[ben_sisko]

Stimulant medication for ADHD has the highest effect size in all of psychiatry. ADHD is highly treatable, when people are properly treated. This just feels like something that somebody made for the parents who are pathologically drug averse at the expense of their children. Of course, the parents don’t realize that their kids don’t get that development time back, so the longer they wait, the harder things can get for their kids.

[Aurornis]

Nonstimulant medication is also very effective, but with the caveat that it takes longer to kick in. The second caveat is that it’s devoid of any recreational value during the startup period, which has an outsized effect on people’s perception of the medication “working”.

Stimulant medication tends to be favorably accepted at first (for entirely unsurprising reasons, even though some people don’t experience quite the same euphoria) but it actually has a high discontinuation rate. The number of people who start stimulants, think they’re the best thing ever, then slowly decline into generally disliking them is far higher than you’d ever imagine if you only ever read short anecdotes on Reddit from people writing glowing reviews after their first dose.

Obligatory: I’m not taking about everyone and I don’t need to hear 10 different anecdotes about people who still like their medications. I’m talking about macro level phenomenon. Stimulant prescriptions are a hot topic on TikTok right now and a lot of people who aren't really ADHD are getting into prescriptions without a full picture of what they’re signing up for.

[anonymoushn]

I would be surprised if even 10% of people taking therapeutic doses of stimulant ADHD meds experience euphoria. IME the noticeable effect of taking 10mg of methylphenidate was that I could stand in my open plan office and not have every word of a dozen conversations invade my consciousness constantly. If I was working in an environment designed to allow people to focus on their work, I probably would not have noticed any effects at all.

[ben_sisko]

I’m not saying the non-stimulant options do nothing, but on average the non-stimulant options have a lower effect size than the stimulants. There are many well designed studies that have covered this territory over and over.

Lots of people take these medications at the same dose for years and years.

I get that many people feel strongly about this topic in all kinds of ways and directions, but that fact by itself changes nothing.

[xlii]

Could you share some sources on stimulants discontinuation?

High discontinuation rate around stimulants aligns with my observations but I was wondering if that was only because of limited medication options where I am (not only for stimulants but in general).

[arresin]

This is the problem with the internet. The post I’m replying to is a complete lie. Non-stimulant medication is basically useless.

[ykonstant]

Which non-stimulant medication do you have in mind?

[api]

Our stupid phobia of stimulants is a major blocker too.

Making it hard to get ADD drugs does nothing to address abuse of street drugs like meth. Unlike opiates there is no evidence they lead people toward street drugs.

I’m personally in favor of OTC availability of some kind of safe abuse resistant mild stimulant. Sure there are a few people who would try to get high with it but hard liquor and weed are legal.

[Falkon1313]

Up until the 2000s, ephedrine and pseudoephedrine were sold over the counter at pretty much every truck stop, gas station, and convenience store. Usually at a big display rack at the checkout counter, where nowadays they might have things like '5 hour energy drink' stuff. Dirt cheap too.

And yes, people did use it recreationally. But it wasn't really a problem. If they took enough that their capillaries burst, they were the only ones getting hurt. And they could easily buy more for a few dollars at any store, so there was no crime associated with it.

Now it's illegal mainly because 'war on drugs' is fun for some people or something. Crime rates were dropping so they needed to invent new crimes.

[ProjectArcturis]

>I’m personally in favor of OTC availability of some kind of safe abuse resistant mild stimulant. Sure there are a few people who would try to get high with it but hard liquor and weed are legal.

Like caffeine?

[Aurornis]

One of my friends works in the rehab field. Prescription stimulants are a common starting point for a lot of younger kids entering their programs right now.

One of the major problems is some primary care doctors and nurse practitioners have started prescribing stimulants to anyone who requests them. Even worse, some of these people are prescribing unreasonably high doses (some times 2/3rd of the maximum allowable dose are given to small teens as their starting dose, which is absolute insanity).

It’s not just pointless fear mongering. These drugs are very popular recreationally among high school and college students and prescriptions are often sought to allow them to drink more alcohol for longer into the night.

[cheeseomlit]

>pathologically drug averse at the expense of their children

I'm sorry but this just comes off as so perverse to me. Giving amphetamines to children and forming a lifelong dependency on pharmaceuticals should be something to be apprehensive about. IMO it should be drastically less common than it is, the industry has every incentive to over-diagnose and act as glorified drug pushers. I'd rather take a closer look at the environmental factors for ADD than just let the pharma industry run wild on it.

[voganmother42]

is the idea this is used instead of medication or in addition to medication?