ADHD=bullshit condition?

[hh339]

here is the chance for people who consider ADHD/ADD/DAMP a "bullshit condition" to speak up. there are many many other "conditions" as well that make life hard on a lot of people. the reasons for this post are the negative condecending minds swim and others have encountered through the years, even on this forum.

swim has done A LOT of amphetamines of different kinds, and thought it would be "cool" to get some legally. swim started studying up on ADD/ADHD/DAMP, and thought he knew it all. well he did, the only thing he didnt realize was that he actually had ADHD himself. it has only been a few weeks since he got the diagnosis for real, and swim finally understands why he liked amphetamines. at first it was kind of a shock for swim, who had always wondered why he felt so different to say the least. well there it was, the answer he had searched for for so long. no wonder he could eat, sleep and so on when he was on it. calling it a bullshit condition makes swim teary eyed, he has felt so down and confused for so long. peoples ignorance and "know-it-all"-attitudes has made life hard for him in the past. swim has hurt a lot of people through the years, without even knowing it. thats not a funny thing to carry around. everyone is different, but swim has found himself because of medicine and theraphy. why the fuck would anyone say swim is just a junkie trying to score stimulants? envy, ignorance, prejudice? swim has no idea, but he knows one thing: a lot of people labeled by society are really in need of help, no matter what their conditions are. they should be taken seriosly. of course swim feels high in a sense, when you have not enjoyed life for as long as you can remember and suddenly you actually do, it beats every drug in the world. OK, swim is on a drug, but without the theraphy and support from others it would not have been nearly as helpful. there COULD be a reason for people wanting a specific drug, and their voices should never go unheard. swim is on concerta now which is not an amphetamine but have quite similar effects in ADHD-treatment, and if theres anyone who think swim and all other people with the condition is bullshitting, please speak your mind. swim feels for the people out there in need of help and support, people who has been broken so many times that they give up. swim has not really been that far down, but others are and have been.

all thoughts are welcome.

Reputation Comments on this post:

	bravo for the topic!
	good thread, very deep

[Beeker]

ADD and ADHD are real as I've lived with it for life. ADD seems linked to dyslexia.

ADD could be defined also as someone who is bored which these compounds work on as well.

Time released Ritalin is a joke for real ADD. Before getting moved to amphetamine salts I was prescribed 3 20mg generic pills a day. Now that I'm back on genetic amps I take one pill for 5 hours..

I get no rush, I tried abusing ritalin and got shaky and cruddy.. no fun. I've taken some Dex pills from a friend once and THAT was real deal ephoria.

I'll stick to the 4 salt combos and life enhancement. No need for support. SWIM is well grounded in who he is and has to be to do research.

[General Tso]

of course its bullshit. just kidding.

i know how you feel right now because i felt that way, but trust me you will still get burnt out on the speed. you didn't miss out on your life.

amphetamines help everyone concentrate. its just that they help different people to different degrees. My doc said that just becuase adhd meds help you concentrate doesn't mean that you "have" adhd. you're still just getting high off speed. come on. dont lie to yourself!

just my opinion. no flames necesary.

[Forthesevenlakes]

swim's opinion is that add/adhd is a real medical condition, but one that is grossly overdiagnosed by a medical community eager to have "high success rates" (read: high prescription rates) with their subjects. since amphetamines can help anyone concentrate, regardless of if they have add or not, these drugs will work on any restless/overly creative/high spirited kid. basically its an easy way out for doctors and parents who dont want to take the time to pursue alternate options for kids being unable to focus. kids are bound to not want to focus in school to begin with, its only natural that they tend to channel their energy towards activities they find more enjoyable. plus with today's society being so focused on rapid-fire entertainment and instant gratification, is it any wonder that children might have shorter attention spans that are LEARNED behaviors instead of innate "disorders" that require medication to "fix"? swims opinion is that only a small fraction of children diagnosed with add actually have a real disorder where they cannot concentrate without the aid of drugs...the rest of these kids are being overmedicated and marginalized simply for acting their age. its pitiful and unfortunate and sickening, all at once. while swim does enjoy the occasional amphetamine, he does so with full knowledge of their effects and consequences, but doubts that most of these young children being forcefed pills do...and who's to say what the long-term consequences of giving children powerful drugs on a daily basis will do to their development? it could be leading our country to produce a bunch of drug dependent, submissive personalities willing to believe whatever so-called 'authorities' are going to tell them. the whole situation disgusts swim, he apologizes for the long tirade, and understands if others have a viewpoint on this different from him.

