Which is quite funny. And considering Vyvanse/Elvanse, they have a long half life. So may find yourself wondering, somewhere before lunch, if you should take it, or simply accept your forgot it, since it may hit your sleep if taken too late. Always juggling the big questions :D
@@bekksterlab The meme is kind of sarcastically saying, "Yeah, these meds are so addictive that I forget to take them!" It's just pointing out how the meds are NOT addictive (when taken as prescribed, of course).
I've never met an adult with adhd that needs reminders for their medication since they are not functional without. most if not all say if they stop they are incapable of doing work, worse than before taking them. this includes myself. Its silly to say it's not addictive, if the dependance it induces makes you want to be back on it. Compared to an ssri which is only dependence forming, you don't crave the feeling of being on it, you just have weird withdrawals. Whereas with stimulants, you miss being confident in your ability to get things done, feel slightly more positive, and have withdrawal that causes extreme fatigue, sometimes depression, and all your adhd symptoms are worse.
The stigma surrounding ADHD is jaw dropping. From experience of stimulant medication I can say my substance misuse has plummeted, in fact if I use cannabis with stimulants it's a negative effect. Its also "fixed" my brain, I'm calmer, thoughts are more organised, memory is improving, highly recommended using them while driving. Zero withdrawal while stopping due to shortages lately. Way too many benefits to warrant the stigma. Of course, this also includes life style management and the good old paper and pen....at all times if you can. Cheers Doc.
yes i reallized the stimulants are really helping in traffic... i'm absolutly less prone to reckless behaviour in the car, or on the bicycle when i took the meds.
@@redbepis4600 in Germany they are allowed in Traffic when prescribed! Urine Tests will show degradation products of amphetamine so you should allways demand a blood Test... Those will show you Just took "Methylphenidat"..
I cried at 39 when my psychiatrist said, “3 to 5 percent of females with ADHD are OCD, it is the only thing that has ever saved you.” I always knew something was wrong but had so many doctors say I could not have it because I was too accomplished . I always wanted to attend medical school but knew something was missing. I asked her how long it would take for the medication to work, and she said that I would know immediately. I remember thinking this is what a level playing field is like. Adderall has been a game changer for me. Thank you for getting this information out.
That is an interesting observation - I don’t think I have clinical OCD, but I have a GAD diagnosis and lifelong hypervigilance. I think this attenuated my ADHD symptoms, fear lessening my inattentiveness (at a cost) and eliminating any potential risk taking activity. I’ve never heard a professional offer any support for this idea before. I believe I inherited my phobic nature from my mother, via prenatal exposure to her high stress hormones, and while she had serious anxiety and significant executive functioning issues, I have never been able to decide if she might have ADHD. OCD is a definitely possiblity though.
Interesting. You just articulated what I couldn’t put a finger on. I was diagnosed with ADHD at 41 but I knew it was my OCD that helped/saved me to success. Now that my ADHD is managed, I took OCD meds and my living space has spiralled but I have peace of mind for the first time in years….
@@amydayrit lol 😂 I know exactly what you mean. When i noticed my house was more cluttered it bothered me at first…then I realized it was probably a sign that the meds were helping with my ADD as well as OCD. Compulsive thoughts can be helpful for intense intellectually difficult tasks or problem solving..it can also make you more creative, but when those thoughts turn for the worse and become paranoia they can be incredibly destructive to you and your relationships with your loved ones. I didn’t realize how compulsive my thoughts were until I started medication.
@@JB-qt3wo yes, I was totally on the obsessive part of the OCD. I was consumed everyday of order, symmetry, etc…my house was spotless. Nowadays, my house is cluttered. Now I wondered if I was originally sloppy, masked by OCD….I hope not.
@@amydayrit Yeah from what i’ve read the constant cleaning is an anxiety driven behavior. Seems like OCD is a by-product of cognitive anxiety that manifests differently from person to person.
I'm an adult who started stimulants recently - almost 4 months ago. Here's my subjective experience and opinion on addiction and dependence on medication: - the stimulant medication I'm on is not addictive. In my personal feeling, my habitual coffee consumption was ACTUALLY an addiction, even if it's not as bad for you as alcohol or other drug addictions. I'd get headaches without my morning coffee or sometimes I'd be grumpy without coffee. Simulants aren't like that. Sometimes I can even forget to take it or misplace my pill in the morning - my body doesn't crave stimulants at all if I don't take them, there's no compulsion to take them. I recently had a cold, and decided that I needed to sleep to get over the cold faster. Stimulants prevent me from napping, and they do increase your blood pressure a bit, and I thought both of those things were not ideal when getting over a cold. The choice not to take medication on those days was very easy - no withdrawal, physically or psychologically. That said, one thing that I noticed on stimulant medication is that my coffee and energy drink cravings completely disappeared, plus I achieved a more significant level of alertness earlier on in the morning. I was worried that I would get addicted to stimulants, but the reality is they inadvertently, instantaneously cured me of a caffeine addiction. I'm saving so much money on coffee, diet pop/soda drinks, and energy drinks. Healthier too!Just going by my subjective experience, I can very easily see how simulants PREVENT self medication in people with ADHD, and actually prevent addiction. It's counter intuitive if your perception of stimulants is that they're drugs and all drugs are equally bad. But if taken as directed, orally, as Dr. Barkley said, I've never experienced anything remotely close to addiction. - dependence. I'm referring to dependence in the following sense - once I start the medication, even if I'm not addicted to it, maybe I come to learn that I need to be on these pills for the rest of my life. Before I started taking them, I was scared of that possibility. The reality for me is that the stimulants are so helpful for basic tasks that I struggled with, that yes, I now believe that I need to be on some kind of ADHD medication for the rest of my life. That might sound scary to people, but once you're going through it, it's not scary. Once I saw the difference in my ability to "just do it" (basically follow through on my intentions), I have the opposite concern - I realized how much I need ADHD medication, and now I'm concerned about making sure I have access to medication for the rest of my life. Is this "dependence"? Philosophically maybe you could make the case that it is. But it's dependence like a diabetic is dependent on insulin or how someone with back pain needs a cane. I wouldn't judge them for using insulin or a cane; so why judge myself? I need medication to achieve the equivalent follow through and productivity as others. Stimulants help me do things like set up appointments, return emails, and keep calendars. I was living my life on hard-mode for so long without meds. It's nice to be able to function normally, I have so much catching up to do lol. I had several family members and friends who encouraged me to try the medication. Here are some encouraging sentences that helped me. - There's no evidence that it's addictive, so you can try it safely; if you don't like it you don't have to keep taking it. - Stimulants are one of the best studied and most effective psychiatric medications. If you believe in drugs for depression, anxiety, or bipolar disorder, you should probably believe even more in the efficacy of ADHD meds. - Ultimately words like addiction and dependency are just words since I'm not already struggling with addiction. What matters is the results, and there's lots of evidence that proves ADHD meds work. That's what matters.
