13 ms·

Ritalin Gone Wrong

200 points by cs702 15y ago

kghose 15y ago
Though one could say "Another Nature vs Nurture"-er, this article is interesting to me from a "responsibility" point of view. Our children are our responsibility. As tempting as it is to put the child in front of a TV, or pop it a pill, or (in the future I am involved in a small way in building) stimulate neurons in the brain to get some effect, there is a huge component of taking responsibility for actually nurturing a child: being near him/her, empathizing and simply supporting. This article reminds us, we are responsible for the kids, by leading through example and by trying to understand and taking up the challenge of correcting wrong behaviors and supporting correct ones.
itmag 15y ago
I'd be interested in hearing what a (non-kooky) fringe scientist like Seth Roberts has to say on ADD. It always seemed weird to me that huge amounts of people should be taking Speed on a daily basis. Has there been any research into treating ADD with stuff like low-carb diets, vitamin D, limiting EMF exposure, limiting videogames, fish oil, filtering chemicals out of drinking water? I'm just throwing those out there as hunches; I have no idea if they're scientifically valid.
- akavi 15y ago
  >filtering chemicals out of drinking water I encourage you to give that a shot and report back on your results.
- deleted 15y ago
  [deleted]
- sebphfx 15y ago
  it really is Speed. I'd be curious to see the percentage of the ADD drugs that are being crushed and snorted. As a kid, we used to snort Dexedrin and Ritalin and it's called the poor man's coke. You even get a heavier crash than bad coke. The same thing is happening with prescribed opiates. More people are taking them for other reasons than for the ones they were intended for. I already know that comment is going to go at the bottom of the page since I'm talking about experience and not scientific studies,but, it's my own experiments and empirical evidence.
- jinushaun 15y ago
  I graduated with a degree in biochemistry hoping to get into the biotech/pharmaceutical industry, but was turned off by the emphasis on treaments instead of cures. Ritalin and Aderall seems analogous to taking pain killers to treat an open wound—masks the symptoms (pain) but doesn't address the cause (open wound). With the explosion of ADD prescriptions, one has to wonder if our society/environment is causing this problem. Is it diet? HFCS? Modern parenting styles? The internet and information overload?
  - _delirium 15y ago
    My cautious guess in the specific context of academia (where I am) is that unreasonable expectations may be one factor (though probably not the only one). Academics calibrate their norms by a handful of famous people who have relatively rare cognitive styles, and due to academic competitiveness there's strong pressure to match that. There are plenty of people who are objectively normal, in the sense of having traits that fall comfortably around the median of the population, who in this context feel that they're pathologically abnormal, because they're using very high baselines: if you calibrate "normal" by the 90th percentile for some trait, and you're 50th-percentile, it's tempting to conclude that what's holding you back from being at the top of your field is a medical problem that should be treated. And maybe it still should; I'm not inherently against taking drugs to mentally enhance people's performance above normal levels (nootropics, etc.), but imo that's a separate discussion that should be had with open eyes.
  - deno 15y ago
    > Ritalin and Aderall seems analogous to taking pain killers to treat an open wound—masks the symptoms (pain) but doesn't address the cause (open wound). And how are you going to address the open wound? There’s no brain surgery for ADHD. A better analogy is that of wearing glasses. Glasses don’t actually fix your eyesight, and you need them all the time, but they allow you to function normally. Medications used for ADHD treatment are exactly like that. > With the explosion of ADD prescriptions There’s an explosion of sensationalist reporting by general media. ADHD is still under-diagnosed in USA, and it’s even worse in Europe. It’s exactly the same as the “explosion” of autism. No, the vaccines are not causing autism, just because there’s more data and a better awareness of the disorder.
- mikeash 15y ago
  I find the juxtaposition of "non-kooky" and "limiting EMF exposure"/"filtering chemicals" to be really odd. A lot of these may well be interesting, but those two in particular just scream pure kook at me.
tokenadult 15y ago
I was interested to see that the researcher who wrote the op-ed, a psychologist based at my alma mater, has participated in some of the research projects he reviews in the op-ed. As I read the comments here, I'll be collecting ideas for questions to ask the local researcher in person as I try to learn more about ADD. I was particularly interested to see that the op-ed criticized several earlier studies for their study designs. http://norvig.com/experiment-design.html http://norvig.com/experiment-design.html I first became interested in what adult ADD treatments do after seeing a testimonial from an HN participant, a programmer, who said that his productivity increased dramatically after beginning ADD medication as an adult. I have since read parts of quite a few of the recent scholarly publications on ADD, especially those that focus on adult ADD, to try to wrap my mind around the trade-offs of medical treatment versus other approaches to symptom management. (I'm also still trying to make sense of just how ADD is defined, especially among adults who were not deemed to have ADD in childhood. The definitional issues are rather complicated.) http://www.cdc.gov/ncbddd/adhd/diagnosis.html http://www.cdc.gov/ncbddd/adhd/diagnosis.html http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/complete-index.shtml http://www.nimh.nih.gov/health/publications/attention-defici... http://www.mayoclinic.org/medical-edge-newspaper-2011/mar-18b.html http://www.mayoclinic.org/medical-edge-newspaper-2011/mar-18... Another participant here has already commented that there may be other interventions to consider when grappling with problems of attention focus. What are the best sources on other interventions (diet, lifestyle, etc.)? What are the trade-offs of those? For the occupations most pursued by participants on Hacker News, do you find it helpful to seek ADD medication if you are found to have ADD symptoms? What do your loved ones and colleagues think about your performance on a before-and-after basis if you have tried treatment? On the whole, ADD seems to involve a minority of participants in any occupation, but perhaps a more significant minority among HN participants than among some other subsets of the human population. I'm still trying to get a reality check, and would like to learn more.
- dlytle 15y ago
  I'm currently taking adult ADD meds (Adderall); it's a double edged sword, and I'd personally really prefer to find another method. The primary problem is, during any sort of transition I would be pretty useless, and I can't afford to take that long being useless with my current job. I went cold turkey from 25mg of Adderall XR daily, and for about a week and a half I was absolutely dead. I'd have a splitting headache due to dehydration, but I couldn't summon the energy to get off the couch and walk 12 feet to where I had bottles of water. I'm glad I went cold turkey rather than just tapering the dose, though, because tapering the dose would have taken months of feeling miserable, rather than 1.5 weeks of feeling like a dead man. If you hear anything interesting from people about biofeedback/etc, long-term non-medicinal adult ADD treatments, could you toss me a mail at taloen@gmail.com? I'd really like to see other peoples' opinions on those routes, and I don't lurk enough on HN to be likely to see a submission about it. (Just to clarify; yes, I'm back on the Adderall XR again, although at 5mg rather than 25 this time.)
jayferd 15y ago
I was diagnosed with ADD as a child, and have experienced firsthand the kind of dependencies these drugs can create. I wasn't able to stop taking Dexedrine (essentially the same as Ritalin) until halfway through my first semester of college, when I undertook a daily practice of meditation. Now I've come to realize that "lack of attentiveness" is part of the human condition. We can make it worse by excessive stimulation and context-switching, but this unscientific idea of an "inbuilt" disability simply doesn't exist.