[hh339]

thanx for the replies people. swim agrees that medications are way over-prescribed and are too much of an easy way out for doctors. this is a very debated issue in sweden as well as in the U.S if swims not mistaken. here in sweden they have just started to medicate prisoners with concerta in some jails. it doesnt take a genious to figure out that every inmate will soon start to claim they have the condition(lol), but it would be no surprise if a good majority of them really have it. swim has found that many of the negative thought he has had, which in turn made swim take it out on others in sometimes VERY cruel ways, were caused by swims inability fo feel guilt, pity and so on. thats what swim meant with "missing out on life". well life is catching up with swim for real, not to mention all the guilt he feels now. its all kind of good though, swim would not have it any other way.

[StigmataLectron]

For a while I've thought that many "disorders" are just personality types that The Man wants to see as derrogatory. My ex girlfriend was once "Skyzotypal"(sp), but for a while I considered it to be just a different way of looking at the world that the doctors didn't want you to have. Of course, there ARE mental illnesses. And of course, many people with said mental "illnesses" really, really don't want to have them.

I don't think that a person's view on the world or personality type should be considered a disorder if it's not normal (ie, skyzotypal or ADHD), unless the person who has it really sees it as a problem they have to deal with (Radeon). I, myself, was diagnosed with ADHD years ago, but never thought of it as making me a strange or out of the ordinary person - just a little different, and at the time I decided that if that's how my brain is build, that's how I'm going to use it. And then I found drugs.*

*Editors note: "drugs" refers to purely legal substances.

[Benga]

Originally Posted by StigmataLectron

I don't think that a person's view on the world or personality type should be considered a disorder if it's not normal (ie, skyzotypal or ADHD), unless the person who has it really sees it as a problem they have to deal with (Radeon).

Hum I would temper that with unless the person's behavioural patterns clash with the accepted limits of social conduct. Of course these limits are overtly or not defined by the society itself, hence the difficulty in defining what mental disorders are, and the sublteties of ethnopsychiatry.

But by what you just wrote, I get a feeling, to take crude examples, that if an individual felt destructive behaviour, say the urge to kill or sexually force himself upon young children and didn't really see it as a problem, it shouldn't be seen as a disorder.
This "seeing it as a problem" is also very hard to define, because many mental conditions imply burying things in a dellusional manner, hence you wouldn't be "seeing it as a problem" because you wouldn't really be aware of the acts you have done...

as for attention and hyperactivity disorders, I have no opinion.
I was trying to find out if people were prescribed Ritalin or amphetamines for such conditions in France since they have in theory been removed from prescribeable medicine some 10 years ago. Found out there were about 3000 children on Ritalin in the country, on a population of 60 million, but I don't really know how the prescription is possible. Adderall and dexedrine are most definetly illegal in France, so I was wondering what people with such disorders did, drink ?
b

[StigmataLectron]

Originally Posted by benga

Hum I would temper that with unless the person's behavioural patterns clash with the accepted limits of social conduct. Of course these limits are overtly or not defined by the society itself, hence the difficulty in defining what mental disorders are, and the sublteties of ethnopsychiatry.

But by what you just wrote, I get a feeling, to take crude examples, that if an individual felt destructive behaviour, say the urge to kill or sexually force himself upon young children and didn't really see it as a problem, it shouldn't be seen as a disorder.
This "seeing it as a problem" is also very hard to define, because many mental conditions imply burying things in a dellusional manner, hence you wouldn't be "seeing it as a problem" because you wouldn't really be aware of the acts you have done...

Of course, what's "good" and "bad" is also a matter of accepted social conduct. If you ask a random person if raping a child unwillingly is bad, chances are they'd say yes. But if you ask a child molester, they could differ, saying something like "Yes, but that's what makes it fun", or "No, he was asking for it". 'Course, everyone in the right mind is going to take the average person's side.

The part where I'd normally draw the line is when one consenting individual isn't consenting. When one has the ability to think about the concequences of saying "Yes", then they're cool. Children can't exactly be trusted with this choice, but to pedophilles, that just adds to the fun. <img>

All kidding aside, the line stands where the rights of others are infringed.

Then again, there's necrophillia. One could say that raping a dead body isn't harming anybody, but for reasons I can't really explain it just raises an alarm in my head.

But what's the consesus on killing people for revenge? Does it depend on what they did to deserve it? Does it make someone crazy to want to do this since it's against social norms to kill, even if they had a good reason?

