5 ms·

I’m not sure why doctors still prescribe any of this stuff. Straterra for ADHD. Tramadol, ibuprofen, Tylenol 3, and gabapentin for pain. Nothing stronger tha

I’m not sure why doctors still prescribe any of this stuff. Straterra for ADHD. Tramadol, ibuprofen, Tylenol 3, and gabapentin for pain. Nothing stronger than hydroxyzine and clonipin for breakthrough anxiety. Everything else should be dealt with by mature coping mechanisms. Europe does it just fine - but not here in USA. I guess providers get rated by customers and we’re capitalists so addicts are the byproduct. Even people in this thread say they make sure to call every month for refills. That behavior is definitely noticed by physicians. Patients won’t do that for other drugs of far greater importance to their health. They’re very sticky for the fun stuff no matter the friction put in place.

junofan 4y ago
I am downvoting this comment for referring to medication as “the fun stuff.” Job loss is not uncommon and a powerful motivator.
- Pigalowda 4y ago
  That’s OK, thank you for your dv. I don’t expect all users to have insight into their conditions. Like I said, there’s straterra, which is a non-amphetamine alternative and effective. But there’s some barriers. Initial constipation is a problem to do tolerance of the GI tract to amphetamine. Another barrier is the loss of “adderolling” which users enjoy.
  - olyjohn 4y ago
    You don't know what the fuck you're talking about, and you're condescending about it to boot.
  - PraetorianGourd 4y ago
    I threw up heavily and daily on straterra. Just because it doesn’t have the same suffix as meth doesn’t mean it’s a panacea. Doctors should have the ability to prescribe what is best for their patients
- atlas_hugged 4y ago
  Seriously. I don’t understand proud ignorance contributes anything.
PraetorianGourd 4y ago
Klonopin is a very powerful benzodiazepine, whereas hydroxyzine is a more akin to Benadryl. You undercut your point when you prepend your point with easily falsifiable information.
- Pigalowda 4y ago
  Its a long acting benzo and less prone to abuse than xanax. When used appropriately for break through anxiety it works well in combination with atarax.
  - PraetorianGourd 4y ago
    Well Stevie Nicks might disagree that it is less prone to abuse.
mickelsen 4y ago
The effect size and response of Atomoextine stacks quite badly against stimulants, which are first line treatments. It also targets noradrenaline mostly, with relatively minor effect in dopamine. If it works for you, great, but for many including myself it was a waste of time. I'm not from the US or Europe btw, but if you want a sound complaint against the status quo in the US, I'd argue against the popularity of the Adderall mixture of L and D-amp over LDX (Vyvanse), which seems more effective (only D-amp) and less addictive.
- salawat 4y ago
  Vyvanse, at least for me, tends to amplify aggressive tendencies to the point I've had my partner comment I scare her. This includes shortening my fuse with people during training, and tolerance for other people making a mistake. All while getting 8 hours or more of sleep a night, actually gaining weight, and having subjectively higher QoL on my end. So no "Adderolling" as @Pigalowda is so fond of criticizing. I get jack and shit out of Straterra in terms of objective therapeutic benefit. Adderall, I have no such aggression amplification problems with, at the cost of needing a substantially higher dose. I'm much more patient and tolerant of frustration, have many fewer ANT's (Automatic Negative Thoughts), and I don't need to take regular breaks to cool off. While Vyvanse undeniably worked for me in terms of increasing my capability to pay attention throughout the day, and as a consequence, get tons done, not only in terms of work, but living a normal life with hobbies; that price tag of inducing eggshell walking among those I love was just too damn high. So I'm back on Adderall... Learning new coping strategies... trying to just get by. Point being, please abstain from painting in broad strokes and assuming just because you may have some pet theory down, that that translates without loss in practice. It doesn't. Not by a long shot.
  - mickelsen 4y ago
    I know there are subtle effect differences between the preparations, sorry that I came across that way. In fact what you describe I also experienced with Vyvanse for years and it just toned down in the recent years by staying at a lower dose and then adding an SSRI (which pretty much removed all those 'triggers' I had of berating people, yet not the 'stim look' that people have on their eyes when on stimulants, that only fades out after the 8-12 hours when you become human again) One time I tried Bupropion instead, I got immediately super short fuse, berating people and so on. Reminded me of a boss I hated so much that would grill me over small things on my PRs for hours, rather than moving on quickly. I didn't want to become anything close to that guy so I just stopped. My point is, the studied outcomes are usually just one variable, that ignores a lot of the extra behavioral effects we as patients get in practice, but it's a good pointer in guiding where to aim treatment first for most. And it seems now LDX is being tried first, before Adderall over there in some practices, with the added convenience of making refills easier. Good luck with your journey pal, I only wish it'd be easier for all of us.
salawat 4y ago
You sir/madam/whatever your pronoun, need to mind thine own beeswax. You are not the sufferer of the malady in question. You have not mastered the art of walking around in someone else's bag o'flesh for 30+ on years, and you have zero place to be lecturing others or opining without having lived with someone whose ADHD isn't responsive to Straterra. Of having to put up with the crippling disorganization; with having to endure the frustration of both the sufferer themselves, and that of those around them. When it gets to the point I have to drop 10+ years of medical records onto a practitioners desk, and STILL get handwringing and whining about "you need a rediagnosis" which requires ceasing treatment and unloading, and results in massive disruption of my, and my loved one's lives, and my ability to work and hold down a job, and my ability to pick up the pieces once everyone ends up going "Welp, yup, that one's a hell of a case of ADHD. Just like they said the first five times they were diagnosed”; which by the way, is fundamentally inflicting diagnostic harm on me; your regulatory regime has gotten out of hand. You think I like this? You think Schedule II is fun to be on the receiving end of? You think I haven't accounted for all the lost time, opportunity, and spend on the drug? You think I like having to fight with insurers for continuity of mental existence? I wouldn't wish it on anyone. And you have the gall to sit here and leave this stain of a bird dropping of a post, pitching >They’re very sticky for the fun stuff no matter the friction put in place. ...as some sort of indicator that "Oh it's because they're a druggie." No, it's because if I don't, the world will be subject to the deleterious consequences of an adult human, tuned to maintain operation with pharmacological assistance, suddenly operating in the abscence thereof in a highly degraded state. Good Lord. Find some bloody perspective. There's about three types of people I can't stand, period; and sanctimonius people that think they can apply one size fits all treatments to others are one of them.
- Pigalowda 4y ago
  The negative externalities of our pharmaceutical industry and its rampant over prescription of amphetamine and opioids aren’t worth it in my opinion. I would gladly get rid of all of it. The homeless users I see walking from Pioneer Square to Harborview Hospital didn’t start off injecting heroin/fentanyl and smoking meth. They almost certainly all started with pills, whether prescribed or illegally obtained. Your argument that it helps you just doesn’t move the needle for me. I see dead 20 year olds nearly every day from fentanyl or hypertensive brain hemorrhages from meth users. That’s just in Seattle - I’m sure it’s similar in every major US city. There’s no So while you describe this benefit to you, I think of it analogously as gun ownership. There are people who use guns appropriately for self defense, hunting, etc - but thousands of people die from them every year due to inappropriate and illegal use. And yet there’s no constitutional protection for amphetamine and opioids - but here the US is today, in a drug crisis of its own making. That’s my perspective. I see the end of one extreme every single day. This is a population level problem and you want me to contextualize it to a single individual. I guess my response to that is that I have contextualized it and reject it. I might be some sanctimonious wind bag to you (who you can’t stand) but you don’t have to see the dead all the time. And this trail of mayhem begins at our irresponsible pharmaceutical industry. The high functioning cheerleading users have 0 perspective and want me to lose sight of the forest. No thank you, I’ll stick to the one size fits all treatments. No opioids or amphetamines.