- deno 15y ago
  If you can meditate, or sit still in one place without any stimulus for that matter, you’re quite lucky. It’s an impossible task for most people with ADHD. > Now I've come to realize that "lack of attentiveness" is part of the human condition. No. ADHD is a hereditary neurological disorder. One of the first things that you’ll see on Wikipedia’s page on ADHD is a PET scan comparing dopamine transporter availability in a healthy brain and one of a person diagnosed with ADHD. In children, the biological differences are real, and can by no means be explained by “experience.” E.g. http://www.msnbc.msn.com/id/21757514/ns/health-mental_health/t/adhd-kids-brains-mature-more-slowly/ http://www.msnbc.msn.com/id/21757514/ns/health-mental_health...
  - jayferd 15y ago
    That's fair. Meditation is hard, and I don't claim to be particularly good at it. On the other hand, I would say it's an extremely difficult task for just about anyone. The study the article you posted cites successfully correlates brain differences with AD(H)D diagnosis. Part of the argument in the original article, though (which I can verify in my own case at least), is that while the brain affects observed behavior, behavior also affects the brain. So it's a very real possibility that experience and learned behavior are causing both the observed behavior and the brain chemistry differences.
gruseom 15y ago
"To date, no study has found any long-term benefit of attention-deficit medication on academic performance, peer relationships or behavior problems".
- jey 15y ago
  Are there any long-term studies of these issues? I'd be surprised if there's actually enough good ones to draw conclusions.
  - adamjernst 15y ago
    A great point. Our brains parse "no study has found any long-term benefit" as "studies have found no long-term benefit", which is not accurate.
  - Tichy 15y ago
    Good point, but doesn't the article specifically mention one 8 year study where all effects were gone by the end of the 8 years?
_delirium 15y ago
On a more basic level before even getting to treatment, imo it'd be useful to have more studies on what the distribution of some sort of trait called "attention" is in the population to begin with, perhaps in various common situations. That might provide some sort of baseline: if, for example, 90% of people have "abnormally low" attention by some measure in some situation, then the definition of "abnormal" is probably wrong. In that case, rather than concluding that 90% of people need to be treated for a disorder, it might make more sense to conclude that the alleged "normal" characteristics are actually quite rare, demanding a characteristic that <10% of humans naturally have. Of course, other numbers might lead to different conclusions. Put differently, it feels like it'd be easier to have rigorous discussions about deviations from normal mental functioning if we first had a good, data-based picture of "normal mental functioning". I've looked but have had difficulty finding any such studies.
- bermanoid 15y ago
  I'm going to go against the grain here, and argue that "normal" is irrelevant - "desired" is the target here. If people want themselves/their children to think/act a certain way, and this opinion is widespread, then it's completely valid to treat that as the target, even if 90% of the people in society need to be chemically modified to make them act that way. Evolution isn't perfect, and at no point has it tried to optimize for happiness, it only goes for reproductive success, which we as individuals don't care too much about, at least in the short term. If there are interventions that we can impose that better optimize for happiness than letting us exist naturally would, we have no reason to avoid these interventions. That said, I have no idea what the optimal desired mental function would look like...
  - _delirium 15y ago
    I have some sympathy for that argument, but I think we should still distinguish the cases and talk about them accurately. If the situation really is that 90% of people need some sort of intervention to reach the desired mental functioning, then we could just say that and argue for it openly; the pro-nootropics community makes those kinds of arguments, for example. I think when loaded terms like "abnormal" or "ill" or "treatment" are used, though, they're only really accurate if we're talking about pathological deviations from a species norm. But actually my interest in what constitutes the "norm" is somewhat more basic; I think how human attention works is quite interesting as a subject of scientific study, and I wish there were more aggregate data on how it varies in different situations and across the population.
mynegation 15y ago
While I am not prepared to discuss specifics of Ritalin's effects, the article raises very important point: a lot of problems happening with children are due to the neglect on their parents' (or primary caregivers') side. I've always wondered how you have to be licensed to drive any more or less complicated mechanism, but yet you can become responsible for things thousand times more complicated and important, like children, just like that. Having children requires a lot of knowledge, but somehow our education system is not designed to prepare us to deal with that. How many parents read books on child psychology or development? The proper alignment of incentive could help here: e.g. having some kind of a test could be a prerequisite for getting children-related tax credits and benefits.
- harryf 15y ago
  > a lot of problems happening with children are due to the neglect on their parents' (or primary caregivers') side. That nails the problem but I disagree strongly with your conclusion this is a problem of individual responsibility. Its a social problem which we have to solve as a society by understanding why parents are having problems giving enough attention to their kids. The problems here are far more fundamental and pervasive to blame any individual parents for "failing". Great video on the topic here http://www.youtube.com/watch?v=_-KqeU8nzn4&feature=youtube_gdata_player http://www.youtube.com/watch?v=_-KqeU8nzn4&feature=youtu...
- oflannabhra 15y ago
  I agree that children are incredibly complicated, and raising them properly requires knowledge, but I fail to see how the educational system and government regulation have any responsibility or authority in this domain.
trotsky 15y ago
When Sroufe suggests the brain disorder known as ADHD may simply be the result of environment without providing a bit of supporting evidence, he ignores mountains of data that show strongly correlated multi-generational symptoms even when there was little or no contact. There is a reason science doesn't get presented on opinion pages. Trying to convince parents that it may not be a real disorder, or may not be developmental, or that drugs are ineffective does a serious disservice to the diagnosed. Stimulant drugs are unlikely to be the end all and be all for ADHD treatment, but they are currently the best we have and they've been shown again and again to provide significant benefit.
- chimeracoder 15y ago
  The same thing can be said about depression too - we don't really know why SSRIs work, but they generally work enough that we use them as a first-line treatment for depression. Like ADHD, depression is sometimes confused for being a product of the environment, when in both cases the environment is really just an exacerbating factor (clinical depression, unlike PTSD, cannot be caused by environment alone). The problem with studying ADHD like this is that we generally agree that ADHD is over-diagnosed and over-prescribed, but then for evidence that ADHD exists as a medical condition, we look to the existing pool of people who are diagnosed or even taking medication to confirm that there is a difference between those who are diagnosed and those who aren't. 'm not saying that this means ADHD is a hoax - I agree with you that it's more than just the environment. It's just very difficult to construct definitions for mental conditions in particular, because there's usually no way to do a double-blind randomized experiment. The problem is that ADHD and depression are both heterogeneous conditions - they're likely not single conditions themselves, but a bunch of somewhat related conditions that we're currently unable to distinguish between. The various hypotheses for what causes ADHD (and depression) may not be mutually exclusive. That makes studies that much harder to conduct, because you have a mixed population, which makes identifying characteristic traits harder (and sometimes impossible, depending on the mixture). It also means that anecdotal evidence is that much more worthless, because what is true about one member in the population could be completely false for another. And, in some cases, having a mixed distribution can give you the exact opposite results; see Simpson's Paradox: http://en.wikipedia.org/wiki/Simpsons_paradox http://en.wikipedia.org/wiki/Simpsons_paradox
