8 ms·

As a college student that is constantly surrounded by Adderall and Vyvanse misuse, this hits close to home. I've had a prescription to similar drugs my entire l

As a college student that is constantly surrounded by Adderall and Vyvanse misuse, this hits close to home. I've had a prescription to similar drugs my entire life, and it was in 8th Grade that I realized that I didn't actually need them to function. The drugs made me unhealthily underweight, constantly antisocial, and easily aggravated. Nowadays when I look at my peers, I see the same things happening to them. Some people take two at one time the night before a big test and don't sleep for days. The worst part is, everybody sees it as normal. Popping an adderall before a test is as common, easy, and normal as opening a beer to relax on a weekend. People don't realize that the 60mg Vyvanse they are taking casually is an extremely hard drug to take for somebody not fully diagnosed with ADHD.

doktrin 14y ago
> People don't realize that the 60mg Vyvanse they are taking casually is an extremely hard drug to take for somebody not fully diagnosed with ADHD. Are controlled stimulants less harmful to those diagnosed with AD(H)D? I'm sincerely curious. Anecdotal accounts abound on this particular subject, but I can't recall seeing any specific literature supporting the claim.
- taylorlapeyre 14y ago
  This is a great question, and I'd love to know the answer as well.
- throwaway54-762 14y ago
  The adverse side-effects do not magically go away; however, the benefits are (supposedly) much greater for a person diagnosed with AD(H)D than recreational users. Thus the net gain (benefits - costs) is positive for some people.
  - biotech_anon 14y ago
    This is how I'd put it. I've been diagnosed with adult ADHD and take a moderate to low dose of Adderall under the direction of my doctor. I can easily forgo taking it for weeks, and do so. These "vacations" without it were advised by my doctor to prevent tolerance buildup, and I suspect to diminish the potential for addiction. My dosage has remained constant and I don't feel a "need" for it, so I guess they work. For many of those with ADHD the drug makes a world of difference, and pushes focus and tendency to move around into the "normal" range. For certain activities the (benefits - costs) equation works out, while for others it does not (which is to say certain activities don't appreciably benefit from the quiet mind--the costs are long term and are more difficult to discern). It's about planning to take it for days where it does help, and being mindful of the health ramifications (staying hydrated, eating normal and healthy meals, monitoring cardiac health with support from a doctor, continuing to consult the doctor, etc.). My biggest fear beyond addiction is that it will be detrimental to my memory and learning in the long term. It's difficult to know if that is true. The author clearly abused it. Taking it "to socialize" seems weird to me. I suspect the author did not need it in the first place, and was already in the "normal" range. My mentally disorganized self is much more outgoing that the focused version of me. If it is impacting sleep, the dosage is probably too high or too extended (though many MDs prescribe the XR version since ostensibly it has less potential for abuse). Some of the alternative pharmaceuticals may work about as well, but Adderall has been around for so long that its risks are fairly well understood--though less so with long term use. Vyvanse is a means to extract more money from patients via patent protection. It's essentially dexedrine with a lysine attached (new side group=new patent). The lysine gets cleaved in vivo, and it becomes dextroamphetamine. Adderall is a mixture of dextro- and levo- handed salts, so it's a bit more nuanced. Taking it without doctor supervision is a major risk, and taking more than is prescribed or mixing it with other drugs as the author did compounds the risk. The potential for abuse is real.
throwaway54-762 14y ago
It's an extremely hard drug for anybody, ADHD or no. Adderall / Vyvanse is prescription meth[0] (something I've heard from several of my AD(H)D friends). If the pros outweigh the cons for an individual, great; I wish them the best. But while I can't find the research I remember to back this up, it's looking like long-term medication with amphetamines may be ineffective or harmful. EDIT [0]: Yes, I know that that prescription meth literally exists under the name Desoxyn, that is not what I mean. See https://news.ycombinator.com/item?id=5321949 https://news.ycombinator.com/item?id=5321949 and https://news.ycombinator.com/item?id=5321935 https://news.ycombinator.com/item?id=5321935 .
- MartinCron 14y ago
  A few years ago, my doctor encouraged me to stop taking Adderall based on the conventional wisdom that it was likely to cause heart disease. I'll always remember what he said, I only prescribe Adderall for depression in my terminal cancer patients, because I'm not worried as much about their long-term heart health OK, Doc. Let's not refill that prescription, then. This conventional wisdom has recently been challenged, but I think there is no great consensus on this issue yet. http://www.dailyrx.com/adhd-medicines-were-not-linked-serious-heart-problems-adults-during-first-few-months http://www.dailyrx.com/adhd-medicines-were-not-linked-seriou...
  - throwaway54-762 14y ago
    Oh, the possible negatives I had in mind were brain-related: "diminishing returns" due to tolerance or other factors after long-term use, and adverse side-effects of the drug flooding your brain with seratonin and dopamine over long periods of time (obviously similar to that observed in long-term methamphetamine use).
    - MartinCron 14y ago
      I see. I wasn't a long-term user and was always extremely conservative with my dosage, so I didn't encounter any of those brain-related issues. Even with the fact that they are in the same family of drugs, comparisons to long-term meth abusers doesn't seem quite right.