junofan 4y ago

I am downvoting this comment for referring to medication as “the fun stuff.” Job loss is not uncommon and a powerful motivator.

Pigalowda 4y ago
That’s OK, thank you for your dv. I don’t expect all users to have insight into their conditions. Like I said, there’s straterra, which is a non-amphetamine alternative and effective. But there’s some barriers. Initial constipation is a problem to do tolerance of the GI tract to amphetamine. Another barrier is the loss of “adderolling” which users enjoy.
- olyjohn 4y ago
  You don't know what the fuck you're talking about, and you're condescending about it to boot.
- PraetorianGourd 4y ago
  I threw up heavily and daily on straterra. Just because it doesn’t have the same suffix as meth doesn’t mean it’s a panacea. Doctors should have the ability to prescribe what is best for their patients
atlas_hugged 4y ago
Seriously. I don’t understand proud ignorance contributes anything.

PraetorianGourd 4y ago

Klonopin is a very powerful benzodiazepine, whereas hydroxyzine is a more akin to Benadryl. You undercut your point when you prepend your point with easily falsifiable information.

Pigalowda 4y ago
Its a long acting benzo and less prone to abuse than xanax. When used appropriately for break through anxiety it works well in combination with atarax.
- PraetorianGourd 4y ago
  Well Stevie Nicks might disagree that it is less prone to abuse.

mickelsen 4y ago

The effect size and response of Atomoextine stacks quite badly against stimulants, which are first line treatments. It also targets noradrenaline mostly, with relatively minor effect in dopamine. If it works for you, great, but for many including myself it was a waste of time. I'm not from the US or Europe btw, but if you want a sound complaint against the status quo in the US, I'd argue against the popularity of the Adderall mixture of L and D-amp over LDX (Vyvanse), which seems more effective (only D-amp) and less addictive.