jdefr89 15y ago
I am currently on two medications. VyVanse for ADD and Anafranil for OCD. As far as effectiveness, yes the medication is helpful at the beginning. However, after being on it for two years the effect of the drugs wear off and you end up doubling your dose. That seems to be the pattern with all the medications I take, even those not concerned with ADD. Honestly I really improve my productivity through therapy related techniques; meditation, therapist, developing my focus muscle. Strangely, I don't have attention problems when it comes to the things I have interest in such as coding and computer science.
- watmough 15y ago
  If it's not too personal, can you outline some of your OCD symptoms and behaviors?
hop 15y ago
I have a real problem labeling 10 year olds that get bored and fidgety in boring situations with having a brain disorder and giving them speed. Find me 10 successful entreprenuers and I bet I can show you 10 people who had a tough time sitting through unengaging lesson plans in school. Doesn't help with ballooning class sizes either.
- drumdance 15y ago
  Possibly related: a surprisingly high percentage of entrepreneurs are also dyslexic.
  - wahnfrieden 15y ago
    Source?
    - foxit 15y ago
      http://www.inc.com/articles/201105/are-dyslexics-better-visionaries.html http://www.inc.com/articles/201105/are-dyslexics-better-visi... http://www.nytimes.com/2007/12/05/business/worldbusiness/05iht-dyslexia.4.8602036.html http://www.nytimes.com/2007/12/05/business/worldbusiness/05i... http://www.businessweek.com/bwdaily/dnflash/content/dec2007/db20071212_539295.htm http://www.businessweek.com/bwdaily/dnflash/content/dec2007/... I can't believe the parent got downvoted so badly. Did people think being dyslexic was an insult? It's not.
      - wahnfrieden 15y ago
        It was the kind of statement that's uselessly skepticism-inducing without a citation.
- nerfhammer 15y ago
  This armchair criticism might apply to the hyperactivity subtype but perhaps not as well to the inattention subtype.
sek 15y ago
So Ritalin is just a usual mind boosting drug, it has rebound effects and people develop a tolerance. Like cocaine, MDMA, ephedrine and meth. It differs in it's euphoric and adverse effects, but the positive influence is not permanent. Not a single drug can help you in the long term, you have to develop the abilities yourself. These drugs have the opposite effect, because as long as you take them you don't evolve. The worst thing is when you get used taking this stuff. You give up faster and think you are unable to deal with it yourself, what leads very fast to an addiction. So many of my fellow students are taking drugs now for learning, especially Ritalin (but also the other stuff i mentioned earlier). I tried Ritalin once and the results were impressive, but i always had a bad feeling about this. This article proves my concerns right, Ritalin is not without downsides.
- tokenadult 15y ago
  because as long as you take them you don't evolve. Homeostasis of the human body does make any intervention hard to keep long-lasting. I take it you mean "develop" (the word you used in the preceding sentence) for where you wrote "evolve," because of course individuals don't evolve (in the biological sense of the word) but rather populations do by changes in gene frequencies. The story of obesity seems to be that change is hard for human beings, period, whether the intervention is medical or a lifestyle intervention. If a person has a personal tendency that is truly a disorder for adaptation in current society, maybe nothing should be taken off the table for the person seeking help. But, yes, I agree with you that willpower-developed kinds of personal behavior changes are surely helpful for ADD and for other problems too, perhaps more possible if they are backed up by external helps of one kind or another.
  - sek 15y ago
    The word develop is the right one. It is the same translation in German, my mistake. The big problem is that while you take it, it feels like it. To make the observation that this is not permanent, while influenced, is very difficult. The feeling is very subtle and not obvious like being drunk for example. You are right, there are extreme forms who need medication. The article suggests, that the whole ADD existence is still not clear and i was diagnosed myself as a kid. I assume that just a little part of the people who take Ritalin really need and benefit from it.
CChristie 15y ago
Physical activity -> exhaustion = improved concentration. Practiced this in college and still to this day. Otherwise, I'm all over the place.
rkon 15y ago
Parents should really take note of the studies and conclusions in this article. As someone diagnosed with ADHD who has tried numerous medications (Adderall regular and XR, Vyvanse, Strattera, Focalin, and Wellbutrin) I have to say I would never ever EVER allow a young child of mine to take any of them. I can't even fathom how confusing and damaging the side effects of these medications could be to the fragile psyche of a child -- anxiety, mood swings, depression, sleep loss, etc. I was diagnosed at the age of 23, so I knew my own personality well enough to tell when it was being altered by the medications, but how would a child know this? The answer is simple: they wouldn't, and in many cases they're prescribed additional medications (usually anti-depressants and/or anti-anxiety pills) to deal with it. I cannot respect any parent who allows their minor child to take these types of psychotropic drugs in any but the most dire of situations. Reading ADHD forums was an absolutely horrifying experience for me: parents list the multiple drugs their children are taking in their signatures as if they're badges of honor. After 2.5 years of trying various ADHD medications I gave up on them completely and have never looked back. Yes, most of them did have the benefits they promised, but the types of side effects they're capable of producing can absolutely wreak havoc on your emotional well being even in their most mild forms.
- nerfhammer 15y ago
  You may have been more sensitive to the side effects than most.
  - rkon 15y ago
    I didn't personally experience all of those side effects, they just seem to be the most common based on dozens of other users of those medications I spoke with after beginning them myself. There are some other very common side effects I didn't mention as well, such as headaches/bouts of anger/crashing when the medication is wearing off each day, dehydration/drymouth, and heart palpitations or racing heartbeat. The side effect that most annoyed me was actually loss of appetite, which is basically accepted as 'normal' when taking stimulants. Anxiety was probably a bigger issue with Adderall, though. I don't recall ever talking to someone who felt zero side effects from any these medications.
psaccounts 15y ago
It is a shame that most people are unaware of the efficacy of Homeopathy to treat ADD, ADHD and autism-spectrum disorders. Do some research and you'll see how hundreds of thousands of people have been cured of these ailments using Homeopathy alone.
- wahnfrieden 15y ago
  Do some research and you'll find homeopathy is bunk. There's no science behind it, studies have shown it completely ineffective, and besides, it's just clean water.
  - psaccounts 15y ago
    You are saying this out of the research you have done yourself, right? And yes, I have done the research and also have experienced it first hand -- something that Stanford doctors could not do (and an army of 3 different specializations nonetheless) was cured using Homeopathy. Is this placebo effect?
    - marshray 15y ago
      Give it up. It doesn't matter if you're right or wrong, or it cured your cancer or whatever, you'll never get past the skeptics.
