2 ms·

I'd refer people to: The Global Market For ADHD Medications (2007) https://sci-hub.se/10.1377/hlthaff.26.2.450 https://sci-hub.se/10.1377/hlthaff.26.2.450 >

I'd refer people to: The Global Market For ADHD Medications (2007) https://sci-hub.se/10.1377/hlthaff.26.2.450 https://sci-hub.se/10.1377/hlthaff.26.2.450 > Several key issues are salient. > First, objective tests for ADHD are lacking, a problem shared with most other psychiatric conditions. Guidelines for proper diagnosis must be followed, so that disorders with similar symptoms (such as conduct disorder or bipolar disorder) do not receive inappropriate stimulant treatment. > Second, prescription rates of stimulants (and other psychotropic medications) have greatly increased, at least in the United States, even for preschoolers. About half of U.S. children and adolescents diagnosed with ADHD receive stimulant medications or related agents. > Third, unintended side effects may accompany stimulant use. Most are mild, but public health concerns have arisen about the potential for negative cardiovascular effects and suicidal thoughts [this is relevant to PKD's history, note he died of a stroke, and had at least one suicidal episode] > Fourth, questions abound about the potential for “diversion” of prescription stimulants to people without ADHD, related to improvement of study skills and possible euphoriant effects. As far as the 'clincal reality' of ADHD, I'd argue that the scientific basis of psychiatric disorder classifications and the efficacy of treatments is not that clear, relative to say, a diagnosis of drug-resitant tuberculosis infection. For example, the entire serotonin theory of depression is now on shaky ground due to apparent fraud in historical studies. This doesn't mean anti-depressants and amphetamine derivatives don't provide some benefit to people, but the whole field's not on very solid ground.

mtlmtlmtlmtl 4y ago
Interesting that you ignore the fact that you were caught grossly misrepresenting the history of ADHD as a clinical entity yourself. This makes it hard to take you seriously. You mention the "serotonin theory" as if it's been a theory with wide consensus behind it, when it never was. The wider monoamine hypothesis was just a loose idea based on the efficacy of monoaminergic medication(starting with MAOIs in the 50s). It was always controversial, and studies have always been mixed on this. The hypothesis saw a brief surge in the 90s when highly selective serotonergic medications were shown to be effective. But research has moved on since then, showing that effect of SSRIs is more strongly linked to upregulation of things like BDNF. The review from 2022 on the serotonin hypothesis was not some earth-shattering result, it just confirmed what most researchers in the field already suspected for the last 2 decades. Once again your description of psychiatric clinical practice and research comes off as a caricature gained from mainly consuming mainstream simplifications of the research, and I'm done engaging with it.
- photochemsyn 4y ago
  "Grossly misrepresenting"? Let's take a look at this CDC graphic ('ADHD https://www.cdc.gov/ncbddd/adhd/documents/Timeline.pdf https://www.cdc.gov/ncbddd/adhd/documents/Timeline.pdf Digging through those references seems to point to a very low level of ADHD diagnoses and treatment in the 1970s relative to the 1990s, for example. Was there a massive undiagnosed disorder among American children in the 1970s? Notably, the CDC only starts tracking ADHD diagnoses starting in 1997! https://www.cdc.gov/ncbddd/adhd/timeline.html https://www.cdc.gov/ncbddd/adhd/timeline.html What does that curve look like if you extend in back to 1967, which is apparently when the NIH began funding US academic studies on the behavioral effects of treating children with amphetamines?
  - mtlmtlmtlmtl 4y ago
    How do you expect people to have a serious discussion with you when you consistently ignore their rebuttals to your misrepresentations?
    - photochemsyn 4y ago
      I'd remind you that this is a Philip K Dick thread. What do you think PKD would make of a program that delivers mass quantities of amphetamines and amphetamine derivatives to children in the name of helping them control their classroom behavior, really?

mtlmtlmtlmtl 4y ago

Interesting that you ignore the fact that you were caught grossly misrepresenting the history of ADHD as a clinical entity yourself. This makes it hard to take you seriously. You mention the "serotonin theory" as if it's been a theory with wide consensus behind it, when it never was. The wider monoamine hypothesis was just a loose idea based on the efficacy of monoaminergic medication(starting with MAOIs in the 50s). It was always controversial, and studies have always been mixed on this. The hypothesis saw a brief surge in the 90s when highly selective serotonergic medications were shown to be effective. But research has moved on since then, showing that effect of SSRIs is more strongly linked to upregulation of things like BDNF. The review from 2022 on the serotonin hypothesis was not some earth-shattering result, it just confirmed what most researchers in the field already suspected for the last 2 decades. Once again your description of psychiatric clinical practice and research comes off as a caricature gained from mainly consuming mainstream simplifications of the research, and I'm done engaging with it.

photochemsyn 4y ago
"Grossly misrepresenting"? Let's take a look at this CDC graphic ('ADHD https://www.cdc.gov/ncbddd/adhd/documents/Timeline.pdf https://www.cdc.gov/ncbddd/adhd/documents/Timeline.pdf Digging through those references seems to point to a very low level of ADHD diagnoses and treatment in the 1970s relative to the 1990s, for example. Was there a massive undiagnosed disorder among American children in the 1970s? Notably, the CDC only starts tracking ADHD diagnoses starting in 1997! https://www.cdc.gov/ncbddd/adhd/timeline.html https://www.cdc.gov/ncbddd/adhd/timeline.html What does that curve look like if you extend in back to 1967, which is apparently when the NIH began funding US academic studies on the behavioral effects of treating children with amphetamines?
- mtlmtlmtlmtl 4y ago
  How do you expect people to have a serious discussion with you when you consistently ignore their rebuttals to your misrepresentations?
  - photochemsyn 4y ago
    I'd remind you that this is a Philip K Dick thread. What do you think PKD would make of a program that delivers mass quantities of amphetamines and amphetamine derivatives to children in the name of helping them control their classroom behavior, really?