6 ms·

How do amphetamines treat the source of ADHD? Psychiatry as its practiced has no idea as to what depression even is under the hood. The entire science is based

How do amphetamines treat the source of ADHD? Psychiatry as its practiced has no idea as to what depression even is under the hood. The entire science is based on the patients self reported feelings or the psychatrists feeling of how someone else is feeling. What you're saying is something else, that drugs can produce long term harm despite short term improvements

Aurornis 7mo ago
> The entire science is based on the patients self reported feelings or the psychatrists feeling of how someone else is feeling. This study is showing that THC, CBD, blends, or cannabis do not improve self-reported feelings over the long term. You can use pedantry and wordplay all you want, but no matter how we look at this study it does not show positive effects. > What you're saying is something else, that drugs can produce long term harm despite short term improvements Recreational drugs make you feel good temporarily. That's literally why people do them. They also cause harm when abused. These are all obvious and well known facts.
- andoando 7mo ago
  I dont have a problem with the study or its conclusions, just the parent post I was replying to. >Recreational drugs make you feel good temporarily. That's literally why people do them. The point Im making is this is true for a ton of psychiatric or even non psychatric treatments. And to be perfectly clear Im not saying you should be treating your anxiety with weed, even if it does help you
  - Aurornis 7mo ago
    > The point Im making is this is true for a ton of psychiatric or even non psychatric treatments That point wasn't intended to be taken in isolation. I was making statements about how long-term treatment of an underlying condition is not the same as taking a drug which temporarily masks a problem or induces altered mood states. The fact that a drug has acute effects, good or bad, is separate from any conversation about chronic effects. For depression, anxiety, and other conditions it's the chronic effects that matter. The acute effects almost become side effects at that point. For some drugs, getting to long-term treatment involves tolerating the acute effects while your body adapts
    - johnisgood 7mo ago
      You keep ignoring the fact that what you just said applies to current medications used to treat depression and anxiety. They do not treat the underlying issue long-term, and if you stop them, you are worse off than before due to rebound effects, and even if those effects subdue, your depression and anxiety returns. And just to add to this for clarification, antidepressants may treat depression, but it does not cure it either. Same with amphetamines for ADHD. And yes, if you take much more, you will experience side-effects ("cause harm when abused"). Opioids are not an outlier at all. > Recreational drugs make you feel good temporarily Drugs are only recreational if you take them recreationally, there is nothing that makes them inherently recreational. And we have not discussed MDMA, which is considered a hard "recreational" drug, yet there are lots of benefits for treatment of PTSD, for one, similarly to psychedelics. ... or ketamine for depression, which is now approved by the FDA, even.
      - dpark 7mo ago
        This is a fair point but there’s also truth to the fact that “I feel better” does not automatically mean it’s an effective/good treatment. Lots of depressed people turn to alcohol to provide a mood lift. But you can’t be drunk all the time and function, and when the alcohol wears off you feel even worse. So it’s a terrible treatment. People talk a lot about cannabis like it’s a great treatment for all kinds of stuff. But is it closer to a drug you can take on a schedule that boosts your mood essentially all of the time with acceptable side effects? Or is it closer to a drug that lifts mood very short term and then makes it worse?
        johnisgood 7mo ago
        > “I feel better” does not automatically mean it’s an effective treatment. Of course, I agree with that. I also agree that you cannot be drunk to function, but there are many other "drugs" that people would oppose that do not make you dysfunctional. Personally I would not use cannabis because I know that it makes me dysfunctional, but it may not be the case for some people for all I know. FWIW I take opioids for my chronic condition, and it also helps with my emotional volatility, depression, and anxiety, too. I have not experienced any side-effects either.
- zug_zug 7mo ago
  >> This study is showing that THC, CBD, blends, or cannabis do not improve self-reported feelings over the long term. Just to clarify, the study is not saying that. The study is saying "there isn't conclusive evidence at this point, but it leans more toward helping than hurting on many categories". Please read the paper if in doubt.
  - Aurornis 7mo ago
    > Please read the paper if in doubt. I did. I don’t know if you did, though, because the categories that they said there might be some signal were secondary topics like insomnia, not depression PTSD and anxiety. I mean, it’s literally in the title. It’s covered again in the abstract.
j45 7mo ago
As doctors Psychiatry should definitely look at imaging of the brain. One place I'm aware of that works from imaging as well is Amen Clinics in the US.
- anewcolor 7mo ago
  we don't understand the brain well enough for images to be of any use. amen is a fraud.
  - j45 7mo ago
    Would love to learn more about how this is the case (both assertions). Mind sharing? Neuroscience seems to be coming through with more and more understanding using technologies like fMRI and others the past 5-10 years. There is definitely some understanding there.
    - convolvatron 7mo ago
      not clinical understanding, not in any useful way. its another tool for study, but my understanding is that aside from some very high level structural information, there's sadly not that much to be learned from watching the flashing lights.
    - dns_snek 7mo ago
      Amen are definitely fraudsters. Russell Barkley talks about this topic in this video: https://youtu.be/R_HCw-QePaA?t=900 https://youtu.be/R_HCw-QePaA?t=900 The short version, as I understand is, is that brain scans show differences at the population level but not on the individual level. Amen claim to both diagnose ADHD through brain scans (which is already impossible) and also diagnose various "subtypes" of ADHD like "Limbic ADD" which have no scientific backing for their existence.
      - j45 7mo ago
        Thanks I’ll check out the video. I didn’t think their clinics only worked on ADHD. Other types of imaging like fMRI are being used successfully by others as well for things like TBI, so I won’t jump to ruling out all types imaging. Is it true that psychiatry doesn’t prescribe off imaging but symptom clusters?
acuozzo 7mo ago
> How do amphetamines treat the source of ADHD? By giving a patient the ability & skills to establish a less dopamine-seeking lifestyle while temporarily relieving them of the deficit. Its use is supposed to be coupled with therapy and/or coaching (e.g. https://www.thriveemerge.com https://www.thriveemerge.com) to ensure that the patient isn't just using it as a lifelong crutch. That's how it's supposed to be done. This approach is more effective in children for obvious reasons. Persons diagnosed later in life are therefore more likely to require it permanently.
- zozbot234 7mo ago
  Why do you need amphetamines to do this? Why not a legal stimulant? Even something as trivial as coffee can be effective if you take it strategically, i.e. stay off of it completely until the rare times when you need the turbo boost.
  - cyberax 7mo ago
    > Why do you need amphetamines to do this? There's also atomoxetine, but it's not very effective. > Why not a legal stimulant? Which ones? People absolutely do self-medicate with coffee, ephedrine, or even cocaine where it's available (coca tea). And these stimulants do work, but they have _more_ side effects than amphetamines when used in theurapeutic doses.
  - acuozzo 7mo ago
    > Why do you need amphetamines to do this? That's a question for a specialist and/or a medical researcher in the field. It's well above our "pay grade" here. Anecdotally, I have tried the majority of legal stimulants at therapeutic doses. Nothing works quite like Amphetamines do for me. > Why not a legal stimulant? My prescription for it IS legal.
  - vovavili 7mo ago
    Yeah, that's what I did. Back before I started ADHD treatment I was averaging about 12-14 cups of coffee a day, and that's before chocolate. That was the only thing that ever calmed me down. My heart pain eventually got so bad that I had to switch.
cyberax 7mo ago
> How do amphetamines treat the source of ADHD? By increasing the baseline dopamine? I think the biological mechanisms for the ADHD treatment are more-or-less clear at this point. Not so much with depression, though.