- WalterSear 15y ago
  This is a lie. Perhaps the poster is lying to themselves, but it is a lie nonetheless.
  - deleted 15y ago
    [deleted]
- mikeash 15y ago
  The placebo effect can be a wonderful thing.
- 15y ago
BasDirks 15y ago
I have taken Concerta for about 3 years and it helped a great deal in getting more organized. I periodically go without it, which is getting easier and easier with time (I guess because I have been able to structure life better). Eventually I will probably quit completely. There is a danger in throwing pills at a common problem. But there is also a danger in dismissing medication as part of a solution. People for who Concerta/Ritalin didn't work often bash these drugs as dangerous or evil.
deleted 15y ago
[deleted]
pizza 15y ago
Ritalin (methylphenidate) and Adderall (Dextroamphetamine / Levoamphetamine) are interesting and powerful nootropics (http://en.wikipedia.org/wiki/Nootropic http://en.wikipedia.org/wiki/Nootropic). I haven't tried them yet, although I am looking forward to the day I do. However, they do have some serious negative aspects; they are addictive and come with a substantial 'crash'. This is where the racetams come in! The racetam family consists of nootropics that enhance mainly memory recall, although I certainly feel there's an increase in ability to think of new ideas and convey them lucidly. They're not all that new (first developed in the 60s) and are widely regarded as non-toxic, in both the short and long term (sorry, don't know how to find the study. However, as anecdotal evidence, this guy did 80 GRAMS of piracetam in one sitting, which is 100x the regular dose http://www.drugs-forum.com/forum/showthread.php?t=153468 http://www.drugs-forum.com/forum/showthread.php?t=153468). The stimulation from piracetam, the racetam that is most commonly used, is sort of similar to caffeine stimulation but less pronounced; I have also never experienced a piracetam crash, even after nasal insufflation of a gram and a half. Piracetam also makes me much more productive, much more than caffeine ever did or probably will ever do, and I highly suggest it for anyone who is interested in nootropics!
- georgieporgie 15y ago
  I'm surprised I haven't seen more buzz about racetams on HN. I recently started experimenting with Piracetam. It's too early to make a judgment, but I did seem to get a heck of a lot more done in the two weeks 'on' than in several weeks prior. I'm currently doing about 2g in the morning, and another 1.5g in the afternoon. I haven't directly noticed any effect, aside from perhaps a short period of mild dizziness one day.
vlad 15y ago
If I remember correctly, a recent article pointed out that prescriptions in every category of drugs have increased year over year at a similar or greater rate, and that prescriptions for ADHD and ADD have actually been increasing slower than expected compared to other categories of drugs. An article like this should qualify the magnitude this way. Secondly, as companies release new drugs that can target specific conditions better or safer than ever, treat conditions that were not treatable before, it makes sense that doctors prescribe medicines more and more often every year, especially as patents on proven drugs expire and the medications become available as cheap generics.
Volpe 15y ago
Why is this on HN?
- Volpe 15y ago
  why the downvotes? its a link from mainstream news on something unrelated to tech... can someone explain?
  - tim_h 15y ago
    The site guidelines ( http://ycombinator.com/newsguidelines.html http://ycombinator.com/newsguidelines.html ) say "On-Topic: Anything that good hackers would find interesting." Judging by the comments on this thread, such is the case here.
  - cs702 15y ago
    I submitted the link, so I should probably respond: IMHO this falls well inside the "What to Submit" paremeters specified on http://ycombinator.com/newsguidelines.html http://ycombinator.com/newsguidelines.html
tim_h 15y ago
I was diagnosed with ADHD at age 18. At that point in my life I had developed pretty much a hatred for school, and had resolved to never go to college. Spending 8 hours/day at school was akin to torture for me. I found it to be mind-numbingly boring. My doctor had me try various medications. Adderall was too intense. It got me high and gave me a tendency to focus too much on the wrong level of a problem (I would obsess over details). Worse, my body acclimated and I found that I needed a higher and higher dosage to have the same "benefit". Everything turned around for me when I found out about a different medication from a friend - Dexadrine. My doctor never mentioned it to me but once I asked him about it he agreed to let me try it. Boy am I glad he did. To make a long story short, I finally went to college, graduated at the top of my class, then went on to Stanford to earn an advanced degree. Now I have a job that I love. I've been on this medication for almost 10 years. I never acclimated to it (in the sense of needing a higher dosage for the same effect) and the side effects are very mild (slight loss of appetite, slightly harder to sleep). Recently I decreased the dosage by almost 50%. I've found that over the years I've somehow learned how to concentrate better, and that therefore my need for the med has decreased. This makes me think that my brain has somehow changed for the better. Perhaps all the concentrating I did while on a higher dosage served as practice and that the benefits from all this practicing apply even without the medication. Maybe some day I'll be able to get off of it completely. But for now I still have a tough time concentrating without it.
jonhendry 15y ago
Remember: Real science and medicine don't happen in newspaper op-eds.
bocmaxima 15y ago
I've been using stimulants for almost five years (age 20 now). The last year or so I reached a point where like the article said — the effects of the drugs tapered off — and there was really nothing I could do about it. As a kid I exemplified the most extreme kind of inattention, behavioral, and regulatory problems that classify ADD, but once I began taking the meds I went through an equally extreme transformation, so I'm skeptical of any article that derides the use of stimulants. I'm also reminded of what the late Christopher Hitchens said in defense of his heavy drinking and smoking: “Writing is what’s important to me, and anything that helps me do that—or enhances and prolongs and deepens and sometimes intensifies argument and conversation—is worth it to me.” I recently met someone who has tourette's syndrome, which means he has increased production of dopamine. In other words — the inverse of ADD. The drugs he took induced a state of ADD that was identical to what I what I experienced sans-stimulants. It's crucial for those of us with the kind of dramatic impairment that comes with ADD to get by with as much help as possible from competent practitioners (of which there seems to be a very short supply of).
laserson 15y ago
Wow, 3 million "children". There are over 62 million children in the US. That means almost 5% of all kids are getting medicated... http://www.wolframalpha.com/input/?i=US+population+under+age+18 http://www.wolframalpha.com/input/?i=US+population+under+age...
- Alex3917 15y ago
  It's worth noting though that three year olds aren't taking these drugs, so the actual rate is more like 9% of kids have ADHD, and a good percentage of those (60%?) are currently taking drugs for it.
vintagius 15y ago
What i never understood over the years was, why Ritalin was given to kids with ADD and ADHD.All though those two disorders are related,they do not have the same effect on a person. People with ADD tend to be tooo calm and appear to be slow ,on the other hand those with ADHD (including me) tend to be too Hyper , our minds are at full speed all the time which affects concerntrating on things we do not enjoy.I found out that Ritalin works well for me by relaxing the pace of my thoughts ,which in turn allows me to focus on a BORING thing like a volumous book. So now how can you give a person with ADD (Slow thoughts) a drug that will make them more slow and expect results. My conclusion is that Ritalin works better for people who have ADHD then those with ADD,and the reason why results on the improvement that Ritalin has ,have varied time and again is because a drug that work for one group (ADHD) was also given to those (ADD) it does not work for.In such a situation results will never be consistant.

