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Distracted

Stimulant use for ADHD sufferers.

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Hi!

I've known a few people with ADHD diagnosed by a professional or self diagnosed. A recurring theme i've noticed is anecdotal reports that stimulant use has vastly different effects in you're a ADHD sufferer than if you are not.

Some of the things I have been told.

Smoking Methamphetamine puts you to sleep

You can take 15mg dexamphetamines and go to sleep without a problem

Caffeine pretty much doesn't affect them (however the ones that say this tend to drink a lot of caffeine :/)

et cetera!

I've tried finding evidence based studies that show amphetamines cause different reactions to people with ADHD but have run afoul, just the odd person in a forum now and then stating it as fact.

I really want to read a study done, either proving or disproving, whatever!

The main one that irks me is the sleeping one. Don't stimulants block a receptor in your brain that encourages you to sleep by making you tired? How is this different in ADHD sufferers?

edit: I put this in this forum as I think it's somewhat relevant and also because it is hidden from google and deals with words like methamphetamine.

Edited by Distracted

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Not sure much on the facts but dexys are the bomb!

Ive known some people who have been diagnosed and medicated since young, in my opinion they didnt actually have adhd it was just bad parenting and the easiest way to deal with a disruptive kid seems to be to drug them up according to some doctors!

I would say those who say it has no effect could in most cases simply be due to a tolerance of adhd meds.

Ask them how their teeth are, I personally know some people with adhd who say that the drugs dont do much in terms of a stimulant, but if you watch carefully they will unknowingly be grinding their teeth away and fidgety as fuck like any ol crack head.

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The ADHD sufferers i've met and talked to claim they do not get 'high' off their medication.

I found this study, has a lot of interesting elements to it. From data gatherered from the Raine study which is still ongoing :)

Long-term outcomes associated with stimulant medication in the treatment of ADHD in children

Edited by Distracted

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I had a partner for two years, she was 40, who had a dex prescription and had been taking for years. It calmed her down and helped her sleep. She was a mess without it.

Just got me high. Can't explain it.

Getafix

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I've wondered about this too. Here's a couple of papers which talk about it:

Understanding the Effects of Stimulant Medications on Cognition in Individuals with Attention-Deficit Hyperactivity Disorder

Methylphenidate normalises activation and functional connectivity deficits in attention and motivation networks in medication-naïve children with ADHD during a rewarded continuous performance task.

Reward anticipation and outcomes in adult males with attention-deficit/hyperactivity disorder.

I'm not sure that I'm understanding it all, but the gist seems to be this: people with ADHD don't deal as well with delayed reinforcement - when they do something, they want a more immediate reward, (which they tend to overreact to - this is the 'hyperactivity' bit). So when they don't pay attention to some task with a longer-term goal, it's because their brain is not set up to reward them for that. Now I think what stimulants like dex might do is to put their brain into a kind of partially-rewarded state (via that whole dopamine-reward system I guess), so that their obstacle to focussing on longer-term tasks is lowered - they're already halfway there, so it becomes easier for them to pay attention to these tasks.

p.s. this forum is no longer hidden as Torsten thought a lot of good clean pharmacology discussion was unavailable to the public that way - we now have a special "Members only - hidden from Google" forum for sensitive topics. You can ask a mod to move it if you want to keep this discussion off the search engines :)

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I've known people dependent on meth who also needed it to fall asleep. This may just be a symptom of long term use rather than ADHD?

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Regarding stims & sleep, I think emcat might be right & they've just adapted over time:

Previously it was thought that the elevated number of dopamine transporters in people with ADHD was part of the pathophysiology but it appears that the elevated numbers are due to adaptation to exposure to stimulants. (link)

...and perhaps they also help by toning down the hyperactivity:

Off medication, the ADHD group had significant performance deficits on CPT, and reduced activation of a brain network that connected frontal, striatal, parietal, and cerebellar brain regions and increased activation of orbitofrontal and superior temporal brain regions. Medication normalized the attentional network (upregulating activity) and in the motivational network (downregulating reward-induced overactivity). (link)

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And the ADHD sufferers drinking lots of coffee might just be self-medicating (and here's another link)

Don't stimulants block a receptor in your brain that encourages you to sleep by making you tired? How is this different in ADHD sufferers?

Well partly they just ramp up adrenergic/dopaminergic activity to make you feel more awake. You might be thinking of adenosine. And yes, there may be a link between ADHD & the genes for adenosine receptors, which could explain why they respond differently to caffeine (which binds to adenosine receptors).