This is a beautifully insightful comment, thank you :) Can I ask you a question? You mention "I achieved a more significant level of alertness earlier on in the morning". In your experience, do you think this is a direct result of taking the medication on that day, or have you found that you already have alertness upon waking up, because of taking the medication regularly on prior days? I'm curious about this subtle distinction. I've never taken a stimulant medication and still in a "curious" phase, so your comment about it is very appreciated!
@@seth_piano The increased alertness is the direct result of taking stimulant medication on that day. If I do not take stimulants one day, then I do not benefit from the medication for that day. If I took simulants yesterday, they do not help me today; the affects are not additive. Medication like SSRIs (for depression) have what's called a "delayed onset of action"; they do work additively and can take weeks to kick in, and you benefit from their use throughout the whole course of the day. Stimulants are short-acting medications, like Advil or Tylenol; you only benefit from it the day you take it, and they wear off later that same day. However, science is great and they found a way to slow release stimulant meds into your body throughout the day, so even though they're a short-acting, they've been designed to work for 8 to 12 hours. This means you should only take an extended release stimulant once per day, at the beginning of your day. They help you stay alert, so if you take them too late in your day it can cause sleep issues. When I take my stimulant medication, this is how I do it. Usually I'm a total zombie in the morning without medication. The night before, I set my meds up by my nightstand with water, and I set my alarm for 1 hour and 15 minutes ahead of when I actually need to be up. For example, if I know I need to start getting ready at 8am, I set an alarm for 6:45am. I take the stimulant at 6:45am, and then I go back to sleep. Usually 30 minutes later I start feeling it a little bit. 45-75 minutes after taking the pill, I am fully alert, and I can start getting ready for my day or for work. This has helped me a lot with getting to work on time, which I've struggled with all my life. On my stimulant medication I am more alert, I have more follow through on tasks, I can manage my time better, I get distracted less, I can choose to focus on one thing, I procrastinate less, and I am less irritated by people. But it's not perfect. It helps me turn motivation into action, but if I have no motivation for a task, then stimulants don't help. The best analogy I've thought of is gas in your car as being motivation. Some people have gas in their car and some people don't. ADHD is like having gas in your car, but your accelerator is broken. Stimulants fix your accelerator, but they don't give you more gas and they don't upgrade your car. Basically, I think that stimulants are useful if you have ADHD, but if you don't have ADHD, it's probably not going to be that helpful. It doesn't give you motivation, and it doesn't make you smarter like college kids think it does. But, as a person with ADHD, I basically feel like 8-9 hours of my day are 30-50% easier on stimulants. I've heard that if you take your pill with food, especially protein, it lasts closer to 12 hours. I'm not sure if that's true, I want to test it. My doctor said that I could take my pill with or without food. If your doctor says you should be taking your meds a certain way, listen to your doctor. Stimulant medication suppresses your appetite. That can exacerbate disordered eating or excessive meal-skipping in some people. Eating healthy snacks is important. One side effect of the medication that some people experience is called "crashing". Crashing is when the medication wears off for the day; you get tired and you have less will power than usual. Crashing for me lasts 30-60min. If I'm "crashing" plus I'm fatigued from accidentally skipping meals, the "crash" will last 3-4 hours and be more severe. The appetite suppression might seem like a bonus, but you risk wasting your entire evening if you skip all your meals. Eating healthy snacks throughout the day almost entirely prevents this for me. These are just my personal experience. I think they're pretty standard for ADHD people who are prescribed stimulants, but people with ADHD can also experience medication in different ways. For example, stimulants can make anxiety worse. I'm not an expert on which meds are best, but I think it's important to be open to more than just stimulants. If you're convinced only 1 specific medication will work for you, it can be very discouraging if it doesn't work. Be open with your doctor about your experiences on meds, and be willing to make medication/dose adjustments. Non-stimulant medications can work better for some people. That said, I have 0 experience with non-stimulant medications for ADHD. Basically everything I said here should be applied to stimulants only, specifically Adderall XR, though I've heard the other stimulants are similar. Also just understand that these are just my experiences which may or may not apply others. Some approaches I take may not be necessary or useful to others. For example, not everyone with ADHD has trouble with waking up in the morning, so for them it might be better to take their pill and start their day, instead of going back to sleep like I do. And maybe other people don't crash like I do. Working with your doctor is important, but I think self education and reading about other people's experiences can make it easier to identify how the medication is affecting you, so you can learn how to manage it better. Get lots of info from lots of different sources, don't trust just one person's recommendations. I think Dr. Barkley is an excellent source of info.
@@jamiejohnson5748 I'm really grateful for this thorough description. You really have outlined a really insightful first-person perspective of what this is like. Thank you so much
@@jamiejohnson5748This is an excellent depiction of how I experienced my 1st day on ADHD meds. However I took my pill too late in the morning and was unable to go to sleep that night also coming down with a cold too, so I will do it differently once I feel better. Waking up earlier to take them I definetley agree with and will try this. I'm keeping a diary which will help me track all the positives.
Hello, thank you for being out there on RUclips .❤️ I am a 64 year old female who has unknowingly survived life with undiagnosed ADHD. PTSD was the diagnosis by a psychiatrist 4 years ago. I was given Sertaline , which i titrated down and discontinued after one year. There was no relief from the overwhelming symptoms. After consulting with my psychologist, i followed up with my GP, i was told by them that testing is expensive and its a long wait list here. So i was given a low dose of methylphenidate to try for one week. What a difference one little pill has made in my everyday life! I am astounded at the focus and calm i am experiencing. Its been 3 weeks now, I am simply joyful . Our lives are a journey and i am grateful to be able to live it more authentically.❤
Congratulations on your diagnosis even though unfortunately late in life. The studies of ADHD in the 1950s and 1960s included only boys, so several generations of girls, now women, were denied the opportunity for diagnosis and treatment. I hope you really enjoy your life.
I went undiagnosed until late adulthood as well. I was diagnosed at 47. My doctor said it’s likely because I was high functioning ADHD (not sure if insomnia, procrastination, chronic depression, and time blindness is high functioning though) and my higher estrogen levels masked the symptoms. Once I began entering menopause the estrogen drop revealed a myriad of other issues that I realized had been there all along, but the tricks I had learned to keep them in check no longer worked. They’re finding this is often the case with women who are diagnosed later in life. Loss of estrogen is problematic for female neurodivergents. I was on HRT and I think thats the only reason I was able to drop down to 10 mg of Vyvanse. I’m off it now and struggling. Will be back on it again soon. Good luck. ♥️
I've been taking my ADHD meds (both atomoxetine and methylphenidate) for over a year now and only just recently I've noticed a big improvement in my life. If you've just started taking meds - don't give up!