200 points by cs702 15y ago

Though one could say "Another Nature vs Nurture"-er, this article is interesting to me from a "responsibility" point of view. Our children are our responsibility. As tempting as it is to put the child in front of a TV, or pop it a pill, or (in the future I am involved in a small way in building) stimulate neurons in the brain to get some effect, there is a huge component of taking responsibility for actually nurturing a child: being near him/her, empathizing and simply supporting. This article reminds us, we are responsible for the kids, by leading through example and by trying to understand and taking up the challenge of correcting wrong behaviors and supporting correct ones.

itmag 15y ago

I'd be interested in hearing what a (non-kooky) fringe scientist like Seth Roberts has to say on ADD. It always seemed weird to me that huge amounts of people should be taking Speed on a daily basis. Has there been any research into treating ADD with stuff like low-carb diets, vitamin D, limiting EMF exposure, limiting videogames, fish oil, filtering chemicals out of drinking water? I'm just throwing those out there as hunches; I have no idea if they're scientifically valid.

akavi 15y ago
>filtering chemicals out of drinking water I encourage you to give that a shot and report back on your results.
deleted 15y ago
[deleted]
sebphfx 15y ago
it really is Speed. I'd be curious to see the percentage of the ADD drugs that are being crushed and snorted. As a kid, we used to snort Dexedrin and Ritalin and it's called the poor man's coke. You even get a heavier crash than bad coke. The same thing is happening with prescribed opiates. More people are taking them for other reasons than for the ones they were intended for. I already know that comment is going to go at the bottom of the page since I'm talking about experience and not scientific studies,but, it's my own experiments and empirical evidence.
jinushaun 15y ago
I graduated with a degree in biochemistry hoping to get into the biotech/pharmaceutical industry, but was turned off by the emphasis on treaments instead of cures. Ritalin and Aderall seems analogous to taking pain killers to treat an open wound—masks the symptoms (pain) but doesn't address the cause (open wound). With the explosion of ADD prescriptions, one has to wonder if our society/environment is causing this problem. Is it diet? HFCS? Modern parenting styles? The internet and information overload?
- _delirium 15y ago
  My cautious guess in the specific context of academia (where I am) is that unreasonable expectations may be one factor (though probably not the only one). Academics calibrate their norms by a handful of famous people who have relatively rare cognitive styles, and due to academic competitiveness there's strong pressure to match that. There are plenty of people who are objectively normal, in the sense of having traits that fall comfortably around the median of the population, who in this context feel that they're pathologically abnormal, because they're using very high baselines: if you calibrate "normal" by the 90th percentile for some trait, and you're 50th-percentile, it's tempting to conclude that what's holding you back from being at the top of your field is a medical problem that should be treated. And maybe it still should; I'm not inherently against taking drugs to mentally enhance people's performance above normal levels (nootropics, etc.), but imo that's a separate discussion that should be had with open eyes.
- deno 15y ago
  > Ritalin and Aderall seems analogous to taking pain killers to treat an open wound—masks the symptoms (pain) but doesn't address the cause (open wound). And how are you going to address the open wound? There’s no brain surgery for ADHD. A better analogy is that of wearing glasses. Glasses don’t actually fix your eyesight, and you need them all the time, but they allow you to function normally. Medications used for ADHD treatment are exactly like that. > With the explosion of ADD prescriptions There’s an explosion of sensationalist reporting by general media. ADHD is still under-diagnosed in USA, and it’s even worse in Europe. It’s exactly the same as the “explosion” of autism. No, the vaccines are not causing autism, just because there’s more data and a better awareness of the disorder.
mikeash 15y ago
I find the juxtaposition of "non-kooky" and "limiting EMF exposure"/"filtering chemicals" to be really odd. A lot of these may well be interesting, but those two in particular just scream pure kook at me.

tokenadult 15y ago

I was interested to see that the researcher who wrote the op-ed, a psychologist based at my alma mater, has participated in some of the research projects he reviews in the op-ed. As I read the comments here, I'll be collecting ideas for questions to ask the local researcher in person as I try to learn more about ADD. I was particularly interested to see that the op-ed criticized several earlier studies for their study designs. http://norvig.com/experiment-design.html http://norvig.com/experiment-design.html I first became interested in what adult ADD treatments do after seeing a testimonial from an HN participant, a programmer, who said that his productivity increased dramatically after beginning ADD medication as an adult. I have since read parts of quite a few of the recent scholarly publications on ADD, especially those that focus on adult ADD, to try to wrap my mind around the trade-offs of medical treatment versus other approaches to symptom management. (I'm also still trying to make sense of just how ADD is defined, especially among adults who were not deemed to have ADD in childhood. The definitional issues are rather complicated.) http://www.cdc.gov/ncbddd/adhd/diagnosis.html http://www.cdc.gov/ncbddd/adhd/diagnosis.html http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/complete-index.shtml http://www.nimh.nih.gov/health/publications/attention-defici... http://www.mayoclinic.org/medical-edge-newspaper-2011/mar-18b.html http://www.mayoclinic.org/medical-edge-newspaper-2011/mar-18... Another participant here has already commented that there may be other interventions to consider when grappling with problems of attention focus. What are the best sources on other interventions (diet, lifestyle, etc.)? What are the trade-offs of those? For the occupations most pursued by participants on Hacker News, do you find it helpful to seek ADD medication if you are found to have ADD symptoms? What do your loved ones and colleagues think about your performance on a before-and-after basis if you have tried treatment? On the whole, ADD seems to involve a minority of participants in any occupation, but perhaps a more significant minority among HN participants than among some other subsets of the human population. I'm still trying to get a reality check, and would like to learn more.

dlytle 15y ago
I'm currently taking adult ADD meds (Adderall); it's a double edged sword, and I'd personally really prefer to find another method. The primary problem is, during any sort of transition I would be pretty useless, and I can't afford to take that long being useless with my current job. I went cold turkey from 25mg of Adderall XR daily, and for about a week and a half I was absolutely dead. I'd have a splitting headache due to dehydration, but I couldn't summon the energy to get off the couch and walk 12 feet to where I had bottles of water. I'm glad I went cold turkey rather than just tapering the dose, though, because tapering the dose would have taken months of feeling miserable, rather than 1.5 weeks of feeling like a dead man. If you hear anything interesting from people about biofeedback/etc, long-term non-medicinal adult ADD treatments, could you toss me a mail at taloen@gmail.com? I'd really like to see other peoples' opinions on those routes, and I don't lurk enough on HN to be likely to see a submission about it. (Just to clarify; yes, I'm back on the Adderall XR again, although at 5mg rather than 25 this time.)

jayferd 15y ago

I was diagnosed with ADD as a child, and have experienced firsthand the kind of dependencies these drugs can create. I wasn't able to stop taking Dexedrine (essentially the same as Ritalin) until halfway through my first semester of college, when I undertook a daily practice of meditation. Now I've come to realize that "lack of attentiveness" is part of the human condition. We can make it worse by excessive stimulation and context-switching, but this unscientific idea of an "inbuilt" disability simply doesn't exist.