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I have known two lads that display the general opposite effects of speed (slows em down) and weed (gears them up), always wondered about their brain chemistry....

One is diagnosed ADD/ADHD ( and I have seen him nodding off) and the other I suspect may be Bipolar dominant (but no expert, just based on observations over many years).

Edited by waterboy

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When i was uni someone gave me dexies to help me study and I went to sleep twenty minutes later. Years later I was diagnosed with an autoimmune problem that lowers my blood pressure and when its bad the only things that help are vasoconstrictors which boost my BP. Whether my reaction was because of this being latent or because i kinda had ADHD I dont really know. But I never had any ADHD symptoms then although I do a bit now days (well i find it impossible to concentrate in noisy environments or when people are talking to me).

A good friend of mine has definate ADHD to the point where on ritalin he is currently studying medicine when previously he couldnt pass first year humanities. However this guy told me that caffeine worked for about 20 minutes and then he'd get a pronounced crash with worsening symptoms. When he had trouble sleeping he used to drink coffee!

The science is all about dopamine (the theory of normalising dopamine levels/release/transmission/uptake or turning off dopamine transporters that are running backwards depending on who you believe)

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Caffeine makes me real tired. I still enjoy drinking it. But I'm sure to get stretchy and yawny soon after.

The appropriate dose for people with ADHD will more-so calm the person and reduce excessive talking/movement... but even for ADHD an overdose will cause these synonyms that are typical in non-ADHD people when using the drug. This is because the low dopamine manifests as excessive talking/movement/impulslivity... self-medicating, so to speak. So the appropriate dose alleviates this, and can make me cool and calm.

I don't believe it helps anybody sleep: it prevents sleep and appetite, hard... but somebody on the appropriate dose, taking it as prescribed for a long time will be tolerant to these effects, and have few issues. I can believe somebody taking a usual amount and being able to nap.

Anyways, I took ADHD meds for years. And now I've been off them completely for a solid two, by choice. But like most things, especially medications, there is a trade of. With amphetamines, this is very distinct and in my opinion, hard to maintain. Unfortunately, since adderall is so effective in treating these symptoms, it also has the other side: personality loss, dependence, etc. My biggest issue with it is that after your plasma levels drop from peak concentration, then you begin to crave other substances and overall feel like crud. This means that while the amphetamines are working well you are productive, feel less compelled by addictions/instant gratification and have your mind easier set towards the future... but then 3-6 hours in, it goes downhill, and you'll likely crave marijuana, nicotine, sex, etc. while simultaneously feeling kinda lame.

My biggest concern is a study I read, where amphetamines were administrated on Rhesus monkeys, in therapeutic doses (I don't remember the mg/kg dosing, but I remember working it out to about 20mg adderall for an adult man)... they gave these monkeys these doses for 1-2 weeks, and then dissected their brains. Upon biopsy, they discovered permanent changes of brain structure. In addition to this, every kid I've met raised on adderall seems to be zombified, but this is anecdotal.

Gosh that was a lot of typing. But this is a topic I felt that I could shed light on.

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I too have this paradoxical reaction with stims as someone diagnosed with ADHD. I have taken 30mg Adderall XRs and fallen asleep for hours.

I tend to get very sleepy on the come-up for amphetamines and after that I tend to be slightly stimulated, probably because of such a large dose.

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But like most things, especially medications, there is a trade of. With amphetamines, this is very distinct and in my opinion, hard to maintain. Unfortunately, since adderall is so effective in treating these symptoms, it also has the other side: personality loss, dependence, etc.

I would agree with this statement completely.

I was diagnosed with ADHD when I was 30yo. When i began taking the meds it was great, I was so much more productive it was ridiculous. But after a year I looked back and I realised for me to be that productive I had to lose a certain part of my personality (or dampen down). So then it became a trade off between being the bubbly person I am or being the productive version of myself. In the end I chose the first and stopped taking my meds.

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My biggest concern is a study I read, where amphetamines were administrated on Rhesus monkeys, in therapeutic doses

Could you please provide a link to the study your referring to ?