Man, you've no idea how much this comment means to me. It's hard to have the patience sometimes, after months and months taking both and not seeing any meaningful improvements. Thanks
@AnnieandCC I’m 62, was in a deep downward spiral in recent years, and was just diagnosed and started meds this spring. I’ve had to stay very low dose so far, but I feel I am seeing what Dr. Barkley describes as an enhancing effect - I would actually describe it as rebuilding, because recent years’ stresses must have seriously damaged my prefrontal cortex. I do have other things going on besides ADHD, and I think some changes this year (both good and bad) have been the effect of going off the SSRI I was on for a year and a half. But it really feels like the stimulant has helped improve my ability to reason and direct myself. If you’re 52 and female, I’ll note that I’ve heard a lot of women with ADHD, autism or both talk about what they view as a hit to their dopamine levels when they hit perimenopause. I think my mother was hit hard by this; I’m not sure if she had ADHD, but she certainly had executive functioning issues and real problems with what was then called PMS. As I understand it, there is unfortunately almost no research to date on ADHD in older adults, and the idea that ADHD can get better but never gets worse as you get older is prevalent, and IMO based mostly on teenage to middle age. Dr. Barkley made a very helpful point in a recent video, that symptoms will remain consistent over time, but impairment may increase. Assumihg you aren’t presently diagnosed: the critical thing for me in getting my diagnosis was that, even though I made it through to my fifties undiagnosed, I could in fact point to markers throughout my life indicating symptoms. This was important in that my parents were both deceased by the time I was diagnosed. If yours are still with you, having corroboration of childhood traits by an adult is very useful. If you’ve made it to 52, it may take some time to tease symptoms out; when I first looked at the DSM criteria, I could only identify about 4 hyperactive traits and almost no inattentive ones. I have a combined diagnosis, and by now I can see the traits in both categories very clearly.
Dear Dr. Barkley, I want to write a simple thank you message here to you, thank you so much for opening this channel and sharing your knowledge and new development around ADHD. All your videos are insightful and valuable for me personally as a ADHD person, though I didn't watch these videos all. I want to let you know I wrote this with tears in my eyes. Thank you from bottom of my heart for helping me improve my life, lives of my parents and my future children, it was lucky for me to get to know you and your work. I wish you all the best!
Thank you for this. You have previously noted that ADHD meds are generally safer than other psychoactive meds, and based on my own experience I would be inclined to agree. What I have found is that certain medical professionals seem quite concerned about ADHD med safety, but can be almost cavalier about other meds. I do have a formal (and expensive) ADHD diagnosis, and lately have been trying to deal with a new prescriber who has repeatedly spoken in disparaging terms about a non stimulant ADHD med i take low doses of, yet pushed me to try an anticonvulsant med used mostly for epilepsy and bipolar. The drug in question did have siezure risks, but she seemed unconcerned about that.
I'd say the biggest issue is prescribing too high a dose. Often, parents see a big difference at a certain dose. When the parents see the big change, it should be backed off a bit, and the proper dose should be more subtle to the parents. I have been off and on stimulants my whole life, and I was 35 before I figured this out. Often going on to high a dose and saying the problem is the stimulants, not the dosage. Also, I regret all the years I went off stimulants as they were all wasted years where I accomplished nothing and had more drug and alcohol dependency.
@FrankTaeger2021 ypu don't get that I have been a zombie feeling until you get off them. It's hard to have the insight while you are taking them. Especially for kids. And the right dose is so calming and peaceful too. I wish everyone could find the proper dose on this stuff. Like I said took me over 20 years to experience the perfect dose.
On adderall and ritalin I've never gotten off the very smallest intro dose. They don't make 5mg adderall in extended release. But I'm hypersensitive and 5 mg in the morning and 2.5 at noon was the most I could handle before it caused serious sleep problems and was obviously too much. Non stimulants did nothing, or had me falling asleep standing up. So since I'm an adult, my dr wrote a narcolepsy med prescription for me. Most adults I know that are taking adderall are taking something between 15 and 60 mg. My whole point to all this is that you might want to talk to his dr and see if they can lower the dose or if there might be another option to try. And that there are more options that become available once he's an adult. @Intothelight72
I put off getting my son medicated for years because I was worried it would make his tourettes worse. Fortunately, his tics have decreased since starting his medication. What a relief. Wish I had started him sooner
I agree! Since being back on Amphetaminge based medication I feel far less pleasure seeking behavioural tendencies than when I had a desperation for Dopaminge. Also if my mum had of let me be put on Amphetaminge when I was younger I know I would've done so much better at school because I absolutely love learning and since I've been back on it I have written an incredible amount of information and my subjects of interest considering previously I couldn't bare up a pen for 5 or 10inutes, let alone the 14 hours I've been known to be sat writing for! ADHD meds makes me feel like I've got my own hands on the wheel instead of being driven around by some maniac who learned to drive by playing Grand Theft Auto! Would still be nice to have a support worker again who has their own tools for incase I find myself driving onto the pavement, but at 32 years old I finally feel like I've got some level of control over my life instead of being dictated by the variety of symptoms that would turn this comment into a stupidly long essay.
I've thought about the risks. Of course, this was about an hour after I took my vyvanse. I'd rather be able to live a little before I do die. I wouldn't be able to even think about that without the vyvanse. Thank you Dr. B!
Dr. Barkley thank you for continuing to bring forth facts about the realities of ADHD and treatments for it. For those that still think it's "fake", what you are saying very much describes my life. I'm a 51 year old female with 4 grown children that within the last several years finally decided to try the medication method for myself, and I did not realize how badly I acted and paid attention until now looking back. I wish I had started medication when I was in 1st grade, or at least 2nd grade when I was first diagnosed. Again thank you for validation that I'm not just crazy.
I'm on Ritalin for 3 years now, 30 mg a day. To be honest I was afraid I developed some sort of addiction, because I feel that I struggle more on med-free days. I asked my psychiatrist about it and she said it is because I notice it more now, like when you need glasses and once you start using them, you feel like your sight is worse when you took them off.
Thanks again, Dr. B. I was JUST having a conversation with a friend about this very topic. I plan to send this to her to reinforce what I had shared with her. I am not a professional but a mom that has struggled for over 7 years with so much misinformation. I deeply appreciate the resources you provide. Grateful!
