Off topic, but I was diagnosed with ADHD about 10 years ago, been taking methylphenidate ER ever since. Throughout the years I have had over ten different doctors at the same location and I informed each doctor that I was a marijuana user.
Recently my latest doctor decided to drug test me, before asking any questions about my usage or even looking at my file he stated he would no longer prescribe me my medicine because I use marijuana and "those two don't interact well together". When I repeatedly asked him to back up his opinion with actual evidence (studies), he repeatedly refused. He would not even explain the reaction that marijuana had with ADHD medication. After less than three minutes I was asked to leave his office. No discussion about my condition was allowed.
I'm aware that the doctors opinion is what goes and he has all the power, but I feel I've been wronged. I really need this medicine and it's probably does more harm to kick me off cold turkey without even looking at my file than to let me smoke marijuana with it, and I feel that his opinion is based more on politics than rigorous medical study.
I have a feeling if I was an alcohol drinker he would have no problem. So it goes.
> I'm aware that the doctors opinion is what goes and he has all the power, but I feel I've been wronged.
He actually has little power. You can go to a different doctor. There are many people that abuse this fact, e.g. keep switching doctors until they find one that prescribes them painkillers, but in your case it sounds perfectly valid. You have ten other opinions that think it's perfectly fine to combine your meds.
After quick search [1][2][3] I'm not surprised your doctor was hesitant, if something would happen to you he would be the first to be sued and possibly lose his license. You still have option to go to a different doctor who is willing to take that risk.
If taking the drug is important to you, what about not taking the drug with marihuana?
and I feel that his opinion is based more on politics than rigorous medical study.
He might also be worrying about the chance that if something bad did happen, he could be in a lot of trouble. In general, doctors can be quite risk-averse.
I think what he is getting at is marijuana may be the reason you cannot focus well. I don't think a study needs to be done to show using marijuana can have a negative impact on your short term memory and attention span.
That is strange. My doctor finds no problem with my cannabis consumption while taking methylphenidate.
I don't find they interact in a negative way, however I find too much coffee + methylphenidate is very counter productive. The caffine stimulation seems to totally overwhelm the focused stimulation of the methylphenidate, and not in a good way.
This really shouldn't be a shocker. I was diagnosed with ADHD in elementary school and have been on and off medication ever since. A large number of friends in the professional world use these stimulants regularly.
I think that these drugs are very useful for short term sprints where one needs to focus, or do rather mundane tasks. But it's incredibly easy to become dependent on them. At one point, I could even begin to focus unless I had the max dose of adderall and a strong cup of coffee.
I don't judge anyone who uses stimulants to increase performance. Just because I was diagnosed with ADHD doesn't mean I'm not using them as a performing enhancing drug; it's just legal for me to do so. However, I would encourage everyone - whether you're prescribed or not - to use them in moderation. It's very easy to build up a tolerance and become dependent, and once you're dependent, you're no better off than where you started.
I have also been on psycho-stimulants for a while. People simply don't realize the effect they are really after is the buzzed high like euphoria. Furthermore, those effects don't last and you need to keep cranking up the dose to achieve your desired mental state.
Something will replace coffee eventually. I refuse to believe that technology will never find a better productivity enhancer, with near-zero side effects like coffee.
Adderall is not the answer as these journalists like to claim though. It's useless for basically anything other than very rare usage and has difficult to manage loss of productivity during withdraw. It has an incredibly fast tolerance buildup. If your work requires steady output instead of rare bursts, it's questionable whether it even surpasses coffee because of these downsides.
The tolerance/withdrawal drawbacks for adderall are nearly non existent if you don't abuse it and take weekends off. Sure, after the well known honeymoon phase of a few weeks it's not the superman pill you might have expected would last forever, but otherwise responsible use will keep you more productive. People with little will power or addictive personalities (which a third party can't possibly always know) aren't usually equipped to deal with such moderation, so instead we let the "gotta work 7 days a week!" grinders stigmatize an otherwise safe and useful medicine/tool.