deno 15y ago
If you can meditate, or sit still in one place without any stimulus for that matter, you’re quite lucky. It’s an impossible task for most people with ADHD. > Now I've come to realize that "lack of attentiveness" is part of the human condition. No. ADHD is a hereditary neurological disorder. One of the first things that you’ll see on Wikipedia’s page on ADHD is a PET scan comparing dopamine transporter availability in a healthy brain and one of a person diagnosed with ADHD. In children, the biological differences are real, and can by no means be explained by “experience.” E.g. http://www.msnbc.msn.com/id/21757514/ns/health-mental_health/t/adhd-kids-brains-mature-more-slowly/ http://www.msnbc.msn.com/id/21757514/ns/health-mental_health...
- jayferd 15y ago
  That's fair. Meditation is hard, and I don't claim to be particularly good at it. On the other hand, I would say it's an extremely difficult task for just about anyone. The study the article you posted cites successfully correlates brain differences with AD(H)D diagnosis. Part of the argument in the original article, though (which I can verify in my own case at least), is that while the brain affects observed behavior, behavior also affects the brain. So it's a very real possibility that experience and learned behavior are causing both the observed behavior and the brain chemistry differences.

gruseom 15y ago

"To date, no study has found any long-term benefit of attention-deficit medication on academic performance, peer relationships or behavior problems".

jey 15y ago
Are there any long-term studies of these issues? I'd be surprised if there's actually enough good ones to draw conclusions.
- adamjernst 15y ago
  A great point. Our brains parse "no study has found any long-term benefit" as "studies have found no long-term benefit", which is not accurate.
- Tichy 15y ago
  Good point, but doesn't the article specifically mention one 8 year study where all effects were gone by the end of the 8 years?

_delirium 15y ago

On a more basic level before even getting to treatment, imo it'd be useful to have more studies on what the distribution of some sort of trait called "attention" is in the population to begin with, perhaps in various common situations. That might provide some sort of baseline: if, for example, 90% of people have "abnormally low" attention by some measure in some situation, then the definition of "abnormal" is probably wrong. In that case, rather than concluding that 90% of people need to be treated for a disorder, it might make more sense to conclude that the alleged "normal" characteristics are actually quite rare, demanding a characteristic that <10% of humans naturally have. Of course, other numbers might lead to different conclusions. Put differently, it feels like it'd be easier to have rigorous discussions about deviations from normal mental functioning if we first had a good, data-based picture of "normal mental functioning". I've looked but have had difficulty finding any such studies.

bermanoid 15y ago
I'm going to go against the grain here, and argue that "normal" is irrelevant - "desired" is the target here. If people want themselves/their children to think/act a certain way, and this opinion is widespread, then it's completely valid to treat that as the target, even if 90% of the people in society need to be chemically modified to make them act that way. Evolution isn't perfect, and at no point has it tried to optimize for happiness, it only goes for reproductive success, which we as individuals don't care too much about, at least in the short term. If there are interventions that we can impose that better optimize for happiness than letting us exist naturally would, we have no reason to avoid these interventions. That said, I have no idea what the optimal desired mental function would look like...
- _delirium 15y ago
  I have some sympathy for that argument, but I think we should still distinguish the cases and talk about them accurately. If the situation really is that 90% of people need some sort of intervention to reach the desired mental functioning, then we could just say that and argue for it openly; the pro-nootropics community makes those kinds of arguments, for example. I think when loaded terms like "abnormal" or "ill" or "treatment" are used, though, they're only really accurate if we're talking about pathological deviations from a species norm. But actually my interest in what constitutes the "norm" is somewhat more basic; I think how human attention works is quite interesting as a subject of scientific study, and I wish there were more aggregate data on how it varies in different situations and across the population.

mynegation 15y ago

While I am not prepared to discuss specifics of Ritalin's effects, the article raises very important point: a lot of problems happening with children are due to the neglect on their parents' (or primary caregivers') side. I've always wondered how you have to be licensed to drive any more or less complicated mechanism, but yet you can become responsible for things thousand times more complicated and important, like children, just like that. Having children requires a lot of knowledge, but somehow our education system is not designed to prepare us to deal with that. How many parents read books on child psychology or development? The proper alignment of incentive could help here: e.g. having some kind of a test could be a prerequisite for getting children-related tax credits and benefits.

harryf 15y ago
> a lot of problems happening with children are due to the neglect on their parents' (or primary caregivers') side. That nails the problem but I disagree strongly with your conclusion this is a problem of individual responsibility. Its a social problem which we have to solve as a society by understanding why parents are having problems giving enough attention to their kids. The problems here are far more fundamental and pervasive to blame any individual parents for "failing". Great video on the topic here http://www.youtube.com/watch?v=_-KqeU8nzn4&feature=youtube_gdata_player http://www.youtube.com/watch?v=_-KqeU8nzn4&feature=youtu...
oflannabhra 15y ago
I agree that children are incredibly complicated, and raising them properly requires knowledge, but I fail to see how the educational system and government regulation have any responsibility or authority in this domain.

trotsky 15y ago

When Sroufe suggests the brain disorder known as ADHD may simply be the result of environment without providing a bit of supporting evidence, he ignores mountains of data that show strongly correlated multi-generational symptoms even when there was little or no contact. There is a reason science doesn't get presented on opinion pages. Trying to convince parents that it may not be a real disorder, or may not be developmental, or that drugs are ineffective does a serious disservice to the diagnosed. Stimulant drugs are unlikely to be the end all and be all for ADHD treatment, but they are currently the best we have and they've been shown again and again to provide significant benefit.

chimeracoder 15y ago
The same thing can be said about depression too - we don't really know why SSRIs work, but they generally work enough that we use them as a first-line treatment for depression. Like ADHD, depression is sometimes confused for being a product of the environment, when in both cases the environment is really just an exacerbating factor (clinical depression, unlike PTSD, cannot be caused by environment alone). The problem with studying ADHD like this is that we generally agree that ADHD is over-diagnosed and over-prescribed, but then for evidence that ADHD exists as a medical condition, we look to the existing pool of people who are diagnosed or even taking medication to confirm that there is a difference between those who are diagnosed and those who aren't. 'm not saying that this means ADHD is a hoax - I agree with you that it's more than just the environment. It's just very difficult to construct definitions for mental conditions in particular, because there's usually no way to do a double-blind randomized experiment. The problem is that ADHD and depression are both heterogeneous conditions - they're likely not single conditions themselves, but a bunch of somewhat related conditions that we're currently unable to distinguish between. The various hypotheses for what causes ADHD (and depression) may not be mutually exclusive. That makes studies that much harder to conduct, because you have a mixed population, which makes identifying characteristic traits harder (and sometimes impossible, depending on the mixture). It also means that anecdotal evidence is that much more worthless, because what is true about one member in the population could be completely false for another. And, in some cases, having a mixed distribution can give you the exact opposite results; see Simpson's Paradox: http://en.wikipedia.org/wiki/Simpsons_paradox http://en.wikipedia.org/wiki/Simpsons_paradox

jdefr89 15y ago

I am currently on two medications. VyVanse for ADD and Anafranil for OCD. As far as effectiveness, yes the medication is helpful at the beginning. However, after being on it for two years the effect of the drugs wear off and you end up doubling your dose. That seems to be the pattern with all the medications I take, even those not concerned with ADD. Honestly I really improve my productivity through therapy related techniques; meditation, therapist, developing my focus muscle. Strangely, I don't have attention problems when it comes to the things I have interest in such as coding and computer science.