🎯 Key Takeaways for quick navigation: 00:00 🧠 *Introduction to ADHD Medication Myths* - ADHD stimulant medications are often misunderstood. - Addressing common misconceptions about stimulant medications. - The need for a nuanced understanding of ADHD medication. 01:08 🚫 *Addiction Misconception* - ADHD stimulant drugs are not addictive when taken orally as prescribed. - Potential for abuse and misuse leading to addiction explained. - Distinguishing between addiction and dependency on medication. 03:08 ⚔️ *Dispelling Aggression Claims* - Contrary to popular belief, stimulants reduce aggressive behavior. - Scientific evidence shows a decrease in criminal behavior. - Addressing the misconception linking stimulants to aggression. 04:10 🧠 *Seizure Risk Clarification* - Stimulants' seizure risk requires extremely high doses, not at prescribed levels. - Studies demonstrate safe use with individuals having pre-existing seizure disorders. - Clarifying the misconception about stimulants increasing seizure risk. 05:00 🤖 *Tics and Tourette's Syndrome* - Stimulants may influence tick frequency, but not the development of Tourette's Syndrome. - Recommending a cautious approach for individuals with tick disorders. - Exploring the nuanced relationship between stimulants and tic disorders. 06:05 ☠️ *Suicide Risk Attribution* - ADHD stimulants are not linked to an increased risk of suicide. - Emphasizing that ADHD itself is associated with a higher likelihood of suicide attempts. - Dispelling the misconception of stimulants causing suicide. 07:41 🎓 *Academic Achievement Improvement* - Overcoming the misconception that stimulants don't improve academic learning. - Longer-term studies show improvements in reading test scores and academic achievement. - Highlighting the positive impact of stimulant medications on academic performance. 08:32 🚭 *Substance Abuse Risk Evaluation* - More than 20 studies refute the claim that stimulant medication increases the risk of substance abuse. - No evidence supporting the notion that stimulants lead to later substance abuse. - Addressing and dismissing the misconception about stimulants and substance abuse. 09:25 🧠 *Long-term Use and Brain Damage* - Oral use of prescribed stimulants does not show evidence of causing brain damage. - Contrasting oral administration with studies involving direct injection into the brain. - Positive findings indicating potential neuroenhancement with long-term stimulant use. 11:29 📈 *Prescription Rates and Overprescribing* - Examining prescription rates nationally and debunking claims of overprescribing. - Analyzing prevalence rates of ADHD and stimulant medication use. - Considering variations in prescription rates across different regions. 13:03 💊 *Pediatric Dosing Misconception* - Contrary to claims, evidence suggests pediatricians often use lower doses than experts recommend. - Dispelling misconceptions about kids being overdosed on stimulant medications. - Highlighting the importance of appropriate dosage for effective treatment. 14:14 🤯 *Medication as a Positive Intervention* - Rejecting the notion that stimulants act as a "chemical straightjacket" or merely sedate individuals. - Numerous studies demonstrate positive benefits, reducing various risks associated with ADHD. - Emphasizing that stimulants contribute positively to individuals' well-being. Made with HARPA AI
I LOVE that someone is finally addressing ADHD myths! I would be really excited to see your take on Huberman’s episode on ADHD. I feel there were several inaccuracies in that episode.
I'd like that as well! Are the guidelines changing already? Even if it is good in general that studies take their time, it's so important for individuals to get an adequate treatment sooner rather than later.
Thanks Dr Barkley for another highly informative and helpful video. Your videos are really important for those of us adults who have this condition and especially for those of us with the condition and who have kids with it too !
Thank you for talking about stimulant medications and talking about it from a factual research-based point of view. I talked a little about my experience with taking stimulant medications for my ADHD and it changed my life for the better.
There's a fine line between "addiction" and "dependency". There have been times when I haven't been able to get my medication for an extended period due to shortages or insurance, and I can tell you I definitely looked into acquiring it illegally.
Atomoxetine has made a significant impact in my ability to complete household care tasks, such as doing the dishes and managing laundry. These are tasks that are necessary but not stimulating, and so it was so hard to get myself to do them. Now they are no big deal. Also my anxious energy around holiday planning is gone, such as for menu planning, gift buying, decorating. I can just enjoy the task in front of me without my brain spinning out on all that is left yet to do. These feel like small but significant quality of life improvements. I don't notice a lot of differences in my work, but I suspect there are improvements that I am blind to.
Just be aware, atomoxetine is not a stimulant, but comes with it's own set of risks and benefits. It is related, but not the same. I'm glad it works for you!
I’ve been on Adderall for 20 year and although this isn’t technically “brain damage”, a SPECT scan showed that I had extremely low cerebral blood flow which is a known side effect of norepinephrine. Adderall also damages your natural dopamine pathways, causes oxidative stress and decreases acetylcholine which can cause dementia.
❤Thank you DR. BARKELY. As always your focus on science and data are immensely helpful. Your presentations are communicated so well that they are useful to share with people who are not knowledgeable about ADHD.
Do you have a video on non-stimulant meds? (Those in the cardiovascular ATC class). Asking because of interest in patient with EDS / autonomic issues (eg POTS, Raynaud's). Patient has inattentive type ADHD. Thank you so much for your videos. They are a breath of fresh air!
I have a seizure disorder and it barely came up in my first appointment with my psychiatric care provider. She's under the same roof as my primary physician and they view the same records. Good to know why it was deemed irrelevant.
Seizure threshold is unlikely to be altered with ADHD medication, with the exception of wellbutrin (bupropion) which definitely does lower the seizure threshold
i'm surprised to hear you say that stimulants aren't addictive. I was diagnosed with ADHD when i was 27 and prescribed adderall 20mg, which made me euphoric. i said what i needed to say to my physician's assistant (who was already writing up the scrip before i got the words out) to increase my prescription to 30, 40, eventually 60mg, and soon was taking it in significantly higher dosage than was prescribed. in my opinion it seems odd and misleading to claim that stimulants aren't addictive "when used as prescribed." for many, stimulants - even at prescribed doses - provide a pleasurable effect that, when it starts to dissipate, can quickly lead to taking more than prescribed. if the prescribed dosage of a stimulant leads a number of people to abuse it the point of addiction, is it not addictive at the prescribed dosage? what do you make of all the addiction centers specializing in the treatment of stimulant addiction? why do i know so many people who have had similar experiences as i have? i also don't understand the relevance of the distinction between dependence and addiction. it is utter bullshit to argue that someone can't develop a physiological dependence on stimulants. when i inevitably ran out of my month's prescription of adderall after 2-3 weeks, the crash would be wretched... nasty, nasty depression, a voracious, insatiable hunger, total fatigue and lethargy... the bulk of these symptoms could perhaps be attributed to the lack of sleep, loss of appetite, and dehydration that tend to accompany stimulant use, and not, i guess, the drug itself. but what does that matter? i'm not at all arguing that stimulants have no place in the treatment of ADHD. but to gloss over the many people who are prescribed stimulants, come to abuse them, and develop an addiction/a dependence/whatever you wanna call it - to the point that it significantly interferes with normal functioning far more than the neurodevelopmental disorder it was prescribed to treat does - is irresponsible. it is an erasure of the very real experiences of many people who respond quite negatively to stimulant prescriptions, and it ensures that nothing will be learned from those experiences or done to prevent them from recurring. what percentage of patients who are prescribed stimulants need to respond in this manner for you to recognize these experiences as 'real'?
The risk of addiction does depend on several factors, including the person's individual response to the various substances, and whether there's a history of addiction to stimulant drugs prior to the ADHD pharmacological treatment. In these cases, it's usually better to try a low dose of an extended release formulation (ex. vyvanse instead of adderall for the amphetamines; concerta or foquest instead of ritalin or focalin in the case of methylphenidate). There's also the option of using a non-stimulant targeting norepinephrine / noradrenaline, as those indirectly contribute to increased dopamine concentration at the synapses. The responsible thing to do is documenting pre-existing addiction behaviors (substance-based or otherwise), followed by trying the pharmacological sequence with the lowest addiction potential first (non-stimulants, then extended release stimulants, and finally the short-acting stimulants), and documenting the side effects to stop the use before they become too problematic.