[hh339]

the line between ADHD/ADD/DAMP and other types of mental illness can be very hard to distinguish, because the symptoms can sometimes be very similiar. enjoying cruel behaviour tells of something more than ADHD, though different conditions can be combined as well. when impulsive behaviour creates problems for the individual, treatment and medication should be considered.

[RealGanjaMan]

ADD is the reason I dropped out of high-school. Its also the reason I can watch a movie, understand the whole thing, love it, and not be able to tell you what happened 5 minutes after I saw it. So no, ADD isn't a bullshit condition.

[fgtss]

It's certainly not bullshit. I have ADHD, and it's hurt me when it comes to my studies, a lot.

[mspen1018]

I was dx'd adhd and whether it was spending between age 4 and age 13 on dexedrine or actual ADHD I definitely use the drug as prescribed and have no problem with not taking it

[Bajeda]

I made some posts concerning this in another thread by Fantasian I believe. Check it here, has some interesting stuff ----> http://www.drugs-forum.com/forum/sho...d.php?p=178472


My thoughts on the matter....

Originally Posted by Bajeda

For some people, ADHD may be debilitating enough to seriously hamper their life. I can understand this, and medications such as adderall may help with this.

The problem is that in the US i've been seeing gross overprescription of anti-ADHD medications based on the fact of people just having some of the symptoms of it, nevermind looking into whether they are actually serious or not or whether they really have a negative impact on the person's life.

Anyways, let me stop ranting and explain the statement I made.




I discussed this in detail with my father not too long ago. We are both ADD and have many of the same symptoms. I have trouble focusing on things for long periods of time, though this only generally happens when its something I'm not interested in. If its something I have an interest in I can concentrate on it, but if its something I don't care for I just can't pay attention even if I have to. This is why I never did well in mathematics in school. Also I can't study. I literally can't study. I do not have the ability to reread a text or go over notes even if I have a huge exam coming up. I can discuss topics with people that were covered but if I try reading over notes or some other form of studying I will just stop of boredom within 5 minutes. These are obvious downsides of having ADD.

Next we discusseed the positives. Many people view ADD or ADHD as totally negative disorders, but they aren't as simple as that. They affect who you are as a person, and are simply just signs that your brain works in different ways. For instance, my father and I share very similar writing styles. For what we lack in mathematical skills we make up in effective and creative writing. You can just read some of my trip reports to see how much I enjoy writing. Writing has always been a strong point of mine, and my performance in English and other writing classes has always been above average. I see things in different ways than people and almost never present an analysis in the same way as another person, or even see something the same way. My brain may be jumping around constantly while I write, causing me to get off track and have to find it again but that just helps to create my style.

When I take adderall I find that the way my mind works is altered quite a bit. Its not just that it helps me concentrate more on things. It affects my processes of thinking. When I take adderall I can go through sets of facts easier, and really analyze tedious mathematical problems. When I write though, while I find I can adhere to the set writing pattern better and lay things out more efficiently, my writing loses some of the characteristics that make it so special to me. It becomes more of the same, rather than something different.

Thats the main reason why I oppose prescribing adderall and ritalin and all those other ADHD and ADD drugs so quickly. They may help you concentrate, and make you behave better (for the younger kids prescribed it) and make you easier for your parents to manage (or bosses), but they change who you are.

I enjoy that I don't always focus on things and that my head is in the clouds much of the time. I love that my writing is all over the place and touches issues in a way people don't see. I love that while in a waiting room people near me are getting irritated at a delay and getting anxiety problems while I just sit there enjoying every bit of the surroundings, no matter how mundane, letting my imagination take over so I can appreciate every second I am not doing something ir order to accomplish something.

For some people ADHD and ADD can be problems that hinder their ability to succeed in society, and drugs can help them fit in. The main question you have to ask though, is how important is it to be able to work efficiently and get a good job, and how important is it to be able to not focus on all the details and just enjoy life.

Its just my opinion, but I feel so much more like me when I am not constantly under the influence of medication, and surprisingly (as I am on this site) I rarely take any medication of any kind. I find that adderall, while helpful academically, is not something I would want to be on any more than possible. It stifles some of the zany and unique characteristics of my mind. I like being me.