salawat 4y ago
Vyvanse, at least for me, tends to amplify aggressive tendencies to the point I've had my partner comment I scare her. This includes shortening my fuse with people during training, and tolerance for other people making a mistake. All while getting 8 hours or more of sleep a night, actually gaining weight, and having subjectively higher QoL on my end. So no "Adderolling" as @Pigalowda is so fond of criticizing. I get jack and shit out of Straterra in terms of objective therapeutic benefit. Adderall, I have no such aggression amplification problems with, at the cost of needing a substantially higher dose. I'm much more patient and tolerant of frustration, have many fewer ANT's (Automatic Negative Thoughts), and I don't need to take regular breaks to cool off. While Vyvanse undeniably worked for me in terms of increasing my capability to pay attention throughout the day, and as a consequence, get tons done, not only in terms of work, but living a normal life with hobbies; that price tag of inducing eggshell walking among those I love was just too damn high. So I'm back on Adderall... Learning new coping strategies... trying to just get by. Point being, please abstain from painting in broad strokes and assuming just because you may have some pet theory down, that that translates without loss in practice. It doesn't. Not by a long shot.
- mickelsen 4y ago
  I know there are subtle effect differences between the preparations, sorry that I came across that way. In fact what you describe I also experienced with Vyvanse for years and it just toned down in the recent years by staying at a lower dose and then adding an SSRI (which pretty much removed all those 'triggers' I had of berating people, yet not the 'stim look' that people have on their eyes when on stimulants, that only fades out after the 8-12 hours when you become human again) One time I tried Bupropion instead, I got immediately super short fuse, berating people and so on. Reminded me of a boss I hated so much that would grill me over small things on my PRs for hours, rather than moving on quickly. I didn't want to become anything close to that guy so I just stopped. My point is, the studied outcomes are usually just one variable, that ignores a lot of the extra behavioral effects we as patients get in practice, but it's a good pointer in guiding where to aim treatment first for most. And it seems now LDX is being tried first, before Adderall over there in some practices, with the added convenience of making refills easier. Good luck with your journey pal, I only wish it'd be easier for all of us.

salawat 4y ago

You sir/madam/whatever your pronoun, need to mind thine own beeswax. You are not the sufferer of the malady in question. You have not mastered the art of walking around in someone else's bag o'flesh for 30+ on years, and you have zero place to be lecturing others or opining without having lived with someone whose ADHD isn't responsive to Straterra. Of having to put up with the crippling disorganization; with having to endure the frustration of both the sufferer themselves, and that of those around them. When it gets to the point I have to drop 10+ years of medical records onto a practitioners desk, and STILL get handwringing and whining about "you need a rediagnosis" which requires ceasing treatment and unloading, and results in massive disruption of my, and my loved one's lives, and my ability to work and hold down a job, and my ability to pick up the pieces once everyone ends up going "Welp, yup, that one's a hell of a case of ADHD. Just like they said the first five times they were diagnosed”; which by the way, is fundamentally inflicting diagnostic harm on me; your regulatory regime has gotten out of hand. You think I like this? You think Schedule II is fun to be on the receiving end of? You think I haven't accounted for all the lost time, opportunity, and spend on the drug? You think I like having to fight with insurers for continuity of mental existence? I wouldn't wish it on anyone. And you have the gall to sit here and leave this stain of a bird dropping of a post, pitching >They’re very sticky for the fun stuff no matter the friction put in place. ...as some sort of indicator that "Oh it's because they're a druggie." No, it's because if I don't, the world will be subject to the deleterious consequences of an adult human, tuned to maintain operation with pharmacological assistance, suddenly operating in the abscence thereof in a highly degraded state. Good Lord. Find some bloody perspective. There's about three types of people I can't stand, period; and sanctimonius people that think they can apply one size fits all treatments to others are one of them.

Pigalowda 4y ago
The negative externalities of our pharmaceutical industry and its rampant over prescription of amphetamine and opioids aren’t worth it in my opinion. I would gladly get rid of all of it. The homeless users I see walking from Pioneer Square to Harborview Hospital didn’t start off injecting heroin/fentanyl and smoking meth. They almost certainly all started with pills, whether prescribed or illegally obtained. Your argument that it helps you just doesn’t move the needle for me. I see dead 20 year olds nearly every day from fentanyl or hypertensive brain hemorrhages from meth users. That’s just in Seattle - I’m sure it’s similar in every major US city. There’s no So while you describe this benefit to you, I think of it analogously as gun ownership. There are people who use guns appropriately for self defense, hunting, etc - but thousands of people die from them every year due to inappropriate and illegal use. And yet there’s no constitutional protection for amphetamine and opioids - but here the US is today, in a drug crisis of its own making. That’s my perspective. I see the end of one extreme every single day. This is a population level problem and you want me to contextualize it to a single individual. I guess my response to that is that I have contextualized it and reject it. I might be some sanctimonious wind bag to you (who you can’t stand) but you don’t have to see the dead all the time. And this trail of mayhem begins at our irresponsible pharmaceutical industry. The high functioning cheerleading users have 0 perspective and want me to lose sight of the forest. No thank you, I’ll stick to the one size fits all treatments. No opioids or amphetamines.