When used responsibly I can assure you it's more effective and has less side effects than caffeine IF you tolerate it well (not everyone can, just like not everyone can tolerate caffeine)
> Adderall is not the answer as these journalists like to claim though. It's useless for basically anything other than very rare usage and has difficult to manage loss of productivity during withdraw. It has an incredibly fast tolerance buildup. If your work requires steady output instead of rare bursts, it's questionable whether it even surpasses coffee because of these downsides.
The problem here is that Adderall isn't meant to be used in this manner, nor is it meant to provide the user with bursts of productivity or euphoria when dosed properly.
Proper usage, as in ADHD or sleep disorders, involves titrating the daily dose to a point at which the attention and/or wakefulness-promoting effects reach the appropriate therapeutic level over the long term. This process takes in to account the inevitable tolerance that comes with downregulation of the systems that are directly (norepinephrine, dopamine) and indirectly elevated by Adderall usage.
Casual users and abusers, on the other hand, are always chasing the initial rush of drug-induced euphoria and the associated productivity and mood boost that comes in the early phases of treatment. These effects are highly prone to tolerance and downregulation (as intended) and thus can't be maintained without constant dose escalation or taking frequent breaks to pay back the built-up tolerance. Neither situation is sustainable or healthy, which is precisely why Adderall should not be considered to be a substitute for the milder stimulants that people consume casually every day.
Beyond that, Adderall has some potential neurotoxicity issues due to the way it upsets dopamine sequestration in neurons (dopamine has neurotoxic metabolites and the systems that clean up these metabolites can be overwhelmed in certain Adderall dosing schemes). Coffee, on the other hand, is associated with a reduction of certain neurodegenerative diseases.
> Adderall is not the answer as these journalists like to claim though. It's useless for basically anything other than very rare usage and has difficult to manage loss of productivity during withdraw. It has an incredibly fast tolerance buildup. If your work requires steady output instead of rare bursts, it's questionable whether it even surpasses coffee because of these downsides.
If that's your experience, then you need to take an extended-release capsule and halve your dose.
It's amphetamine. Its dose-to-efficacy graph is linear.
If you're losing a day of productivity on off-days, then you're simply taking too much on on-days.
Why replace coffee? Coffee has evolved alongside the human organism and become a great fit.
There are also many other drugs (both plant and pure chemical) that may offer interesting and useful effects, but I don't think that any will "replace" coffee.
The military ran tests comparing the efficacy of caffeine and amphetamine. Amphetamine was not shown to improve performance over caffeine, although it gave the perception that performance was improved.
Honestly though what percentage difference does this make in productivity and is that percentage really going to be the difference between a startup's success and failure? Being fired or not? Being happy or not?
If the thing makes you happy then that's one thing. If you think getting 10% or 20% more work done is going to move you from mediocre to exceptional or is going to make you happy, I beg to differ.
There's more to it than just a general percentage-based productivity boost.
It's also about gaining the energy to drill down into things you otherwise couldn't be faffed to care about.
People always joke about popping amphetamine and organizing their sock drawer in incredible detail. Apply that to some product you're working on. In software, it's common to gain the energy to spend time coming up with the perfect abstraction. Or fleshing out those API docs in great detail. Or really just fully immersing yourself in a problem and your solution.
Often things you otherwise simply wouldn't ever do because your sober self isn't going to spend half a day obsessing over the UX of a form.
Interesting that there was no mention of Modafinil.
I believe that one of the most "abused" drugs for "productivity" is currently Modafinil, far more powerful than Adderall and without all those side effects.
I'd disagree with it being far more "powerful" than Adderall, having been prescribed both at one time or another. They're effects on me are quite different:
Adderall - I seem to focus on anything I needed to without resistance, similar to how I would focus on something I enjoy. The side effects on me were (to me) extreme emotional instability, which was too off putting to use regularly - could not play well with others.