[oz man]

Wow there are people out there who have gone through hell and back.I was the same .I always was stressing over this and that and wondered why nobody cared.I have seen too many doctors over the years saying I have slight depression to manic depression to anxiety disorders and panic attacks.My whole life has been screwed right up.I wondered why I kep't loosing good jobs I liked and I always blammed the boss etc.I have hurt so many people with years of drug abuse and general abuse as well.I honestky hated life and use to say to people there is no hell when you die because we live in hell.A doctor finally listened to what I was saying and agreed to try me on Dexamphetamine since he beleived I was miss diagnosed for my entire life.God It's a waste of a life being 35 and only finding the golden answer approx 5 weeks ago.My life has changed.I'm slower, sleep better and things are so different.Its like I'm high.For the first week I was in a daze and felt the best ever.Support and people understanding have to go along with the medication.This is because everything is so different and things have to be sort of learnt again.I just hope it's my chance in life to make it at something.I feel for all the others out there mis diagnosed.The whole mediacal system sucks and most doctors don't have a clue.I hope they wake up and stop people suffering like a had for 35 years.

[Ranke]

Science is here to save the day!

http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum
http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum
http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum

[AntiAimer]

Smurf is sure he has it, was told by idiots he has it. But refuses to go to the doctor for it. Teachers always nagged him, since nothing in school EVER intrested him other then girls and the bell ringing. Always being hyper(since kids are hyper) and talking to others instead of doing the work,thought process races...etc.

In Smurfs eyes, BS or not, no kid should be given SPEED! untill there mentally able to know what's going on. So giveing your child drugs at the age of 5, is leading them on the wrong path and is child abuse in Smurfs eyes. Saw it happen to many times in middle school and HS.

Smurf has tryed ritalin, makes him depressed. Want's to try adderall but hasn't. Pretty much something that's supposed to be a upper, isn't for Smurf. But even knowing\thinking Smurf has it, comes to believe it's pretty much BS. He thinks it's all in the person\mind....which one can overcome without drugs.

Also someone said they watch a movie and can't remember it 5 minutes later....what does that have to do with add\adhd? Smurf always thought that was just haveing crappy memory. Smurf has beaten plenty of video games, not remembering the endings nor most the game. Also watching movies or reading parts of books not remembering what he just saw\read. One reason school was HELL! for Smurf. They assume every person is the same with great brains, memory and skills.

[jezzmo]

Originally Posted by AntiAimer

Also someone said they watch a movie and can't remember it 5 minutes later....what does that have to do with add\adhd? Smurf always thought that was just haveing crappy memory.

It's usually not even about having a bad memory. Usually SWIM be able to remember a movie on the spur of a moment at a party 5 months later .. but if SWIM tries to think about it, put it together, or recollect a simple quote .. BAM! Brainwaves go sleepy Working memory is the main issue.

Originally Posted by towelie

i don't think that medication is the answer. the docs want to substitue medication for self-discipline and personal responsibility. jux, you said that ADD people can "hyperfocus" on things that they want to do,but can't do homework for some reason. this just sounds like lazyness to me. part of growing up is doing things that you don't want to do. i did not like to sit through boring lectures either but i had to,and i made myself do it. ADHD turns lazyness into a diease.

The problem here is it's not always the cases that an ADDer is lazy. Some put in really hard work to try and understand and grasp, say a lecture. They read a paragraph 4 or more times just to get a vague conception of what's going on. It can take them hours longer to do a simple task. Many do end up giving up on it, and become lazy. Others work recklessly long hours and over time lose self esteem, feeling quite useless. Functional control over our conscious mind is something too many people take for granted; but certainly brings up moral issues.

Also, the focus of ADD in the media seems to be on School/Uni/Work impairments. A good proportion of the general public don't like the idea that these people are being provided stimulants in a competitive environment.

But what is often lost to the clouds is social and personal issues. Some, particularly a percentage of the hyperactive can really flourish out in society, and live happy lives. Others face uncontrollable repercussions, or in the case of inattentives, simply can't connect to the world. Getting lost in conversation consistently is not good for peer relations. Their own subjective world is flooded with irrelevant information ad lib, and it can subdue the unwilling person. I think if this consequence of the disorder was highlighted more, perhaps people would see this more as a life disorder like anxiety/depression, and less of a "get ahead of the rest" disorder. SWIM finds even a simple transaction at the grocery store can be difficult, looks drunk before drinking.

As to medication, if it works and it works well, I can't see any case where it shouldn't be used. I believe this with any substance. If it makes the individual feel better about themselves with no societal ramifications nor dire health risks(as opposed to "productivity" as a measure); I see no reason why any substance should not be administered if these boxes are ticked. If it makes a kid concentrate but he just doesn't feel himself, take him off it right away, IMO.