Aurornis 7mo ago

> The entire science is based on the patients self reported feelings or the psychatrists feeling of how someone else is feeling. This study is showing that THC, CBD, blends, or cannabis do not improve self-reported feelings over the long term. You can use pedantry and wordplay all you want, but no matter how we look at this study it does not show positive effects. > What you're saying is something else, that drugs can produce long term harm despite short term improvements Recreational drugs make you feel good temporarily. That's literally why people do them. They also cause harm when abused. These are all obvious and well known facts.

andoando 7mo ago
I dont have a problem with the study or its conclusions, just the parent post I was replying to. >Recreational drugs make you feel good temporarily. That's literally why people do them. The point Im making is this is true for a ton of psychiatric or even non psychatric treatments. And to be perfectly clear Im not saying you should be treating your anxiety with weed, even if it does help you
- Aurornis 7mo ago
  > The point Im making is this is true for a ton of psychiatric or even non psychatric treatments That point wasn't intended to be taken in isolation. I was making statements about how long-term treatment of an underlying condition is not the same as taking a drug which temporarily masks a problem or induces altered mood states. The fact that a drug has acute effects, good or bad, is separate from any conversation about chronic effects. For depression, anxiety, and other conditions it's the chronic effects that matter. The acute effects almost become side effects at that point. For some drugs, getting to long-term treatment involves tolerating the acute effects while your body adapts
  - johnisgood 7mo ago
    You keep ignoring the fact that what you just said applies to current medications used to treat depression and anxiety. They do not treat the underlying issue long-term, and if you stop them, you are worse off than before due to rebound effects, and even if those effects subdue, your depression and anxiety returns. And just to add to this for clarification, antidepressants may treat depression, but it does not cure it either. Same with amphetamines for ADHD. And yes, if you take much more, you will experience side-effects ("cause harm when abused"). Opioids are not an outlier at all. > Recreational drugs make you feel good temporarily Drugs are only recreational if you take them recreationally, there is nothing that makes them inherently recreational. And we have not discussed MDMA, which is considered a hard "recreational" drug, yet there are lots of benefits for treatment of PTSD, for one, similarly to psychedelics. ... or ketamine for depression, which is now approved by the FDA, even.
    - dpark 7mo ago
      This is a fair point but there’s also truth to the fact that “I feel better” does not automatically mean it’s an effective/good treatment. Lots of depressed people turn to alcohol to provide a mood lift. But you can’t be drunk all the time and function, and when the alcohol wears off you feel even worse. So it’s a terrible treatment. People talk a lot about cannabis like it’s a great treatment for all kinds of stuff. But is it closer to a drug you can take on a schedule that boosts your mood essentially all of the time with acceptable side effects? Or is it closer to a drug that lifts mood very short term and then makes it worse?
      - johnisgood 7mo ago
        > “I feel better” does not automatically mean it’s an effective treatment. Of course, I agree with that. I also agree that you cannot be drunk to function, but there are many other "drugs" that people would oppose that do not make you dysfunctional. Personally I would not use cannabis because I know that it makes me dysfunctional, but it may not be the case for some people for all I know. FWIW I take opioids for my chronic condition, and it also helps with my emotional volatility, depression, and anxiety, too. I have not experienced any side-effects either.
zug_zug 7mo ago
>> This study is showing that THC, CBD, blends, or cannabis do not improve self-reported feelings over the long term. Just to clarify, the study is not saying that. The study is saying "there isn't conclusive evidence at this point, but it leans more toward helping than hurting on many categories". Please read the paper if in doubt.
- Aurornis 7mo ago
  > Please read the paper if in doubt. I did. I don’t know if you did, though, because the categories that they said there might be some signal were secondary topics like insomnia, not depression PTSD and anxiety. I mean, it’s literally in the title. It’s covered again in the abstract.