Modafinil (and Adrafinil before that) - The concentration assistance is there for when I'm focused, but it doesn't seem to help me stay on topic - I'm still easily distracted. The upside is I can still play well with others, and if anything seem more energetic (I hit the gym every morning I use it). The reduced sleep effect is real, I went from an average of 6 hours a night to <4, and it feels like the regained time is still productive. I have no hard numbers around this, and not really sure how to build a baseline to compare to.
I'd like to see how I react to both together, but hesitant given my poor reaction to Adderall. When I was younger I remember preferring Ritalin over Adderall.
EDIT: Adding to the throwaway comment below, the long halflife of Modafinil is true, especially when trying to sleep. For me, after months of 3-4 days on a week, there seemed to be no long term issues with this, where days I had taken Modafinil I only slept 3-4 hours.
I definitely had issues with alcohol and Modafinil, where at my weight (220lbs) I could normally drink 3-4 pints to reach 'buzzed' status, this seemed to happen at 1-2 pints. This trend stayed consistent - and proper 'drunk' came much quicker. This had the effect of limiting my drinking, to the point where I would switch to light beers and stop drinking after 1-2. This has been positive to me, but a bit concerning as I hadn't read of that effect before.
I've used Adrafinil where legal, which is converted by the body into that, and Adderall under prescription. I don't consider them equivalent at all. You can skip sleep on Adrafinil/Modafinil for many days, which matches the usual military uses or how it is prescribed for people who can't stay awake - it doesn't help pay attention to boring things like Adderall and the like do, though.
Modafinil doesn't even come close to amphetamine. And I doubt anyone with therapeutic amphetamine experience would disagree.
I've been taking Adderall XR and Vyvanse for eight years. Now that I live in Mexico where amphetamine isn't prescribed but you can buy Modafinil over the counter, I gave Modafinil a shot.
It's pretty forgettable. That it only comes in instant tablets is also a deal-breaker.
While I continue to experiment with Modafinil, it's worth the $500 round-trip back to Austin just to re-up my 3-month supply of Vyvanse.
Also, amphetamine is used on every American college campus, not Modafinil. Almost everyone has heard of Adderall even if they've never taken it.
> I believe that one of the most "abused" drugs for "productivity" is currently Modafinil, far more powerful than Adderall and without all those side effects.
Modafinil is easier to acquire than Adderall, but it certainly isn't "far more powerful" than Adderall. Just the opposite, in fact, which is also why Adderall is a more tightly controlled substance than Modafinil.
Modafinil is a poorly-understood medication, but we do know that it has a moderate affinity for the dopamine reuptake transporter, which is a mode of action that overlaps slightly with other stimulants such as Methylphenidate. The remaining, additional modes of Modafinil's action are still a matter of active research.
Adderall, meanwhile, not only inhibits dopamine reuptake like Methylphenidate and Modafinil, but also enters the presynaptic terminals to exert effects within the cell. Through a series of actions, it forces more dopamine into synapses than would normally be released. This essentially makes it more powerful, and thus more prone to abuse, than Modafinil.
Those same intra-neuron actions also make Adderall potentially more neurotoxic than Modafinil. By upsetting the natural dopamine balance within a cell, Adderall can theoretically overwhelm certain systems that keep the cells working properly. Dopamine metabolism can unfortunately produce toxic metabolites, which are difficult for cells to cope with when produced in excess. Adderall can indirectly produce enough of these toxic metabolites to cause cell death. There is much debate over the exact dosage level at which this damage happens, but there is already one controversial study showing damage in non-human primates at typical therapeutic doses.
Modafinil is not the safest medication either, given the number of potential sensitivity reactions that some people have. Taking Modafinil without a doctors supervision, as many here seem to do, is thus not a good idea. Fortunately Modafinil seems to be more self-limiting due to the unpleasant side effects many experience at higher doses, such as decreased verbal fluency.
Long-term, the largest problem with Modafinil might just be its long half-life. Although the marketing material would lead you to believe it doesn't affect sleep, it's virtually impossible for a wake-promoting agent with an incredible 15-hour half-life would not negatively impact sleep. The 15-hour half-life means that by the time you're ready for bed, your body has only eliminated roughly half of your Modafinil does from the morning. Long-term sleep impairment is not conducive to long-term health.