Reputation Comments on this post:

	Good points raised, though careful not to lump all ADD into one category, people express different symptoms which can af...
	Thanks jezzmo

[GForce]

Bajeda, you're forgetting something very important in your analysis of ADHD prescriptions, which would be tolerence to amphetamines. The reason I bring this up is because my brother has had ADHD for years now and been taking Adderall for an equal amount of time. In the beginning anyone who takes ADHD medication will "feel" different because they're taking a euphoric stimulant. However for peope who take it everyday (like my brother) after, at most, a month taking Adderall hardly phases them in an active sense. In fact, after taking Adderall for just a few days psychiatrists recommend reducing dosage if you still feel ANY resulting euphoria from the drug. The effect Adderall is supposed to have on ADHD patients is a passive effect. It is supposed to keep them focused and keep them from being hyperactive, without the patient actually noticing they're on a drug, except for the fact that they are performing better.

My brother actually ran into a problem of too high a doseage for therapuetic considerations. He had been taking 30mg XR but the problem was that the effects didn't last for the time after school, so he switched to 30 XR in the morning and 10 IR in the afternoon. This dosage combination was too high for him and he felt as thought, socially, he couldn't perform like he used to. He was noticing that he'd watch his friends in deep conversation and find himself unable to interject anything while on a high dose. For SWIM its completely different. If he is feeling euphoria from amphetamines he will talk nonstop. However for my brother this was a major problem easily solved by a reduction in dose.

The point is that Adderall is not supposed to "change who you are." If it does, for an extended period of time, you're taking too much of it to treat ADHD. And given tolerence issues I can understand very high does of Adderall used to treat ADHD. SWIM for example recieves 60mg a day, of which he usually doesn't take much. Still, if he took 60mg a day, it would probably mostly be a passive effect for him because of how quickly his tolerence has built. He can take 40mg IR in a single dose and not really be actively phased by the drug. Of course he'll notice the passive effects, but he won't be jittery, sweating, or all over the place. For him, its around the right dose for treatment of his ADHD.

Finally to address the issue the ADHD is mostly a bullshit condition, I agree and disagree with this. I do think that a lot of people get prescribed ADHD medications when they don't have ADHD. Is this necessarily bad? Not really, becasue ADHD medications are honestly something everyone could benefit from at some point or another. Everyone at some point needs to be more productive, needs help focusing, and procrastinates. ADHD medications will obviously help fight some of this. As for SWIM, his original plan was to "fake" ADHD because he wanted the medication to use in such situations. However as he began to take the initial tests and surveys he realized he didn't have to fake anything because he had it all along (which makes sense considering his father and brother have it). The issue with him was what his psychiatrist described as a product of going to college. In High School SWIM found the work incredibly easy, even when he procrastinated, didn't do it, didn't take notes, etc. He still graduated with a 3.7 GPA and got into a top university. The issue then was college level classes that actually required him to stay on top of his work; something he couldn't do and never did because he didn't have to. This is when he began struggling and got his diagnosis.

There is a very fine line between ADHD and no ADHD, though. I feel that anyone who highlights certain traits, while downplaying others, in a consultation could get an ADHD diagnosis. It is in this sense that ADHD is over-diagnosed. However, as I said earlier, I don't necessarily think that is a bad thing, at least for responsible adults. I don't think a child should be taking ADHD medication if they don't have ADHD. If they do, then almost certainally it will be more of a "high" for them than a therapuetic drug. Adults I feel it is different, however. I could just say that I believe adults have the right to put whatever they want in their body and end it at that (I do believe that) but I think with adderall it does go further. As I mentioned earlier I believe everyone could benefit from Adderall. Its just a very good all purpose drug to have around when you need to be more productive, something adults need to be often. If it helps them with their work, even if they don't have ADHD, why shouldn't they use it as long as they don't abuse it?

[bewilderment]

I don't have any qualms with the adults taking amphetamines to increase performance. I also believe that people differ in their concentration abilities and some can be hindered if they cannot concentrate as well as others. But, I believe ADD/ADHD/whatever variants is a functional disorder just as many other mental illnesses are. It's also a learning disorder which makes it worse. If we were still in the days when formal education wasn't so crucial then these conditions wouldn't be a big deal.