watmough 15y ago
If it's not too personal, can you outline some of your OCD symptoms and behaviors?

hop 15y ago

I have a real problem labeling 10 year olds that get bored and fidgety in boring situations with having a brain disorder and giving them speed. Find me 10 successful entreprenuers and I bet I can show you 10 people who had a tough time sitting through unengaging lesson plans in school. Doesn't help with ballooning class sizes either.

drumdance 15y ago
Possibly related: a surprisingly high percentage of entrepreneurs are also dyslexic.
- wahnfrieden 15y ago
  Source?
  - foxit 15y ago
    http://www.inc.com/articles/201105/are-dyslexics-better-visionaries.html http://www.inc.com/articles/201105/are-dyslexics-better-visi... http://www.nytimes.com/2007/12/05/business/worldbusiness/05iht-dyslexia.4.8602036.html http://www.nytimes.com/2007/12/05/business/worldbusiness/05i... http://www.businessweek.com/bwdaily/dnflash/content/dec2007/db20071212_539295.htm http://www.businessweek.com/bwdaily/dnflash/content/dec2007/... I can't believe the parent got downvoted so badly. Did people think being dyslexic was an insult? It's not.
    - wahnfrieden 15y ago
      It was the kind of statement that's uselessly skepticism-inducing without a citation.
nerfhammer 15y ago
This armchair criticism might apply to the hyperactivity subtype but perhaps not as well to the inattention subtype.

sek 15y ago

So Ritalin is just a usual mind boosting drug, it has rebound effects and people develop a tolerance. Like cocaine, MDMA, ephedrine and meth. It differs in it's euphoric and adverse effects, but the positive influence is not permanent. Not a single drug can help you in the long term, you have to develop the abilities yourself. These drugs have the opposite effect, because as long as you take them you don't evolve. The worst thing is when you get used taking this stuff. You give up faster and think you are unable to deal with it yourself, what leads very fast to an addiction. So many of my fellow students are taking drugs now for learning, especially Ritalin (but also the other stuff i mentioned earlier). I tried Ritalin once and the results were impressive, but i always had a bad feeling about this. This article proves my concerns right, Ritalin is not without downsides.

tokenadult 15y ago
because as long as you take them you don't evolve. Homeostasis of the human body does make any intervention hard to keep long-lasting. I take it you mean "develop" (the word you used in the preceding sentence) for where you wrote "evolve," because of course individuals don't evolve (in the biological sense of the word) but rather populations do by changes in gene frequencies. The story of obesity seems to be that change is hard for human beings, period, whether the intervention is medical or a lifestyle intervention. If a person has a personal tendency that is truly a disorder for adaptation in current society, maybe nothing should be taken off the table for the person seeking help. But, yes, I agree with you that willpower-developed kinds of personal behavior changes are surely helpful for ADD and for other problems too, perhaps more possible if they are backed up by external helps of one kind or another.
- sek 15y ago
  The word develop is the right one. It is the same translation in German, my mistake. The big problem is that while you take it, it feels like it. To make the observation that this is not permanent, while influenced, is very difficult. The feeling is very subtle and not obvious like being drunk for example. You are right, there are extreme forms who need medication. The article suggests, that the whole ADD existence is still not clear and i was diagnosed myself as a kid. I assume that just a little part of the people who take Ritalin really need and benefit from it.

CChristie 15y ago

Physical activity -> exhaustion = improved concentration. Practiced this in college and still to this day. Otherwise, I'm all over the place.

rkon 15y ago

Parents should really take note of the studies and conclusions in this article. As someone diagnosed with ADHD who has tried numerous medications (Adderall regular and XR, Vyvanse, Strattera, Focalin, and Wellbutrin) I have to say I would never ever EVER allow a young child of mine to take any of them. I can't even fathom how confusing and damaging the side effects of these medications could be to the fragile psyche of a child -- anxiety, mood swings, depression, sleep loss, etc. I was diagnosed at the age of 23, so I knew my own personality well enough to tell when it was being altered by the medications, but how would a child know this? The answer is simple: they wouldn't, and in many cases they're prescribed additional medications (usually anti-depressants and/or anti-anxiety pills) to deal with it. I cannot respect any parent who allows their minor child to take these types of psychotropic drugs in any but the most dire of situations. Reading ADHD forums was an absolutely horrifying experience for me: parents list the multiple drugs their children are taking in their signatures as if they're badges of honor. After 2.5 years of trying various ADHD medications I gave up on them completely and have never looked back. Yes, most of them did have the benefits they promised, but the types of side effects they're capable of producing can absolutely wreak havoc on your emotional well being even in their most mild forms.

nerfhammer 15y ago
You may have been more sensitive to the side effects than most.
- rkon 15y ago
  I didn't personally experience all of those side effects, they just seem to be the most common based on dozens of other users of those medications I spoke with after beginning them myself. There are some other very common side effects I didn't mention as well, such as headaches/bouts of anger/crashing when the medication is wearing off each day, dehydration/drymouth, and heart palpitations or racing heartbeat. The side effect that most annoyed me was actually loss of appetite, which is basically accepted as 'normal' when taking stimulants. Anxiety was probably a bigger issue with Adderall, though. I don't recall ever talking to someone who felt zero side effects from any these medications.

psaccounts 15y ago

It is a shame that most people are unaware of the efficacy of Homeopathy to treat ADD, ADHD and autism-spectrum disorders. Do some research and you'll see how hundreds of thousands of people have been cured of these ailments using Homeopathy alone.

wahnfrieden 15y ago
Do some research and you'll find homeopathy is bunk. There's no science behind it, studies have shown it completely ineffective, and besides, it's just clean water.
- psaccounts 15y ago
  You are saying this out of the research you have done yourself, right? And yes, I have done the research and also have experienced it first hand -- something that Stanford doctors could not do (and an army of 3 different specializations nonetheless) was cured using Homeopathy. Is this placebo effect?
  - marshray 15y ago
    Give it up. It doesn't matter if you're right or wrong, or it cured your cancer or whatever, you'll never get past the skeptics.
WalterSear 15y ago
This is a lie. Perhaps the poster is lying to themselves, but it is a lie nonetheless.
- deleted 15y ago
  [deleted]
mikeash 15y ago
The placebo effect can be a wonderful thing.
15y ago