doktrin 14y ago

> People don't realize that the 60mg Vyvanse they are taking casually is an extremely hard drug to take for somebody not fully diagnosed with ADHD. Are controlled stimulants less harmful to those diagnosed with AD(H)D? I'm sincerely curious. Anecdotal accounts abound on this particular subject, but I can't recall seeing any specific literature supporting the claim.

taylorlapeyre 14y ago
This is a great question, and I'd love to know the answer as well.
throwaway54-762 14y ago
The adverse side-effects do not magically go away; however, the benefits are (supposedly) much greater for a person diagnosed with AD(H)D than recreational users. Thus the net gain (benefits - costs) is positive for some people.
- biotech_anon 14y ago
  This is how I'd put it. I've been diagnosed with adult ADHD and take a moderate to low dose of Adderall under the direction of my doctor. I can easily forgo taking it for weeks, and do so. These "vacations" without it were advised by my doctor to prevent tolerance buildup, and I suspect to diminish the potential for addiction. My dosage has remained constant and I don't feel a "need" for it, so I guess they work. For many of those with ADHD the drug makes a world of difference, and pushes focus and tendency to move around into the "normal" range. For certain activities the (benefits - costs) equation works out, while for others it does not (which is to say certain activities don't appreciably benefit from the quiet mind--the costs are long term and are more difficult to discern). It's about planning to take it for days where it does help, and being mindful of the health ramifications (staying hydrated, eating normal and healthy meals, monitoring cardiac health with support from a doctor, continuing to consult the doctor, etc.). My biggest fear beyond addiction is that it will be detrimental to my memory and learning in the long term. It's difficult to know if that is true. The author clearly abused it. Taking it "to socialize" seems weird to me. I suspect the author did not need it in the first place, and was already in the "normal" range. My mentally disorganized self is much more outgoing that the focused version of me. If it is impacting sleep, the dosage is probably too high or too extended (though many MDs prescribe the XR version since ostensibly it has less potential for abuse). Some of the alternative pharmaceuticals may work about as well, but Adderall has been around for so long that its risks are fairly well understood--though less so with long term use. Vyvanse is a means to extract more money from patients via patent protection. It's essentially dexedrine with a lysine attached (new side group=new patent). The lysine gets cleaved in vivo, and it becomes dextroamphetamine. Adderall is a mixture of dextro- and levo- handed salts, so it's a bit more nuanced. Taking it without doctor supervision is a major risk, and taking more than is prescribed or mixing it with other drugs as the author did compounds the risk. The potential for abuse is real.

throwaway54-762 14y ago

It's an extremely hard drug for anybody, ADHD or no. Adderall / Vyvanse is prescription meth[0] (something I've heard from several of my AD(H)D friends). If the pros outweigh the cons for an individual, great; I wish them the best. But while I can't find the research I remember to back this up, it's looking like long-term medication with amphetamines may be ineffective or harmful. EDIT [0]: Yes, I know that that prescription meth literally exists under the name Desoxyn, that is not what I mean. See https://news.ycombinator.com/item?id=5321949 https://news.ycombinator.com/item?id=5321949 and https://news.ycombinator.com/item?id=5321935 https://news.ycombinator.com/item?id=5321935 .

MartinCron 14y ago
A few years ago, my doctor encouraged me to stop taking Adderall based on the conventional wisdom that it was likely to cause heart disease. I'll always remember what he said, I only prescribe Adderall for depression in my terminal cancer patients, because I'm not worried as much about their long-term heart health OK, Doc. Let's not refill that prescription, then. This conventional wisdom has recently been challenged, but I think there is no great consensus on this issue yet. http://www.dailyrx.com/adhd-medicines-were-not-linked-serious-heart-problems-adults-during-first-few-months http://www.dailyrx.com/adhd-medicines-were-not-linked-seriou...
- throwaway54-762 14y ago
  Oh, the possible negatives I had in mind were brain-related: "diminishing returns" due to tolerance or other factors after long-term use, and adverse side-effects of the drug flooding your brain with seratonin and dopamine over long periods of time (obviously similar to that observed in long-term methamphetamine use).
  - MartinCron 14y ago
    I see. I wasn't a long-term user and was always extremely conservative with my dosage, so I didn't encounter any of those brain-related issues. Even with the fact that they are in the same family of drugs, comparisons to long-term meth abusers doesn't seem quite right.