I had an interaction between Concerta and Escitalopram causing 4-hour episodes of tachycardia. No such episodes since switching to Adderall, but be aware of potential side effects while taking ADHD meds and SSRIs at the same time.
Just curious, which medication were you on first and which was added (if they weren't started at the same time)? Tachycardia could potentially be the concerta alone but its def warranted to monitor for symptoms of serotonin syndrome whenever you add serotonergic agents on top of SSRIs
Amphetamine helps with my ADHD a ton, i also found that i can even sleep after taking 0.25-0.35g of amphetamine if am actually tired before taking it. No side effects so far. Maybe slight "addiction" but not physical to be exact. Addiction from the fact that it brings mental focus and clarity which leads to improved productivity which leads to being able to prolong gratification and work hard on any subject that i choose to. And this "relief" syndrome can be quite addictive. Because you finally find something that is actually working. There is way more to add but this comment would have been too long and too tiring for me at the moment. I just find it extraordinary that solution to such complex problem as ADHD is so simple.
Could it be the case that children diagnosed and medicated may show fewer symptoms as adults as they could have 'rewired' their brains (i.e. learned) to more effectively learn habits, behaviours and thought processes as opposed to those undiagnosed until adulthood?
Atomoxetine was causing me to experience testicular pains required an ultrasound to rule out any conditions, eventually once I quit taking the drug, the pains went away. Thank you doc!
Myself, I receive a calming effect when I drink coffee. I spoke with a Neurologist that would rather patients take their prescribed stimulants rather than consume copious amounts of espresso/coffee.
Hello, and thank you for sharing your amazing knowledge with the world! I have heard Prozac and Paxil can adversely react with adderall, vyvance, and dexedrine. Has there been studies that have reliably proven this? If not, have you seen this in your practice to make you believe there is a relationship? I love everything you do, and as a nurse practitioner, person with adhd, and 2 sons with ADHD, I am so inspired by you and grateful for what you give back to your ADHD community! Thank you, thank you, thank you.
Dr. Barkley, thank you so much for your work. Do you have any video on BPD and adhd or any article? I would appreciate if you can make a video on this topic. It’s really confusing when it comes to diagnosis for adults. Thanks again!
is sublingual absorption of methylphenidate comparable to nasal? Studies suggest sublingual dosage is up to twice as bioavailable as taking it orally, and it certainly enters the bloodstream faster
Having been on lisdexamphetamine for almost a year now, one hundred percent I believe it makes people less aggressive, not more aggressive. The FIRST thing I noticed at even the LOWEST dosage was a huge drop in impulsive anger. That SEARING RAGE I would feel tear through my skull at the smallest interruption or annoyance went pretty much entirely away. I still feel angry at things that would make anyone angry, but that horrible white hot rage at the smallest of small shit? Good fucking riddance to that and thank you Vyvanse.
Same...I noticed I don't feel super irritated by work emails and interruptions like I used to be. I'm much more even-keeled with my work now. (Also on Vyvanse)
Many things here speaks to the tragedy that when a 16 year old had been made to quit his ADHD-medication quite abruptly at the same time as he was moved to an abusive environment where most people didn't share his language. He ended up tragically killing someone innocent who also was controlled by under this abusive culture. (I'm talking about Scientology). As far as I understand this boy was not seen as competent to stand trial and he was placed in a psychiatric facility. I can't help but being worried about if he is lucky enough to have competent and caring professionals or not. If not he must be att great risk of spiraling downwards with no or little chance of increased quality of life. The latest I heard of this was four days ago on the channel of Mike Rinder. The videos name is" Scientology's Big "Blood on Your Hands" Lie Exposed".
I've never really had much or any tics with stimulant meds during its time of effect. Instead I do sometimes have A LOT of tics for about 15- 30 minutes 30-90 minutes or about 12 hours after taking the meds. In between there's nothing at all. More interesting to me is that I had less or less noticeable tics before trying bupropion. It's been 2 years since I stopped using it and I'm still not entirely sure if bupropion caused or worsened the tics or just made me notice them consciously. I suppose the latter seems more likely, because the former would mean the meds caused possibly permanent side effects. But at the end of it, the only way tics have really bothered me was when I felt ashamed of them. Once I stopped caring what others think about it, they're really nothing but a way to recognize the adhd freeze as overstimulation rather than under.
On aggression: I personally have found since beginning adhd meds in adulthood (as a mid-20's male), I have had a serious tendency to yell. I take no other medications. I'm very soft spoken, and this external anger seems to solely occur when I take adhd meds.
I will also note that many of the documented benefits or potential benefits of stimulants are less known for the nonstimulants - as just one example, the recent Israeli dementia study showed dementia being fourfold more common in those with adult diagnosed ADHD, but people with ADHD returned to average rate if treated with stimulants - it wasn't compared for the very different nonstimulants, for whatever reason. If dementia can be prevented, that elevates the human and financial cost of lack of treatment significantly. When we experiment with other medications, we are possibly eliminating a possible risk, but may be eliminating a possible benefit.
@@TheDavveponken used general population data for a group in Israel that is better tracked and with more available data than other places. So, you look at everyone diagnosed in a population of a few thousand or hundred thousand and everyone diagnosed with ADHD x number of years ago, how are they doing now with different treatments - various issues that means more studies are needed, but that is true for everything - you can Google Israel ADHD dementia study JAMAnetwork and that should find it.
Thank you for these valuable information, can you please share what are your thoughts on the medications limiting hight growth at preteen/teen age years , is that true or is it a myth ?
You seem to forget Richard Fee's Adderall addiction. Where's he these days? Adderall is a drug and can be addictive if taken anyway. Snorted, or orally. Fee was smashing plant pots, threatened to run his parents over, drilling holes in walls, talking to stars, thinking cameras were spying on him, was committed. So it can increase aggression. Causes suicide. Did in Fee's cause or John Edwards III. Richard Fee was diagnosed with ADHD in August 2009.
Do we have any information if and how the time necessary for long term improvement alters, when taking medication with off days? I for example take it Mo-FR and leave it out at the weekends, based on the prescription and recommendation from my Psychiatrist. Good to see this mentality isn´t a problem just where I live. Rural eastern Germany pretty much still lives in the medieval age when it comes to such issues.
"Sedating into submission" would indeed be very out of place with a stimulant that makes one "more awake" than baseline, as it is the polar opposite of sedation. Also a lot of success is about productivity, and lack of productivity leads to poor outcome. Should be undeniable that increase of productivity is helpful in someone's life in the society with its demands, and the endless procastination can ruin it.