The problem is that the biological underpinnings of attention-deficiencies aren't known at all. And, giving children amphetamines can retard normal growth and functioning of dopamine pathways. I just stumbled upon two interesting articles:

Before it was replaced by other stimulants in the 1980s, methylphenidate was one of the most commonly used street drugs (Spotts and Spotts, 1980). In our home town of Bethesda, youngsters nowadays sell their prescribed methylphenidate to classmates who abuse it along with other stimulants.2 In working with community groups, we often hear anecdotal reports of individuals who have graduated from using medically prescribed methylphenidate to alcohol or street drugs. One of the authors (P.B.) has seen some cases in his own practice.

Like any addictive stimulant, methylphenidate can cause withdrawal symptoms, such as "crashing" with depression, exhaustion, withdrawal, irritability, and suicidal feelings. Parents will not recognize a withdrawal reaction when their child gets upset after missing even a single dose. They will mistakenly believe that their child needs to be put back on the medication.

MORE FACTS WITHHELD FROM PARENTS

Parents are not told that methylphenidate, as a stimulant, can cause the very disorders it is supposed to cure-inattention, hyperactivity, and aggression. When the child becomes worse while taking the medication, he or she is likely to be given higher doses of the drug, or an even stronger medication, such as the neuroleptics thioridazine (Mellaril) or haloperidol (Haldol). This can result in a vicious circle of increasing drug toxicity (side effects of methylphenidate are further discussed and documented in Breggin, 1991).

Rarely are parents informed that methylphenidate can cause permanent disfiguring tics. One of us (PB) has recently consulted in the case of a young boy in whom routine dosage produced disfiguring muscle spasms and tics of the head, neck, face, eyes, and mouth.

Parents are sometimes told that methylphenidate can suppress growth (height and weight), but the explanation is usually given in a manner calculated not to frighten them. Much of the brain's growth takes place during the years in which children are given this drug; but doctors don't tell parents that there are no studies of the effect of this growth inhibition on the brain itself. If the child's body is smaller, including his head, what about the contents of his skull? And if size can be reduced, what about more subtle and perhaps immeasurable brain deformities?

Parents are infrequently informed that like any form of speed, methylphenidate can often make children anxious and sometimes cause them to behave in ways that seem "crazy." Most surely, parents will not be told about any danger of permanent brain damage from long-term exposure to methylphenidate. While no consistent brain abnormalities have been found in children labelled ADHD, one study has found brain shrinkage in adults labelled ADHD who have been taking methylphenidate for years (Nashrallah et al., 1986). The authors of the study suggested "cortical atrophy may be a long-term adverse effect of this [methylphenidate] treatment."

Finally, parents will not be told by their doctor that there are almost guaranteed non-drug methods to improve the conduct of nearly all so called DBD children-through more interesting, engaging schools and through more rationally managed, loving family relationships.

http://www.breggin.com/methylphen.html

Attention deficit/hyperactivity disorder (ADHD) is a complex condition that can include elements of hyperactivity, impulsive behavior and inattention. Its prevalence in childhood is variably estimated to be between 2 and 14%, and is often treated with stimulant drugs such as methylphenidate (Ritalin) or D-amphetamine (Dexedrine). This may at first seem not only paradoxical, but also potentially dangerous, given the view that sensitization to drugs of abuse may predispose towards adult drug addiction1. An association between ADHD and substance abuse in adulthood is well-established2, 3, but its exact nature remains unclear. Some have suggested that methylphenidate treatment during childhood, far from enhancing the risk of drug dependence, may actually reduce the incidence of drug abuse during adulthood4. Studies with experimental animals may be useful for resolving this issue as they allow the control of important variables such as the history of stimulant drug exposure during defined stages of development and provide an objective measurement of subsequent drug-taking or drug-seeking behavior in adult animals. Indeed, a report by Andersen et al.5, published the January issue of Nature Neuroscience, sheds some light on this complex issue. They demonstrated that juvenile rats treated chronically with a clinically relevant dose of methylphenidate exhibit less cocaine-seeking behavior as adults.

Aside from its important societal and clinical implications, this issue is theoretically crucial in light of suggestions that drug-induced sensitization may contribute to drug addiction1, and that early developmental stages may be particularly susceptible to such sensitization because of the dynamic nature of the developing brain dopamine systems before and during adolescence. A role for the mid-brain dopamine projections to the nucleus accumbens in ADHD has been postulated, given the established role for this anatomical structure in hyperactivity, impulsivity, reward and drug abuse. The findings of Andersen et al.5 also clearly implicate this pathway in the plastic changes associated with chronic methylphenidate administration to the developing rat; they use molecular indices that include changes in a transcription factor, cAMP receptor element−binding protein (CREB), in cells postsynaptic to the dopamine neurons and within the nucleus accumbens itself.

