in year 11 because the anxiety was completely fucking ruining my social development, regardless of whether it was useful to get good grades. I'm unmedicated now (30) and still in some ways quite a difficult human to deal with due to erractic behaviour and unreliability and disorganisation, however, I don't think I could go back to the ritalin man.
  - kortex 7y ago
    Ritalin (methylphenidate in general) is a rough one, cause of its stupidly short half life (as short as 90min in some). On top of that, most extended release systems for it are garbage. Sure on average, the blood plasma level graph is smooth, but you look at individual profiles, and some individuals have way higher peak amplitudes. In my experience, MPH, even the ER/concerta stuff, thrashes your mental state too much to be productive. I actually had more stability dosing slivers of MPH IR every hour, but man, that's tedious, it's easy to miss, and once you drop, it's not the same, even if you get back to therapeutic range.
vonseel 7y ago
I like that explanation especially the first paragraph. I don’t understand pharmacology well enough to really know exactly what’s going on, but I’ve always thought today’s ADHD drugs are extremely broad, perhaps even crude solutions to a poorly-understood condition. Kind of a super broad-spectrum antibiotic versus a narrow-spectrum antibiotic. Today, my (non-medical) understanding is essentially the same as yours, and that we use Adderall and other stimulants to do what you say - push them to the normal side of the spectrum - but at its core it's just messing with dopamine levels. Having ADHD and being medicated for many years, it's not like the feeling of "being on a drug" ever goes away completely. It's not completely benign like, e.g. taking an allergy pill. It still curbs my appetite, so I have to be careful about scheduling doses (always eat before). There's a bunch of personality changes when the drugs are in my system, mostly stuff that makes you want to just work "heads down" and not talk to anyone, sometimes that's great, sometimes it's not. I wonder if I am less emotional and am more selfish because of being on it so long, I can't imagine telling someone "I miss you", for example, that just seems like an overly-sensitive emotion that I'm not capable of producing. Especially not in a world connected by iMessage and the Internet, where everyone seems like they are right beside you, even if they are thousands of miles away. Not sure where I'm going with this, but I guess what I meant by "broad action" is that we are kind of killing one person by carpet-bombing. I wonder if in the future we'll have meds that work much better with less side-effects. Maybe we even have them now in the form of the non-stimulant options, but my doc did not sound enthusiastic about switching from stimulant to non-stimulant ADHD meds.
thonos 7y ago
Wow that first paragraph is an explanation I never heard before but nails the concentration part of ADHD

temporaryvector 7y ago

>This simply is a misconception and myth perpetuated by uneducated people I think it's less of a misconception and more of the fact that people whom stimulants noticeably calm down are a lot rarer than people with ADHD, if that makes sense. I know personal anecdotes are not data, and I've not taken Adderall itself, but when I got prescribed Vyvanse (lisdexamfetamine) for the first time, and pretty high dose at that, the difference was immediate and notable. I went from being anxious, waking up a couple of times a night, generally sleeping badly when I did and always feeling tired to getting a full 8 hours of restful sleep and a nap during the day if I wanted (despite taking the strong dose of Vyvanse) and being a lot less shaky during the day. Before that, I had never taken any stimulants besides coffee, which never seemed to do anything for me anyway so I wasn't one of those people who "couldn't function without their morning cup of joe" so I skipped it most days because I wasn't feeling up to breakfast. This has been the greatest change in quality of life for me and if you had told me 5 years earlier that I would feel this way I wouldn't have believed you. Improved quality of sleep aside, I don't really get euphoria when I'm taking stimulants. If I had to compare it to anything, when I started taking ADHD meds (I started with Straterra but it was only partially effective) it was like no longer being drunk.

thonos 7y ago

> And beyond that, this simply is a misconception and myth perpetuated by uneducated people. ADHD patients calm down when they take Adderall because they’ve been on it for years and have a tolerance. Hmm I have to disagree here. Even with my first dosage of Concerta (Methylphenidate) on no tolerance, I started feeling calmer. Like a lot of the chatter in my head got muted and I stopped jumping from thought to thought like a pingpong ball. This experience matches with other friends that have ADHD. On the other hand when I give them out to friends for trying more often the other person ended up not being able to concentrate due to restlessness or wanting to do a lot of things at the same time (kind causing similar things that it gets rid of for me)

Doxin 7y ago

> ADHD patients calm down when they take Adderall because they’ve been on it for years and have a tolerance. Speaking of myths, this is wildly incorrect. I've now been on methylphenidate -- AKA ritalin -- for a couple months. I do not and have not ever experienced a high or otherwise any euphoria. Partially this is indubitably because of the relative low dosage and low bioavailability. But partially it's because ADD makes me react differently to it. There's roughly three effects I experience. Primarily it's way easier to stay focussed. The only side-effects I've been experiencing is some feelings of stress towards the end of the effective time of a dosage and some slight muscle twitching in my leg. Anecdote aside, one of the possible side-effects of these sorts of medication is "a rushed feeling". Most people do not get this side effect, and if they do it's a cause for looking at different medication. It's definitely not the case that that's just something you build a tolerance to. Tolerance building is a thing, but it applies to the beneficial effects just as much as it applies to the side effects.

OGWhales 7y ago
Agreed. I have built a tolerance to it before but know that I do not have ADHD. My friend who certainly does reacts to adderall differently than I do. We have discussed it in detail and seem to be effected differently despite taking similar doses daily. This far beyond my understanding, but ADHD patients appear to have an imbalance between dopamine and norepinephrine in the mesocorticolimbic dopamine pathway and the locus coeruleus-noradrenergic system. There is more to this of course and I'm sure I botched even that part. Regardless, the point is that these medications actually treat their underlying issue instead of overdriving the same systems. Tolerance is mostly irrelevant in this regard as people without ADHD do not have these same differences which means they do not react to the drug in the same manner. Simply put, these medications tend to make ADHD patients more calm and focused and normal people tend to feel "tweaked".
- vonseel 7y ago
  In a way, calm and focus are the same thing as tweaked, but I guess you'd have to be on it to understand what I mean by that.