What degree of heaviness is okay for drugs to be an okay recommendation on a quite specific problem? Did you ever recommend someone to get an Aspirin due to headache? Hope you didn’t - Aspirin is so dangerous, there’s no way we would allow it on the market according to today’s regulation.
That said, the point here cannot be the danger of medication, but the public perception. Ritalin in adults is very safe if prescribed and monitored by a doctor and supervised by therapy. Taking into account the rate of comorbidities of untreated adhd symptoms (btw, as far as science goes, it’s a spectrum, not a classification, so you’re higher high or low in such treats), such as depression, implying Ritalin were dangerous even if taken as a part of a broader treatment regimen, is much more dangerous.
There are a ton of different classes of ADHD medications that are all very different. The most popular- stimulants like adderall and ritalin are probably the most well studied psychiatric drugs in history, and not without some risk of adverse effects, but overall are quite safe even for young kids.
Untreated ADHD itself is far more dangerous than any of the medications: high rates of mortality, suicide, addiction, job loss, relationship difficulties, car accidents, etc.
There is also some evidence that giving children stimulant medications for ADHD can make it less likely that they will continue to have ADHD as adults.
You make some good points here, but it's important to avoid the false dichotomy that medication is either good for everyone or always scary and dangerous.
Stimulants for ADHD have a long history of use (Ritalin's been approved for medical use since 1955!), and there's lots of scientific literature indicating it can have a variety of long-term benefits for people with ADHD.
That said, no two people are the same, and there is no one-size-fits-all approach to treatment. I've met someone who takes monstrous 70+mg doses of vyvanse (essentially extended release dex-amphetamine) to function normally, has been stable that way for years, and is happily pursuing an impressive, productive life. Conversely, I've met people who can't take 5mg of instant release dex-amphetamine and get to bed 14 hours later.
Obviously, there is the risk of heretofor-unknown side effects with some of the newer drugs. We also cannot forget about known side effects of well-studied drugs: Atomoxetine, for example, can cause suicidal ideation as a side effect. That being said, if Ritalin and Adderall were going to lead to massive settlements because of side effects, I think we would have already seen that happen in the last 65 years.
Sorry, I responded to an exaggeration with one of my own. Mea culpa.
Of course every medication has risks. You should evaluate them for yourself, with a physician.
However, generalizing that to “medication is dangerous and can cause psychosis, or death, and thus you shouldn’t take it because it can have side effects, even if it could otherwise help you” is garbage advice.
Also, the dosages at which stimulants and such are used for ADHD as a therapy (as opposed to abused) are generally quite small, fwiw.
Why not? People are suffering and we have safe medications which improve their lives.
Not treating ADHD is far more dangerous. People with unmedicated ADHD are more likely to do poorly in school, abuse drugs/alcohol, suffer from depression etc.
Ritalin's been used to treat ADHD for about 70 years. Also, we know that ADHD results in reduced life expectancy, so ADHD medication just has to improve that number for it to be pretty good. If your life expectancy due to taking ADHD meds improves by a couple years because you're less likely to crash your car or overdose on recreational drugs then ADHD meds are a far preferable option to not taking them.
I would have been kicked out of school with out ritalin so there wasn't much option when I started taking it at 9. You have to judge for yourself as an adult if the costs out weight the risks.
Everyone is that way to some extent, but if you have ADHD its severe. Treatment is effective for most people, and its completely safe for adults. Occasional concern for children.
As someone who has found ADHD medication to be hugely beneficial, I completely agree with you. Treatment has its tradeoffs. In general, stimulants greatly improve my quality of life. But at the same time, they can wreck my appetite and make me prone to anxiety and irritability. And dealing with the bureaucracy of scheduled medications is a serious headache. If someone is happy with their life and their symptoms aren't negatively impacting them, then what's the point?
In that case it may well be worth you trying ADHD medication as it could potentially be safer and have fewer side effects and negative consequences. Go through a professional, obviously.
I vehemently disagree with you here. Stimulant therapy for ADHD is literally the most effective psychiatric intervention we know of. Everything else wishes it has the effectiveness that stimulants have for people with ADHD. If you think you have ADHD and you fit the stereotype (smart kid that'd only do well if they applied themselves), you absolutely should try it.
Yes, it has risks and is not 100% safe. No, that doesn't mean that the risk/reward ratio is anywhere near "think carefully before trying it." People with ADHD have enough trouble scheduling stuff and getting through the bureaucracy standing between them and a diagnosis already, it's downright irresponsible IMO to suggest that they go down a rabbit hole of research and doubt.
That’s why the recommendation was to see a doctor (and ideally a psychiatrist not a general practitioner). There are many legally prescribed medications to treat ADHD and most jurisdictions allow at least one of them.
I'm not sure I'd use the phrase 'trigger happy' for doctors willing to prescribe stimulant medication to adults. The literature is clear that the stimulant meds are very effective for ADHD and the side effects of normal doses are pretty minimal. https://slatestarcodex.com/2017/12/28/adderall-risks-much-mo... is a pretty balanced take on the risks/benefits.
So, as a doctor, if an otherwise responsible adult is stating that their inability to focus is having a negative impact on their life, and you know there are reasonably safe and potentially very effective drugs that can be tried, what, exactly should hold you back? Likewise, as an informed patient, what is the harm in trying a low dose and seeing if it helps enough to be worth it?
I think this is a misunderstanding. People with ADHD don't really want to be medicated. Taking stimulants whole your life is not nice. There are many side effects. But we have to. We don't have a choice most of the time. Without meds ADHD is often a fatal disease. Not for everyone of course.
Are ADHD medications really that effective for those without ADHD? They can boost your mood, for sure. And, they can keep you awake. But, for me, the dosage needs to be precisely adjusted just to be effective, and I have to take them just to be functional.
I've seen a lot of people in the workplace taking them lately. But, the result isn't pretty. Overly focused but on all the wrong things. Less creative. In a tweaked out state where they just keep switching tasks. Or, sending rambling emails or going on long tangents about nothing. To me, it seems like they were much more effective before the medications.
I remember watching a show years ago where the hosts had drugged people doing different types of tasks. One of them was amphetamine, and they were trying to put an ikea desk together. But, they took a really long time because of all of the reasons above.
Interestingly, ADHD has strong genetic correlation and has comorbidity with other psychiatric disorders. And, ADHD was certainly under diagnosed for a long time, as were many mental diseases. In the US there is strong social pressure to not reveal mental diseases, and it's awkward to discuss them with others because many people don't even believe they are real. It's sad really, because many smart people could have succeeded in life if only they had been diagosed and treated.
They can be harmful, but diagnosed ADHD/ADD is almost guaranteed to be harmful, maybe especially in todays society. More than doubled risk of depression is only one of the risks of the above diagnoses, and while many of the risks could be said to be more of a societal issue - at least in the beginning - they tend to cause actual health problems over time. Overprescription can always be an issue for any medication, but that's not really an issue with the medication itself is it ?
Meh, after having seen how my unmedicated self turned out, depressed, anxious, isolated and chronically unsatisfied with their life, getting an ADHD diagnosis and stimulant medication means I can slightly stress my body in exchange for a meaningful life. Fuck yes.
And from what I can see in the research, therapeutic doses of amphetamines do not damage the body by any meaningful level, while untreated ADHD may shorten life expectancy by 10 to 20 years.
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