Beyond all of this, there is a conversation about how the "productivity" aspect of these stimulants is largely limited to acute dosing, and is heavily prone to tolerance and withdrawal effects, but I've gone on long enough already.
I have a prescription for Adderall, Modafinil and a have tried bunch of others. Adderall was prescribed for fibromyalgia related symptoms of brain fog and lack of memory, modafinil for chronic fatigue.
Adderall aggravated the Renaud's syndrome that I have had for 5 years, to the point where the blood flow stopped and the fingers began to suffer from continuos lack of blood . See http://imgur.com/Djy6g2A This has been a daily challenge for the last couple of months, and it has greatly impacted my ability to work. I have a hard time using my hands to do anything, even typing. I am now off Adderall (6 months), withdrawal was not too bad for me.
I miss the Adderall, since it made me feel like my brain worked again. I felt like my old self, much sharper mentally - no focus change, still ADD as ever, but felt restored in the brain. I felt 25 again (45 now) and was able to work better, in the sense that 25 year old me was more energetic than 45 year old me. I tried Strattera for a few days, but found that has nasty side effects and also aggravated my hands.
Modafinil I don't notice any other effect, other than I don't feel as tired all the time. I don't feel smarter, or better, only not exhausted. For me, there is no stimulant feeling with Modafinil, or ability/skills change, just an change in the tired all the time feeling.
So, if you are going to use these drugs, pay attention to the side effects. I would recommend avoiding them unless you need them.
> Isn't "Do they respond to ADHD medication?" our only test?
No, absolutely not. It's a common internet myth that response to ADHD medication is indicative of ADHD. In reality, nearly anyone who takes ADHD medication acutely will experience increased focus and productivity (again, acutely) due to the acute (pre-tolerance build-up) effects of the drugs. Additionally, new users experience a short-lived euphoria that convinces many people that they need a stimulant to feel "normal," when in fact they're just experiencing the initial euphoric effects of the drug. Be warned that the euphoria fades and, more importantly, does not return without abusing dosing schedules.
ADHD marketing materials combined with pop-psychiatry have stretched the definition of ADHD to encompass nearly anyone. It's trivial to find low-grade internet forums in which users believe that anything and everything is a symptom of ADHD. You can even find a large number of people who believe that something called "hyperfocus" (being able to focus very intently on one thing for a long period of time) is a symptom of ADHD, believe it or not. Of course, the term "hyperfocus" does not appear in ADHD medical literature or any ADHD studies.
ADHD is a complex disorder, and the modern world can (and does) drive people in to ADHD-like states with all of the distractions available to us. The single best approach to dealing with this is to pursue constant discipline and self-monitoring, in order to train yourself back to a healthier mental process. ADHD medications can help people implement those disciplines and healthy processes, but they don't actually substitute for proper habits. It's not uncommon for people to pop Adderall expecting their ADHD to disappear, only to be drawn in to extended video game or web-browsing sessions that are in no way productive.
So my advice would be to make efforts to structure your life in ways to minimize distractions and hold yourself accountable for your results. Realize that everyone is distracted in modern life, but that's not necessarily indicative of a disease. Stimulant medications are not to be taken lightly, and you're best avoiding them long-term if possible.
And these practices are in a way unfair against the rest of us workers!
> Most users who were interviewed said they got pills by feigning symptoms of A.D.H.D., a disorder marked by severe impulsivity and inattention, to physicians who casually write prescriptions without proper evaluations.
And thus these practices disturb statistics about the true prevalence of ADHD.
>And these practices are in a way unfair against the rest of us workers!
This raises interesting philosophical questions about work in general. If work is inherently valuable, isn't anything that enhances it a good thing (assume lack of side effects for simplicity)? Is it "unfair" if a doctor/scientist/programmer uses a product to be more productive? Very few of us are formally competitive athletes, and special rules apply to those of us who are. I think it's unfair that some people can afford secretaries, accountants, editors, private schools, etc., those seem much less fair than ADHD medicine.