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Yes, googling that phrase gives you an abstract about tweakin' monkeys. And if you click on its reference section, you'll get a list of twenty more. You can keep playing that game for ages, people really like giving drugs to animals it seems.... but I'm not convinced about the efficacy of this method when looking for a specific paper. The one you've linked to doesn't seem to match the one Derkshaman described. Now whether this is because he misunderstood or misrepresented that study, or whether the salient details are hidden behind paywalls and so not accessible to us plebs, either way this might not a problem that can be solved by google alone. It would certainly be simpler if he could just tell us where he read it, at least.

to be specific - the abstract CrayZ linked to is talking about observing behavioural changes in tweaked monkeys that had been pre-brain-damaged. As far as I can tell the researchers were working on isolating the brain areas involved in ADHD or something. Not talking about brain damage caused by meth.

There have been some studies that hint at it (like this one, although I'm not sure we should believe anything he says after that mislabelled "MDMA" /neurotoxicity debacle). But then there's a whole related argument about whether this supposed "damage" might actually be positive changes. I mean, the theory is that people with ADHD already have abnormal brains, right? So do we really know enough about how the brain works to say "well, these changes occurred & it's not something we'd normally see, so they must be bad"? I'm not arguing that meth can't cause negative changes in the brain, I'm just saying that you really need to be asking yourself all of these questions when you read these papers. Many grains of salt & all that. Don't assume the researchers have done everything right (eg. Ricaurte, see above), and don't assume that the conclusions they've drawn are correct, necessarily follow from the data, or in some cases even make any sense whatsoever! The people running these experiments are human. Some of them are geniuses - and others are corrupt biased idiots who should be first up against the wall. If it's a subject that has some personal relevance for you, never ever take the word of the researchers on their own conclusions, and certainly don't take the word of some journalist - they almost always miss the point, occasionally so badly that they say the opposite of what actually happened in the experiment. Track down the original paper, and find the full-text version if you can so you can check all the details - I guarantee you will find subtleties & caveats & notes that say things like "of course, this toxic effect is only seen at stupidly-high doses, we saw no negative effects at normal doses" or words to that effect, which always seem to get missed in the news reports.

But yes CrayZ, I agree in principle - a majority of problems can be solved by turn-it-off-then-on-again, &/or search engines - it's pretty amazing how much information is out there once you start looking.

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The study I found reported significantly reduced dentrite length and density in the dopamine receptors after two weeks administered. It was a study that involved treating a group of Rhesus monkeys for two weeks with I remember around 0.2-0.5mg/kg daily (It was definitely in proportions to what is prescribed for ADHD). I don't believe I misinterpreted this study. This study isn't very old, but I'm currently trying to dig it back up.

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Derkshaman - I didn't mean to suggest that you had misinterpreted anything, was just trying to point out the futility of asking google to guess which paper you had read. Is this the one you're talking about?

Chronic Methamphetamine Induces Structural Changes in Frontal Cortex Neurons and Upregulates Type I Interferons
Alice Coutinho,1 Claudia Flynn,1 Tricia H. Burdo,1,^ Ronald F. Mervis,2 and Howard S. Fox1,

Nonhuman primates provide excellent animal models to study the effects of drugs of abuse on the brain. We have reported a METH dose-escalation protocol in nonhuman primates, resulting in administration of levels of METH similar to that seen in recreational users, which results in both behavioral and physiological effects (Madden et al., 2005)... Here, we used this protocol of chronic METH treatment on rhesus monkeys to first examine whether METH induced changes in neuronal structure, and second to assess whether the chronic METH treatment produced changes in brain gene expression.

Rhesus monkeys...Three animals were treated with METH using our previously described dose escalation protocol (Madden et al., 2005). Animals received the maintenance dose of METH (0.75 mg/kg/dose, twice a day Monday through Thursday, once on Friday, none on weekends) for 31-32 weeks before sacrifice per experimental protocol.

...Significant loss of dendrites was found in the anterior cingulate and middle frontal gyri, but not in the caudate. Examination of spines on the terminal dendritic tips revealed significant loss (17% less in the METH group) only in the middle frontal gyrus. These data are consistent with METH-induced damage in the brain, and reveals that frontal lobe neurons are targets of the direct or indirect actions of chronic METH administration.

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No, it's hardly debatable for methampehtamine to be considered neurotoxic; it is very much so.

But this study:

http://www.nature.com/npp/journal/v20/n1/full/1395233a.html

shows impact on a short term (12-week) and low dose (0.4-0.46mg/kg) with amphetamine.

I still can't find the study that shows the impact on the dendrites and DAT density on a short term and low dose regimen as well, but I remember reading it clearly, because what I interpreted worried me! But until I find it and it's interpreted by yourself, don't take my word completely, as suggested! Very good advice.

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