In younger children with ADHD, the stimulants are often effective to curb out hyperactive behavior. With them, the most noticeable effect is enhancing inhibition of motor impulsivity. Now, a problem is that toddlers / pre-schoolers specifically are prone to overdosage with ADHD meds, and specifically those with methylphenidate as the active ingredient. Excessive doses of this medication cause flat affect and emotional blunting, on top of the inhibition of motor impulsivity. This is what's being described as making the toddlers 'doze off' or act as zombies. The caveat here is that official drug regulation bodies (ex. the FDA) specifically advise against using ADHD stimulant medications on children younger than 6 years of age, because the ratio of side effects to intended effects is less favorable (too many side effects for the intended effect).
I myself am on dexamphetamine (adderall), I've been on the same dosage for 4 years, 2-3 pills a day (10-15 mg). It's a relatively low dosage, especially for such an extended period of time but taking more I experience side effects, at this level it's helpful for me and it makes me able to concentrate and function better than without the medication. Unfortunately health insurance doesn't cover this particular stimulant so I pay for it myself, that's honestly the only real complaint I have.
I’m curious if Ritalin is more neuro-protective to the brain than Adderall due to the fact that it increases neuronal firing…aren’t Amphetamines toxic to the brain??
Recreational stimulant abuse, or therapeutic dosages for treatment of adhd? if it was for the treatment of adhd with no med misuse, then the literature is very clear that adhd medications is most likely to be noncontributory to cardiac health, unless comorbidity is present
@@RuthlessandDisciplined Interesting. If someone already has a history of cardiovascular disease, such as high blood pressure, certainly stimulants can worsen those conditions and further increase cardiac risk. The marginal increase in heart rate and blood pressure from therapeutic doses of ADHD medications aren't likely on their own to cause harm in an otherwise healthy person, if anything the ADHD itself would be more contributory to negative cardiac outcomes independent of stimulant use. Of course the physicians knew their patients background, history, etc. so its impossible to draw conclusions over the internet
Even non-stimulants made my BP increase significantly. I've tried Wellbutrin and Straterra. Straterra gave me significant chest pain and tachycardia. My research on how these two meds can impact other organs, including the heart, was concerning to me.
I'm not an expert or anything, but I'm pretty sure I've heard Dr. Barkley mention in the past that properly dosed stimulants might actually contribute to a decreased cardiovascular disease risk in people with ADHD through indirect means. So the medication would help you manage other lifestyle factors such as having a healthy diet, exercising, managing stress, lower rates of substance abuse, etc. which those then have a more direct impact on CVD risk. I'm pulling this from memory from a lecture of his I saw a while ago, titled, "Special Presentation: Health and Life Expectancy in ADHD. Treatment Matters More Than You Think" you can search on youtube if you're interested.
Good morning from the UK 😊 I hv lately been diagnosed with ADHD ( I suspected it for about a year but got full on l diagnosis in November 23' ) I am an entry level academic myslef ( ecologist /naturalist ) and I'm very greatful for your scientific based free education on social media. I wonder would you be interested in pointing me into right directions as per the neuro-enhancement. I'm taking concerta for about 4 weeks now but I have discovered and interesting side effect - if I could call it such. Even when the medication wears off ... my nervous-system seems to be calmer overall ( I'm happy to explain more in a DM if you wish) So my question here is : are there any studies that have been done in this area .... as this to me sounds like the neuro-engancement, neuro-protection that you have mentioned in today's presentation. Perhabs 4 weeks is just a placebo effect ( I was really hoping for this meds to work 🙂) but I'd love to read some research about that. I'll be most grateful for any info from yourself. Have a great day Sir and thank you for your work !!! 🙏🏽
Looking at the package insert of lisdexamphetamin it clearly states "aggression" as a side effect of unknown quantity. Furthermore there are other side effects that could be viewed as connected to aggressive behaviour (e.g. mood swings). Looking at the package insert of atomexetin it includes suicidal thoughts and other related symptoms as side effect. So would be nice if you could clarify.
@@matt.108 That's not the point. When a medication prescribed by a doctor can cause those side effects you cant call these side effects a "myth". A myth is something that is not true but commonly believed in. But these side effects are true and known and thereby not a myth.
These are too absolute to be considered as a solid fact. Addiction isn't limited to snorting and injection. Reported aggressive behaviors are usually due to a sudden drop in dose of medicine, which would be known as a withdrawl. Which would be a symptom of addiction.... Because the anger burst is a result of a physical change in chemical levels which causes physical stress I would say that it qualifies as a physical reaction to the lack of the drug. Suicide.... I'm 34, diagnosed at 6. I haven't had any suicidal thoughts in my life.... Until I started medication as an adult. I only have ever had one moment in my life where that thought crossed my mind and it was when I was starting the meds as an adult, 9 days in. You can't say that the drug doesn't induce or encourage the chemical imbalance that leads to suicide or suicidal thoughts. You simply cannot. Show me the MRI that backs this up. Map the brain and show me how it's the ADHD and not the meds. You can't.
I have developed clinching and unclenching of my teeth during the day now, but before Vyvanse I was only a night time clincher, grinder. I also purse and pucker my lips now both day and night and did not do that before Vyvanse. It’s so bad that I get spasms and locking. When I’m off of vyvanse I do not clench during the day unless there’s severe stress. I do still purse and pucker my lips but if off of Vyvanse for a significant time that symptom decreases significantly. It’s honestly the only annoying side effect. I have tachycardia due to POTS so had to reduce from 50 mg to 10 mg Vyvanse. The clenching and puckering is the same on 10 mg as it was on 50 mg.
my guy, i hope you are reading this. the solution to your problem might be this: drink one glas of salt water in the morning, one in the evening. doesnt have to be vomit inducing, but so that you can drink it without to much bother. try it 3 days, the effects will be pretty immiediate. you are down on elektrolytes, this has a huge effect on the heart and the brain.
@@grummelameise No I’m not. I add very balanced Electrolytes to my water regularly and I also take salt/electrolyte tablets. I’m not dehydrated or lacking anything. Having POTS I have to make sure everything is good or low electrolytes are the least of my worries. It’s due to the Vyvanse. I appreciate the response, but I know the issues that I grapple with and why. When I stop taking Vyvanse it goes away. I grind at night due to TMJ, and have done that my whole life. I wear a night guard, but daytime clenching is due to medication. It’s an unconscious clamping up and then down like a nervous habit. Almost like chewing but it’s just clenching and unclenching the teeth. Unfortunately lots of people have that type of side effect with these types of medications, some even with antidepressants. Google clenching on Vyvanse or on ADHD meds.
I think you need to re-read Dr Matés book I did not get the impression he was saying ADHD is caused by generational trauma. He was saying trauma puts them at a predisposition for development of ADHD
I’d love to know the science behind why Elvanse, Concerta and Equasym made me either very depressed and zombie like, or angry. It’s been such a rollercoaster year trying all 3! Now onto Intuniv - it certainly doesn’t help executive function 😂 but enjoying the sleep! Thanks for your videos!