One of my childhood heroes, the great mathematician Paul Erdos, was a famous amphetamine user, does that mean the wonderful contributions he made to our understanding of the universe are "unfair"?
> And thus these practices disturb statistics about the true prevalence of ADHD.
Maybe in the future doctors would say "You have no prior history with ADHD, so we'll have to run a long check to see if you really need these meds". Then of course parents will start getting ADHD perscriptions for their children when they're young, so they will have a history... and we come full circle.
[+] [-] zxcvcxz|11 years ago|reply
Recently my latest doctor decided to drug test me, before asking any questions about my usage or even looking at my file he stated he would no longer prescribe me my medicine because I use marijuana and "those two don't interact well together". When I repeatedly asked him to back up his opinion with actual evidence (studies), he repeatedly refused. He would not even explain the reaction that marijuana had with ADHD medication. After less than three minutes I was asked to leave his office. No discussion about my condition was allowed.
I'm aware that the doctors opinion is what goes and he has all the power, but I feel I've been wronged. I really need this medicine and it's probably does more harm to kick me off cold turkey without even looking at my file than to let me smoke marijuana with it, and I feel that his opinion is based more on politics than rigorous medical study.
I have a feeling if I was an alcohol drinker he would have no problem. So it goes.
[+] [-] snarfy|11 years ago|reply
He actually has little power. You can go to a different doctor. There are many people that abuse this fact, e.g. keep switching doctors until they find one that prescribes them painkillers, but in your case it sounds perfectly valid. You have ten other opinions that think it's perfectly fine to combine your meds.
[+] [-] takeda|11 years ago|reply
If taking the drug is important to you, what about not taking the drug with marihuana?
[1] http://ritalinaddictioninfo.com/addiction-information/danger...
[2] https://www.erowid.org/experiences/exp.php?ID=96384
[3] http://www.addforums.com/forums/showthread.php?t=46740
[+] [-] userbinator|11 years ago|reply
He might also be worrying about the chance that if something bad did happen, he could be in a lot of trouble. In general, doctors can be quite risk-averse.
[+] [-] jdefr89|11 years ago|reply
[+] [-] jp555|11 years ago|reply
I don't find they interact in a negative way, however I find too much coffee + methylphenidate is very counter productive. The caffine stimulation seems to totally overwhelm the focused stimulation of the methylphenidate, and not in a good way.
[+] [-] mej10|11 years ago|reply
[+] [-] ryan90|11 years ago|reply
I think that these drugs are very useful for short term sprints where one needs to focus, or do rather mundane tasks. But it's incredibly easy to become dependent on them. At one point, I could even begin to focus unless I had the max dose of adderall and a strong cup of coffee.
I don't judge anyone who uses stimulants to increase performance. Just because I was diagnosed with ADHD doesn't mean I'm not using them as a performing enhancing drug; it's just legal for me to do so. However, I would encourage everyone - whether you're prescribed or not - to use them in moderation. It's very easy to build up a tolerance and become dependent, and once you're dependent, you're no better off than where you started.
[+] [-] jdefr89|11 years ago|reply
[+] [-] solve|11 years ago|reply
Adderall is not the answer as these journalists like to claim though. It's useless for basically anything other than very rare usage and has difficult to manage loss of productivity during withdraw. It has an incredibly fast tolerance buildup. If your work requires steady output instead of rare bursts, it's questionable whether it even surpasses coffee because of these downsides.
[+] [-] ugexe|11 years ago|reply
When used responsibly I can assure you it's more effective and has less side effects than caffeine IF you tolerate it well (not everyone can, just like not everyone can tolerate caffeine)
[+] [-] throwaway98031|11 years ago|reply
The problem here is that Adderall isn't meant to be used in this manner, nor is it meant to provide the user with bursts of productivity or euphoria when dosed properly.