Andersen et al. treated rats throughout the pre- and periadolescent stage (postnatal 20−35 days of age) with a clinically relevant dose of methylphenidate. They then found reductions in the locomotor-stimulant effects of cocaine when adult. This alteration in the stimulant response to cocaine was also accompanied by changes in its ability to act as a reward. The methylphenidate-treated rats exhibited less preference for environments associated with cocaine, suggestive of reduced cocaine-seeking behavior. In fact, the treated rats actually showed a significant aversion for the cocaine-paired environment. The findings were also developmentally specific in that different results were found when the same chronic methylphenidate treatment was given to adult rats: The locomotor-stimulant response was unaltered, and the rats no longer exhibited aversion to a cocaine-associated environment, although the usual preference was blunted. These behavioral changes in the adult rats were also accompanied by increases in CREB expression, as previously, but there were additional changes in expression of the GluR2 receptor in the nucleus accumbens.

These findings suggest, first of all, that repeated treatment with stimulants in youth does not necessarily lead to enhanced drug-seeking behavior in adulthood; in fact, it suggests the reverse and is apparently at odds with a simple form of sensitization theory. Second, the age at which the stimulant treatment is given seems to be an important factor—presumably because of the way it impacts on the maturation of the dopamine system. And third, increased CREB expression in response to chronic methylphenidate occurs regardless of the developmental stage of the chronic drug treatment and is therefore less likely to explain the difference than the developmental variations in GluR2 receptors.

However, these findings must also be considered in the light of another recent study that does find evidence for the sensitization view of methylphenidate treatment. In this study, adolescent rats were chronically exposed to the same dose of methylphenidate, although for a shorter period beginning late in adolescence6. During adulthood, the rats had a normal locomotor-stimulant response to cocaine but an enhanced tendency to self-administer low intravenous doses of the drug. These small variations in the schedule of methylphenidate treatment over slightly different developmental stages, or alternatively the focus on 'drug-seeking' in the Andersen et al. study (as distinct from 'drug-taking' quantified by intravenous self-administration), may have led to these contrasting sets of findings, which must now be investigated further.

Another problem has to be addressed before extrapolating the results to the complex clinical issues reviewed above. Both of the new studies have used 'normal' rats, and so the data may have only limited applicability to human ADHD. If children with ADHD do indeed have a 'paradoxical' response to stimulant medication, which causes reduced rather than enhanced activity, then it may not be valid to model the disorder with normal animals. According to the paradoxical response view, the stimulant medication serves to correct a presently undefined brain abnormality and presumably works in a qualitatively different way from the normal action of the drug (Fig. 1). This reasoning has led to the development of animal models of ADHD (ref. 7) that have core features of the human disorder, such as locomotor hyperactivity and a paradoxical reduction of such hyperactivity following stimulant drugs. Such models include the spontaneously hypertensive rat, neonatal depletion of catecholamines by treatment with the neurotoxin 6-hydroxydopamine and transgenic mice with abnormalities of the dopamine transporter—all these models share the property of altered functioning of the central dopamine system7. Clearly, it would be advantageous if such models could also be used to assess the effects of early methylphenidate treatment on adult drug-seeking and drug-taking behavior.

But there is one further possibility to consider, which may after all serve to endorse the focus on normal development taken by Andersen et al. A study by Rapoport et al.8 showed that normal as well as hyperactive boys exhibit reductions in activity following d-amphetamine treatment, although adult men were more active after the drug. As hypothesized earlier9, these findings might represent a model of ADHD in which the response to methylphenidate could be understood in terms of its normal actions (Fig. 1). According to this reasoning, methylphenidate reduces the high levels of activity that occur in ADHD children, but which can also occur in many normal children. This pattern is distinct from that of adults, in whom baseline activity tends to be less and so locomotor stimulation is more evident. The basal locomotor responses of these groups thus fall along a single, 'normal' continuum, with amphetamine treatment producing a predictable and proportionate inverse effect on activity according to the baseline—with ADHD children showing the biggest reductions, normal children smaller ones, and adults actually exhibiting psychomotor stimulation instead. In support of this reasoning, there has been a recent mechanistic explanation of how such baseline 'rate-dependent' effects could apply at the neuronal level10. Regardless of the underlying mechanisms, the immediate implications of the findings reviewed above are clear. To supplement the existing data, new investigations should perhaps also take into account individual differences in baseline activity as possible determinants of the response to methylphenidate. This could be done, for example, by selecting the most active sub-groups of developing rats from the least active ones and comparing the effects of chronic methylphenidate medication on the adult responses to cocaine (or other drugs of abuse) in these two sub-groups. These experiments would further explore the clinical issue of whether methylphenidate treatment must strike a balance between short-term expediency in treatment and the longer-term risk of promoting future drug abuse. We would also learn whether maturational factors—and the plastic neuronal and molecular changes associated with development—are the crucial variables determining the outcome of chronic treatment with methylphenidate, as suggested by the findings of Andersen et al.5, or whether other principles, such as individual differences, might also play roles.
http://www.nature.com/nm/journal/v8/...nm0102-24.html