j45 7mo ago

As doctors Psychiatry should definitely look at imaging of the brain. One place I'm aware of that works from imaging as well is Amen Clinics in the US.

anewcolor 7mo ago
we don't understand the brain well enough for images to be of any use. amen is a fraud.
- j45 7mo ago
  Would love to learn more about how this is the case (both assertions). Mind sharing? Neuroscience seems to be coming through with more and more understanding using technologies like fMRI and others the past 5-10 years. There is definitely some understanding there.
  - convolvatron 7mo ago
    not clinical understanding, not in any useful way. its another tool for study, but my understanding is that aside from some very high level structural information, there's sadly not that much to be learned from watching the flashing lights.
  - dns_snek 7mo ago
    Amen are definitely fraudsters. Russell Barkley talks about this topic in this video: https://youtu.be/R_HCw-QePaA?t=900 https://youtu.be/R_HCw-QePaA?t=900 The short version, as I understand is, is that brain scans show differences at the population level but not on the individual level. Amen claim to both diagnose ADHD through brain scans (which is already impossible) and also diagnose various "subtypes" of ADHD like "Limbic ADD" which have no scientific backing for their existence.
    - j45 7mo ago
      Thanks I’ll check out the video. I didn’t think their clinics only worked on ADHD. Other types of imaging like fMRI are being used successfully by others as well for things like TBI, so I won’t jump to ruling out all types imaging. Is it true that psychiatry doesn’t prescribe off imaging but symptom clusters?

acuozzo 7mo ago

> How do amphetamines treat the source of ADHD? By giving a patient the ability & skills to establish a less dopamine-seeking lifestyle while temporarily relieving them of the deficit. Its use is supposed to be coupled with therapy and/or coaching (e.g. https://www.thriveemerge.com https://www.thriveemerge.com) to ensure that the patient isn't just using it as a lifelong crutch. That's how it's supposed to be done. This approach is more effective in children for obvious reasons. Persons diagnosed later in life are therefore more likely to require it permanently.

zozbot234 7mo ago
Why do you need amphetamines to do this? Why not a legal stimulant? Even something as trivial as coffee can be effective if you take it strategically, i.e. stay off of it completely until the rare times when you need the turbo boost.
- cyberax 7mo ago
  > Why do you need amphetamines to do this? There's also atomoxetine, but it's not very effective. > Why not a legal stimulant? Which ones? People absolutely do self-medicate with coffee, ephedrine, or even cocaine where it's available (coca tea). And these stimulants do work, but they have _more_ side effects than amphetamines when used in theurapeutic doses.
- acuozzo 7mo ago
  > Why do you need amphetamines to do this? That's a question for a specialist and/or a medical researcher in the field. It's well above our "pay grade" here. Anecdotally, I have tried the majority of legal stimulants at therapeutic doses. Nothing works quite like Amphetamines do for me. > Why not a legal stimulant? My prescription for it IS legal.
- vovavili 7mo ago
  Yeah, that's what I did. Back before I started ADHD treatment I was averaging about 12-14 cups of coffee a day, and that's before chocolate. That was the only thing that ever calmed me down. My heart pain eventually got so bad that I had to switch.

cyberax 7mo ago

> How do amphetamines treat the source of ADHD? By increasing the baseline dopamine? I think the biological mechanisms for the ADHD treatment are more-or-less clear at this point. Not so much with depression, though.