Proper usage, as in ADHD or sleep disorders, involves titrating the daily dose to a point at which the attention and/or wakefulness-promoting effects reach the appropriate therapeutic level over the long term. This process takes in to account the inevitable tolerance that comes with downregulation of the systems that are directly (norepinephrine, dopamine) and indirectly elevated by Adderall usage.
Casual users and abusers, on the other hand, are always chasing the initial rush of drug-induced euphoria and the associated productivity and mood boost that comes in the early phases of treatment. These effects are highly prone to tolerance and downregulation (as intended) and thus can't be maintained without constant dose escalation or taking frequent breaks to pay back the built-up tolerance. Neither situation is sustainable or healthy, which is precisely why Adderall should not be considered to be a substitute for the milder stimulants that people consume casually every day.
Beyond that, Adderall has some potential neurotoxicity issues due to the way it upsets dopamine sequestration in neurons (dopamine has neurotoxic metabolites and the systems that clean up these metabolites can be overwhelmed in certain Adderall dosing schemes). Coffee, on the other hand, is associated with a reduction of certain neurodegenerative diseases.
[+] [-] danneu|11 years ago|reply
If that's your experience, then you need to take an extended-release capsule and halve your dose.
It's amphetamine. Its dose-to-efficacy graph is linear.
If you're losing a day of productivity on off-days, then you're simply taking too much on on-days.
[+] [-] jMyles|11 years ago|reply
There are also many other drugs (both plant and pure chemical) that may offer interesting and useful effects, but I don't think that any will "replace" coffee.
[+] [-] jotm|11 years ago|reply
[+] [-] Synaesthesia|11 years ago|reply
[+] [-] berntb|11 years ago|reply
[deleted]
[+] [-] fasteo|11 years ago|reply
Running a health start-up and popping Aderalls like there is no tomorrow does not seem a good fit.
[+] [-] jotm|11 years ago|reply
[+] [-] whybroke|11 years ago|reply
If the thing makes you happy then that's one thing. If you think getting 10% or 20% more work done is going to move you from mediocre to exceptional or is going to make you happy, I beg to differ.
[+] [-] danneu|11 years ago|reply
It's also about gaining the energy to drill down into things you otherwise couldn't be faffed to care about.
People always joke about popping amphetamine and organizing their sock drawer in incredible detail. Apply that to some product you're working on. In software, it's common to gain the energy to spend time coming up with the perfect abstraction. Or fleshing out those API docs in great detail. Or really just fully immersing yourself in a problem and your solution.
Often things you otherwise simply wouldn't ever do because your sober self isn't going to spend half a day obsessing over the UX of a form.
It's not just about getting more work done.
[+] [-] mej10|11 years ago|reply
Also, they make most people feel fantastic and like they can conquer the world. Is it really any question why people would find that appealing?
[+] [-] tomrod|11 years ago|reply
[+] [-] josephagoss|11 years ago|reply
I believe that one of the most "abused" drugs for "productivity" is currently Modafinil, far more powerful than Adderall and without all those side effects.
Of course, long term side effects are unknown.
[+] [-] jronald|11 years ago|reply
Adderall - I seem to focus on anything I needed to without resistance, similar to how I would focus on something I enjoy. The side effects on me were (to me) extreme emotional instability, which was too off putting to use regularly - could not play well with others.
Modafinil (and Adrafinil before that) - The concentration assistance is there for when I'm focused, but it doesn't seem to help me stay on topic - I'm still easily distracted. The upside is I can still play well with others, and if anything seem more energetic (I hit the gym every morning I use it). The reduced sleep effect is real, I went from an average of 6 hours a night to <4, and it feels like the regained time is still productive. I have no hard numbers around this, and not really sure how to build a baseline to compare to.
I'd like to see how I react to both together, but hesitant given my poor reaction to Adderall. When I was younger I remember preferring Ritalin over Adderall.
EDIT: Adding to the throwaway comment below, the long halflife of Modafinil is true, especially when trying to sleep. For me, after months of 3-4 days on a week, there seemed to be no long term issues with this, where days I had taken Modafinil I only slept 3-4 hours.