I find that dexamphetimine can help me get certain things done but can also cause me to focus more intensely and even ruminate on negative thoughts, trauma and grief. Whereas ADHD makes it difficult to remain focused on negative or positive thinking which is like a pendulum so I never get stuck very long in either types of thinking. I was thinking of trying Adderall instead, any thoughts from anyone??
Do they have an affect on Body Focused Repetitive Behaviors? I have dermatophagia and also bite the inside of my mouth. And i have panic disorder. But my adhd had a pretty stong effect on my driving and handling my kids. So we feel i need to be on stimulants, but its hard to tell of its making my anxiety/panic/BFRB worse.
Honestly, it depends on you yourself as a person. Starting or altering meds I've found does affect my sleep - but these are short term and it wears off after a couple of weeks. Longterm (so once the sleep sorted itself out), my amount of anxiety decreased massively as it was the ADHD that was causing most if not all of this
I wouldn’t say I have been addicted to my prescription adderall, but when I take time off of taking it(sometimes from forgetting to refill my prescription in time 😂) but I also just take breaks from time to time just because, I definitely have some withdrawal symptoms. They start on the second day after stopping and continue usually to the fourth day. Low mood and energy levels for me.
Interdose withdrawal from ADHD stimulants can increase aggressive behavior, apparently. Rage upon waking is seen until the stimulant dose takes effect. Time off the drug reduces morning rage, but morning rage doesn’t go away completely.
@@sarahsalom5452 well, this guy claims that morning rage is a feature of ADHD itself and not a feature of drugging people with ADHD - whereas I’m just observing my gf’s behavior on meds
Does ADHD medication effect your aging? Like smoking could make look older quicker. Is this true for Stimulants though? Has anyone experienced something like this or regret using them for any other reasons?
That medication (stimulants) are not additive at all. But one pill a day (like Vyannce XR) can make a difference, make you more efficient and creative at work, alleviate even the anxiety of making mistakes or forgetting deadlines, and increase the PSTD of being a failure to society and risking your financial situation losing the job. But what I blame is BIG Pharma for the high cost of medication and in Costa Rica, the poor or absence of the knowledge of adult ADHD. At my last appointment, my psychiatrist told me to avoid any medication and have a healthy life because that medication was harmful.
With respect to addiction vs dependence, when I stop drinking coffee, I crave it. When I don't take my Concerta, I feel like shit, but I don't crave it, nor do I have any impulse to take it.
How much does your average person benefit from using ADHD medication? I hear people talking about it as a performance enhancer. There are problems with these drugs that those who perscribe them don't want to talk about. It is their business and how they make money.
Why would the method of consuming a drug affect its addictive nature, if you drink opium you still get addicted , including withdrawal symptoms.i know this from personal experience, opiates are addictive regardless of which method of ingestion. I would have thought this was the case with any addictive substance.
The faster onset of a high (and potentially stronger high) of injection/snorting/smoking is much more reinforcing to the brain than the slower onset of a high via oral route-- higher peaks of dopamine are more rewarding and reinforcing
I'm guessing that there being a natural obstacle ( pill, injection or liquid) adds to an effect delay? The faster it work the quicker you get addicted? I'm no one important who's throwing guesses.
The way you consume it has massive influences. Let's take cocaine as a great example: It is drank in Peru daily, as coca tea. The leaves are somewhat harmless. Invaders/conquerors tried to ban the leaves, but workers simply became lazy. So they allowed the leaves again. You drink the tea, little bit of long term dopamine hits and that is fine. NOthing that bad happens. Now you take it out of the plants, create somewhat of power that can be snorted. Uptake and dosage is now much higher. Rather than taking 30-40 minutes, it now takes mere 5-10 minutes and the amount entering your system per minute is much, much higher. Your dopamine receptors get hit by a much, much higher flood than before. Also, no digestion, no liver first pass. Your dopamine spikes go way up. Now you see not only laziness, but a true depressive comedown, and within 45 minutes. So people go up and down and up and down and their personality is affected. The more often they go up, the harder they come down. And since dopamine is somewhat depleted, that down can last a day, or two, or even a bit longer. Now, enter the two worst ways to consume it: Injection and creating a smokable form, crack. Both allow you to get a very high amount of the substance into your system, in a very short amount of time. Your dopamine system is hit so hard, so fast, you get a massive euphoric situation. The peak of dopamine is off the charts. And then you repeat it. Your basal ganglia and d-receptors are overworked and once it goes down - boom, that heavy peak you just felt, it comes as a massively dark valley. You are instant depressed and likely, if you did it enough, your nervous system will be out of whack and you get other side effects of withdrawal. And that is all with the same substance. Route of administration and speed of uptake massively influence how someone is affected by a substance.
@@I_SEE_RED I would put it differently. When you are "dependent", it is like having glasses. I know i can live without my glasses. I just won't see that much. I can switch to contact lenses or do LASIC, but in the end, without aids, i will simply be shortsighted. With ADHD medication is quite similar. You can easily live without it. And since I donate blood, i get off it quite frequently. We require at least 72h of abstinence, so i usually make it a week. There is no "addiction" tendency where you really need that thing. At day 1, things are basically almost like the day before, a bit more chaotic. You sleep well. At day 2, when there shouldn't be any active trace anymore in your body, the chaos slowly returns. And tiredness. At day three, you are chaotic and tired, but it is like you have never taken anything and things really are... fine. Of course the reasons why you took it in the first place are there, but that is about it.
I think one factor to take into consideration is that pop-up online "prescribers" of ADHD are doing 20 minute meetings, usually with a nurse practicioner, to diagnose ADHD. This recent phenomenon likely has made the stimulant shortage worse as people who don't have ADHD (but may be slightly or moderately below average in EF domains) try to get these medications to help cope, thus making it harder for people who have been adequately assessed to get the medication they need to function.
Russ, can you disclose how much money and benefits you received from pharmacological companies? Did you pay for your international travel and hotels out of pocket yourself?
All studies are highly influenced by conformation bias. The all or none approach is and always has been the standard. Either your with or against. This leaves no room for nature (life) ebb and flow. We give a lot of lip service to individuality but in practice it's not recognized. I don't believe that we are deficient in a chemical however I do believe we are deficient in nutrients and over ingested with toxins. I would like to see us resolve this human induced biological shit storm but not by totally removing the crutch we developed before real alternatives are available. I appreciate your work in this area of behavior medicine. The desire to separate every little nuance do everyone in medicine can be a specialist is so short sighted. The synergy is paramount. Stay well!!!
Sorry but isn't absurd. That's what the scientific data resoundingly shows and personal anecdotes do not overturn results from controlled studies. See the International Consensus Statement on ADHD for references.
@@iliyanovslounge I looked it up myself and it reduces fertility. However what I said is still true due to the fact that amphetamines increase sex drive and men on it will get more people pregnant.