BasDirks 15y ago

I have taken Concerta for about 3 years and it helped a great deal in getting more organized. I periodically go without it, which is getting easier and easier with time (I guess because I have been able to structure life better). Eventually I will probably quit completely. There is a danger in throwing pills at a common problem. But there is also a danger in dismissing medication as part of a solution. People for who Concerta/Ritalin didn't work often bash these drugs as dangerous or evil.

deleted 15y ago

[deleted]

pizza 15y ago

Ritalin (methylphenidate) and Adderall (Dextroamphetamine / Levoamphetamine) are interesting and powerful nootropics (http://en.wikipedia.org/wiki/Nootropic http://en.wikipedia.org/wiki/Nootropic). I haven't tried them yet, although I am looking forward to the day I do. However, they do have some serious negative aspects; they are addictive and come with a substantial 'crash'. This is where the racetams come in! The racetam family consists of nootropics that enhance mainly memory recall, although I certainly feel there's an increase in ability to think of new ideas and convey them lucidly. They're not all that new (first developed in the 60s) and are widely regarded as non-toxic, in both the short and long term (sorry, don't know how to find the study. However, as anecdotal evidence, this guy did 80 GRAMS of piracetam in one sitting, which is 100x the regular dose http://www.drugs-forum.com/forum/showthread.php?t=153468 http://www.drugs-forum.com/forum/showthread.php?t=153468). The stimulation from piracetam, the racetam that is most commonly used, is sort of similar to caffeine stimulation but less pronounced; I have also never experienced a piracetam crash, even after nasal insufflation of a gram and a half. Piracetam also makes me much more productive, much more than caffeine ever did or probably will ever do, and I highly suggest it for anyone who is interested in nootropics!

georgieporgie 15y ago
I'm surprised I haven't seen more buzz about racetams on HN. I recently started experimenting with Piracetam. It's too early to make a judgment, but I did seem to get a heck of a lot more done in the two weeks 'on' than in several weeks prior. I'm currently doing about 2g in the morning, and another 1.5g in the afternoon. I haven't directly noticed any effect, aside from perhaps a short period of mild dizziness one day.

vlad 15y ago

If I remember correctly, a recent article pointed out that prescriptions in every category of drugs have increased year over year at a similar or greater rate, and that prescriptions for ADHD and ADD have actually been increasing slower than expected compared to other categories of drugs. An article like this should qualify the magnitude this way. Secondly, as companies release new drugs that can target specific conditions better or safer than ever, treat conditions that were not treatable before, it makes sense that doctors prescribe medicines more and more often every year, especially as patents on proven drugs expire and the medications become available as cheap generics.

Volpe 15y ago

Why is this on HN?

Volpe 15y ago
why the downvotes? its a link from mainstream news on something unrelated to tech... can someone explain?
- tim_h 15y ago
  The site guidelines ( http://ycombinator.com/newsguidelines.html http://ycombinator.com/newsguidelines.html ) say "On-Topic: Anything that good hackers would find interesting." Judging by the comments on this thread, such is the case here.
- cs702 15y ago
  I submitted the link, so I should probably respond: IMHO this falls well inside the "What to Submit" paremeters specified on http://ycombinator.com/newsguidelines.html http://ycombinator.com/newsguidelines.html

tim_h 15y ago

I was diagnosed with ADHD at age 18. At that point in my life I had developed pretty much a hatred for school, and had resolved to never go to college. Spending 8 hours/day at school was akin to torture for me. I found it to be mind-numbingly boring. My doctor had me try various medications. Adderall was too intense. It got me high and gave me a tendency to focus too much on the wrong level of a problem (I would obsess over details). Worse, my body acclimated and I found that I needed a higher and higher dosage to have the same "benefit". Everything turned around for me when I found out about a different medication from a friend - Dexadrine. My doctor never mentioned it to me but once I asked him about it he agreed to let me try it. Boy am I glad he did. To make a long story short, I finally went to college, graduated at the top of my class, then went on to Stanford to earn an advanced degree. Now I have a job that I love. I've been on this medication for almost 10 years. I never acclimated to it (in the sense of needing a higher dosage for the same effect) and the side effects are very mild (slight loss of appetite, slightly harder to sleep). Recently I decreased the dosage by almost 50%. I've found that over the years I've somehow learned how to concentrate better, and that therefore my need for the med has decreased. This makes me think that my brain has somehow changed for the better. Perhaps all the concentrating I did while on a higher dosage served as practice and that the benefits from all this practicing apply even without the medication. Maybe some day I'll be able to get off of it completely. But for now I still have a tough time concentrating without it.

jonhendry 15y ago

Remember: Real science and medicine don't happen in newspaper op-eds.

bocmaxima 15y ago

I've been using stimulants for almost five years (age 20 now). The last year or so I reached a point where like the article said — the effects of the drugs tapered off — and there was really nothing I could do about it. As a kid I exemplified the most extreme kind of inattention, behavioral, and regulatory problems that classify ADD, but once I began taking the meds I went through an equally extreme transformation, so I'm skeptical of any article that derides the use of stimulants. I'm also reminded of what the late Christopher Hitchens said in defense of his heavy drinking and smoking: “Writing is what’s important to me, and anything that helps me do that—or enhances and prolongs and deepens and sometimes intensifies argument and conversation—is worth it to me.” I recently met someone who has tourette's syndrome, which means he has increased production of dopamine. In other words — the inverse of ADD. The drugs he took induced a state of ADD that was identical to what I what I experienced sans-stimulants. It's crucial for those of us with the kind of dramatic impairment that comes with ADD to get by with as much help as possible from competent practitioners (of which there seems to be a very short supply of).

laserson 15y ago

Wow, 3 million "children". There are over 62 million children in the US. That means almost 5% of all kids are getting medicated... http://www.wolframalpha.com/input/?i=US+population+under+age+18 http://www.wolframalpha.com/input/?i=US+population+under+age...

Alex3917 15y ago
It's worth noting though that three year olds aren't taking these drugs, so the actual rate is more like 9% of kids have ADHD, and a good percentage of those (60%?) are currently taking drugs for it.

vintagius 15y ago

What i never understood over the years was, why Ritalin was given to kids with ADD and ADHD.All though those two disorders are related,they do not have the same effect on a person. People with ADD tend to be tooo calm and appear to be slow ,on the other hand those with ADHD (including me) tend to be too Hyper , our minds are at full speed all the time which affects concerntrating on things we do not enjoy.I found out that Ritalin works well for me by relaxing the pace of my thoughts ,which in turn allows me to focus on a BORING thing like a volumous book. So now how can you give a person with ADD (Slow thoughts) a drug that will make them more slow and expect results. My conclusion is that Ritalin works better for people who have ADHD then those with ADD,and the reason why results on the improvement that Ritalin has ,have varied time and again is because a drug that work for one group (ADHD) was also given to those (ADD) it does not work for.In such a situation results will never be consistant.