I definitely had issues with alcohol and Modafinil, where at my weight (220lbs) I could normally drink 3-4 pints to reach 'buzzed' status, this seemed to happen at 1-2 pints. This trend stayed consistent - and proper 'drunk' came much quicker. This had the effect of limiting my drinking, to the point where I would switch to light beers and stop drinking after 1-2. This has been positive to me, but a bit concerning as I hadn't read of that effect before.
[+] [-] lnanek2|11 years ago|reply
[+] [-] danneu|11 years ago|reply
I've been taking Adderall XR and Vyvanse for eight years. Now that I live in Mexico where amphetamine isn't prescribed but you can buy Modafinil over the counter, I gave Modafinil a shot.
It's pretty forgettable. That it only comes in instant tablets is also a deal-breaker.
While I continue to experiment with Modafinil, it's worth the $500 round-trip back to Austin just to re-up my 3-month supply of Vyvanse.
Also, amphetamine is used on every American college campus, not Modafinil. Almost everyone has heard of Adderall even if they've never taken it.
[+] [-] throwaway98031|11 years ago|reply
Modafinil is easier to acquire than Adderall, but it certainly isn't "far more powerful" than Adderall. Just the opposite, in fact, which is also why Adderall is a more tightly controlled substance than Modafinil.
Modafinil is a poorly-understood medication, but we do know that it has a moderate affinity for the dopamine reuptake transporter, which is a mode of action that overlaps slightly with other stimulants such as Methylphenidate. The remaining, additional modes of Modafinil's action are still a matter of active research.
Adderall, meanwhile, not only inhibits dopamine reuptake like Methylphenidate and Modafinil, but also enters the presynaptic terminals to exert effects within the cell. Through a series of actions, it forces more dopamine into synapses than would normally be released. This essentially makes it more powerful, and thus more prone to abuse, than Modafinil.
Those same intra-neuron actions also make Adderall potentially more neurotoxic than Modafinil. By upsetting the natural dopamine balance within a cell, Adderall can theoretically overwhelm certain systems that keep the cells working properly. Dopamine metabolism can unfortunately produce toxic metabolites, which are difficult for cells to cope with when produced in excess. Adderall can indirectly produce enough of these toxic metabolites to cause cell death. There is much debate over the exact dosage level at which this damage happens, but there is already one controversial study showing damage in non-human primates at typical therapeutic doses.
Modafinil is not the safest medication either, given the number of potential sensitivity reactions that some people have. Taking Modafinil without a doctors supervision, as many here seem to do, is thus not a good idea. Fortunately Modafinil seems to be more self-limiting due to the unpleasant side effects many experience at higher doses, such as decreased verbal fluency.
Long-term, the largest problem with Modafinil might just be its long half-life. Although the marketing material would lead you to believe it doesn't affect sleep, it's virtually impossible for a wake-promoting agent with an incredible 15-hour half-life would not negatively impact sleep. The 15-hour half-life means that by the time you're ready for bed, your body has only eliminated roughly half of your Modafinil does from the morning. Long-term sleep impairment is not conducive to long-term health.
Beyond all of this, there is a conversation about how the "productivity" aspect of these stimulants is largely limited to acute dosing, and is heavily prone to tolerance and withdrawal effects, but I've gone on long enough already.
[+] [-] rbanffy|11 years ago|reply
It's recommended you check your liver function when taking modafinil.
[+] [-] gregpilling|11 years ago|reply
Adderall aggravated the Renaud's syndrome that I have had for 5 years, to the point where the blood flow stopped and the fingers began to suffer from continuos lack of blood . See http://imgur.com/Djy6g2A This has been a daily challenge for the last couple of months, and it has greatly impacted my ability to work. I have a hard time using my hands to do anything, even typing. I am now off Adderall (6 months), withdrawal was not too bad for me.