I really don't think it's appropriate for anyone to take amphetamines on a daily basis. But, I think it can still be helpful for adults to take on an "as-needed" basis.

Reputation Comments on this post:

	Excellent information to bring into the discussion, thank you.
	great post on add

[Ranke]

As my last post doesn't actually include swims personal beliefs or really much text at all I will make up for that here.

Swims is in total agreement with swibewilderment. He has serious problems with the reckless prescription of stimulents to both adults and children without providing adequate information. This is not to say he supports the prescription of stimulents to children, only that he believes more information needs to be provided. If swim had it his way no one under 13-14 would be prescribed any dopaminergic stimulents. The risks for perminent damage are too great and based on swims memory of primary school and middle school, there is really no need for even those with ADD to take medication. Swim cannot speak for highschool as he never attended (he skipped to go to a community college).

[lulz]

I have medically diagnosed Atention Deficit Disorder.

It's hard making people understand what that means.

To non-drug users, they think it means I'm hyperactive. But in my case I'm not, I just have attentive problems.

To drug users, they think it means I need dopamine boosting drugs. Now they can help, but they don't really apply to me. I had a qEEG reading taken on my brain and it's noradrenaline that I'm deficient in.

Thing is, in my case what works PERFECTLY is Straterra and yohimbine. ADD comes in many different forms, mine is a deficit of noradrenaline. So combining a noradrenaline reuptake inhibitor with a noradrenaline autoreceptor antagonist cranks me up to full speed.

Unfortunately I had to figure the yohimbine part out myself. (note to anybody potentially in my boat)

[Psych0naut]

That could be very useful info for me, I have ADD as well. I'm now on dexedrine but only have been on it for 1,5 weeks yet.
Before it I was presribed methylphenidate for a while, but it was utter crap, way too much side-effects, and no positive effects.
Before I was prescribed dexedrine, SWIM self-medicated with racemic amphetamine, which was a big improvent, just like dexedrine is now, but still not completely what he hoped for, he'll give strattera a try this summer as well, thanks for the info.

[lulz]

I was prescribed methylphenidate too, and at the prescribed dose (60 mg/day extended release) it had barely any use. Someone who was my identical clone only found the stuff useful if he crushed the stuff up and snorted it, but that only gave him energy and clarity of thought, it had no effect on helping him focus on tasks he wasn't particularly interested in.

Straterra for me has been a strange medication, and I suspect that people with ADD are troubled with all kinds of different chemical circumstances so I have never recommended it to anyone. On its own, the only benefit I got out of it was that it regularised my sleep for the first time in my LIFE. Plus, when I slept I had strong, vivid dream sleep on a regular basis for the first time ever. Waking up feeling like my mind had RESTED was a new thing for me. This wore off after a while, which was part of the reason I started towards the path that ended up with trying yohimbine.

Actually what made me start off in the first place was when my clone tried BZP, which is also a noradrenaline autoreceptor antagonist, among other things. He had already experiences those other effects through various drugs, but the noradrenaline autoreceptor antagonism produced an effect he had never experienced before.

If your neurochemistry is anything like my clones, it'd be worth trying BZP to at least see if it has any similar effect. That being said, it's just a shot in the dark. But I'm proof that shots in the dark can pay off!

[Psych0naut]

Indeed it seems to be different for everyone with ADHD, especially ADD(a good reason why it isn't a bullshit condition, since they do improve with specific medications, but not with others). It's really weird they prescribe a whole range of different medications, from amphetamines to methylphenidate, and from SSRI's to Strattera, but now I see why, everyone reacts differently, and everyone has a specific type of medication that works best for him or her.

[Son of Axeman]

ADHD of all kinds (this includes various types of ADD) is a condition involving documented, replicable symptoms. Therefore, to suggest that it is a bullshit condition is unfathomable. Scientifically speaking, it's valid, and deserves to be treated equally to all other mental ailments.