I miss the Adderall, since it made me feel like my brain worked again. I felt like my old self, much sharper mentally - no focus change, still ADD as ever, but felt restored in the brain. I felt 25 again (45 now) and was able to work better, in the sense that 25 year old me was more energetic than 45 year old me. I tried Strattera for a few days, but found that has nasty side effects and also aggravated my hands.
Modafinil I don't notice any other effect, other than I don't feel as tired all the time. I don't feel smarter, or better, only not exhausted. For me, there is no stimulant feeling with Modafinil, or ability/skills change, just an change in the tired all the time feeling.
So, if you are going to use these drugs, pay attention to the side effects. I would recommend avoiding them unless you need them.
[+] [-] SCAQTony|11 years ago|reply
http://www.beyondchron.org/will-ritalin-become-the-human-gro...
[+] [-] ams6110|11 years ago|reply
[+] [-] afarrell|11 years ago|reply
Isn't "Do they respond to ADHD medication?" our only test?
[+] [-] throwaway98031|11 years ago|reply
No, absolutely not. It's a common internet myth that response to ADHD medication is indicative of ADHD. In reality, nearly anyone who takes ADHD medication acutely will experience increased focus and productivity (again, acutely) due to the acute (pre-tolerance build-up) effects of the drugs. Additionally, new users experience a short-lived euphoria that convinces many people that they need a stimulant to feel "normal," when in fact they're just experiencing the initial euphoric effects of the drug. Be warned that the euphoria fades and, more importantly, does not return without abusing dosing schedules.
ADHD marketing materials combined with pop-psychiatry have stretched the definition of ADHD to encompass nearly anyone. It's trivial to find low-grade internet forums in which users believe that anything and everything is a symptom of ADHD. You can even find a large number of people who believe that something called "hyperfocus" (being able to focus very intently on one thing for a long period of time) is a symptom of ADHD, believe it or not. Of course, the term "hyperfocus" does not appear in ADHD medical literature or any ADHD studies.
ADHD is a complex disorder, and the modern world can (and does) drive people in to ADHD-like states with all of the distractions available to us. The single best approach to dealing with this is to pursue constant discipline and self-monitoring, in order to train yourself back to a healthier mental process. ADHD medications can help people implement those disciplines and healthy processes, but they don't actually substitute for proper habits. It's not uncommon for people to pop Adderall expecting their ADHD to disappear, only to be drawn in to extended video game or web-browsing sessions that are in no way productive.
So my advice would be to make efforts to structure your life in ways to minimize distractions and hold yourself accountable for your results. Realize that everyone is distracted in modern life, but that's not necessarily indicative of a disease. Stimulant medications are not to be taken lightly, and you're best avoiding them long-term if possible.
[+] [-] bulletsvshumans|11 years ago|reply
[1] http://www.cdc.gov/ncbddd/adhd/diagnosis.html
[+] [-] amelius|11 years ago|reply
> Most users who were interviewed said they got pills by feigning symptoms of A.D.H.D., a disorder marked by severe impulsivity and inattention, to physicians who casually write prescriptions without proper evaluations.
And thus these practices disturb statistics about the true prevalence of ADHD.
[+] [-] xamuel|11 years ago|reply
This raises interesting philosophical questions about work in general. If work is inherently valuable, isn't anything that enhances it a good thing (assume lack of side effects for simplicity)? Is it "unfair" if a doctor/scientist/programmer uses a product to be more productive? Very few of us are formally competitive athletes, and special rules apply to those of us who are. I think it's unfair that some people can afford secretaries, accountants, editors, private schools, etc., those seem much less fair than ADHD medicine.
One of my childhood heroes, the great mathematician Paul Erdos, was a famous amphetamine user, does that mean the wonderful contributions he made to our understanding of the universe are "unfair"?
[+] [-] anon4|11 years ago|reply
Maybe in the future doctors would say "You have no prior history with ADHD, so we'll have to run a long check to see if you really need these meds". Then of course parents will start getting ADHD perscriptions for their children when they're young, so they will have a history... and we come full circle.