@@willissudweeks1050 I just referenced you the global scientific consensus which summates bodies of research showing why (primarily due to alleviation of disinhibition). It seems you either didn’t want to or couldn’t read it, but that’s not my problem.
Not everything that appears herritable is genetic; like generational trauma. Generational trauma can look like genetics. Until it's proven that my adhd is genetic, i'll try Mate's way and make a few trips to Oregon ;)
How much money do you get as a KOL shilling for pharmaceutical industry? These are very dangerous meds for kids over prescribed for very weak diagnostic methods to inform treatment. You know it!
01:10 it is literal meme in the adhd community that it is so addicting that people with adhd forget taking them...and need reminders to take it
Which is quite funny. And considering Vyvanse/Elvanse, they have a long half life. So may find yourself wondering, somewhere before lunch, if you should take it, or simply accept your forgot it, since it may hit your sleep if taken too late. Always juggling the big questions :D
Wait I'm confused. Why would something being addicting make you forget to take it?
@@bekksterlab Because it isn't ;) That is the joke.
@@bekksterlab The meme is kind of sarcastically saying, "Yeah, these meds are so addictive that I forget to take them!" It's just pointing out how the meds are NOT addictive (when taken as prescribed, of course).
I've never met an adult with adhd that needs reminders for their medication since they are not functional without. most if not all say if they stop they are incapable of doing work, worse than before taking them. this includes myself. Its silly to say it's not addictive, if the dependance it induces makes you want to be back on it.
Compared to an ssri which is only dependence forming, you don't crave the feeling of being on it, you just have weird withdrawals. Whereas with stimulants, you miss being confident in your ability to get things done, feel slightly more positive, and have withdrawal that causes extreme fatigue, sometimes depression, and all your adhd symptoms are worse.
The stigma surrounding ADHD is jaw dropping.
From experience of stimulant medication I can say my substance misuse has plummeted, in fact if I use cannabis with stimulants it's a negative effect. Its also "fixed" my brain, I'm calmer, thoughts are more organised, memory is improving, highly recommended using them while driving. Zero withdrawal while stopping due to shortages lately. Way too many benefits to warrant the stigma.
Of course, this also includes life style management and the good old paper and pen....at all times if you can.
Cheers Doc.
yes i reallized the stimulants are really helping in traffic... i'm absolutly less prone to reckless behaviour in the car, or on the bicycle when i took the meds.
Its actually illegal to drive with them in my country. Damned idiocracy
@@redbepis4600 in Germany they are allowed in Traffic when prescribed! Urine Tests will show degradation products of amphetamine so you should allways demand a blood Test... Those will show you Just took "Methylphenidat"..
I cried at 39 when my psychiatrist said, “3 to 5 percent of females with ADHD are OCD, it is the only thing that has ever saved you.” I always knew something was wrong but had so many doctors say I could not have it because I was too accomplished . I always wanted to attend medical school but knew something was missing. I asked her how long it would take for the medication to work, and she said that I would know immediately. I remember thinking this is what a level playing field is like. Adderall has been a game changer for me. Thank you for getting this information out.
That is an interesting observation - I don’t think I have clinical OCD, but I have a GAD diagnosis and lifelong hypervigilance. I think this attenuated my ADHD symptoms, fear lessening my inattentiveness (at a cost) and eliminating any potential risk taking activity. I’ve never heard a professional offer any support for this idea before.
I believe I inherited my phobic nature from my mother, via prenatal exposure to her high stress hormones, and while she had serious anxiety and significant executive functioning issues, I have never been able to decide if she might have ADHD. OCD is a definitely possiblity though.
Interesting. You just articulated what I couldn’t put a finger on. I was diagnosed with ADHD at 41 but I knew it was my OCD that helped/saved me to success. Now that my ADHD is managed, I took OCD meds and my living space has spiralled but I have peace of mind for the first time in years….
@@amydayrit lol 😂 I know exactly what you mean. When i noticed my house was more cluttered it bothered me at first…then I realized it was probably a sign that the meds were helping with my ADD as well as OCD. Compulsive thoughts can be helpful for intense intellectually difficult tasks or problem solving..it can also make you more creative, but when those thoughts turn for the worse and become paranoia they can be incredibly destructive to you and your relationships with your loved ones. I didn’t realize how compulsive my thoughts were until I started medication.
@@JB-qt3wo yes, I was totally on the obsessive part of the OCD. I was consumed everyday of order, symmetry, etc…my house was spotless. Nowadays, my house is cluttered. Now I wondered if I was originally sloppy, masked by OCD….I hope not.
@@amydayrit Yeah from what i’ve read the constant cleaning is an anxiety driven behavior. Seems like OCD is a by-product of cognitive anxiety that manifests differently from person to person.
I'm an adult who started stimulants recently - almost 4 months ago. Here's my subjective experience and opinion on addiction and dependence on medication:
- the stimulant medication I'm on is not addictive. In my personal feeling, my habitual coffee consumption was ACTUALLY an addiction, even if it's not as bad for you as alcohol or other drug addictions. I'd get headaches without my morning coffee or sometimes I'd be grumpy without coffee. Simulants aren't like that. Sometimes I can even forget to take it or misplace my pill in the morning - my body doesn't crave stimulants at all if I don't take them, there's no compulsion to take them. I recently had a cold, and decided that I needed to sleep to get over the cold faster. Stimulants prevent me from napping, and they do increase your blood pressure a bit, and I thought both of those things were not ideal when getting over a cold. The choice not to take medication on those days was very easy - no withdrawal, physically or psychologically. That said, one thing that I noticed on stimulant medication is that my coffee and energy drink cravings completely disappeared, plus I achieved a more significant level of alertness earlier on in the morning. I was worried that I would get addicted to stimulants, but the reality is they inadvertently, instantaneously cured me of a caffeine addiction. I'm saving so much money on coffee, diet pop/soda drinks, and energy drinks. Healthier too!Just going by my subjective experience, I can very easily see how simulants PREVENT self medication in people with ADHD, and actually prevent addiction. It's counter intuitive if your perception of stimulants is that they're drugs and all drugs are equally bad. But if taken as directed, orally, as Dr. Barkley said, I've never experienced anything remotely close to addiction.
- dependence. I'm referring to dependence in the following sense - once I start the medication, even if I'm not addicted to it, maybe I come to learn that I need to be on these pills for the rest of my life. Before I started taking them, I was scared of that possibility. The reality for me is that the stimulants are so helpful for basic tasks that I struggled with, that yes, I now believe that I need to be on some kind of ADHD medication for the rest of my life. That might sound scary to people, but once you're going through it, it's not scary. Once I saw the difference in my ability to "just do it" (basically follow through on my intentions), I have the opposite concern - I realized how much I need ADHD medication, and now I'm concerned about making sure I have access to medication for the rest of my life. Is this "dependence"? Philosophically maybe you could make the case that it is. But it's dependence like a diabetic is dependent on insulin or how someone with back pain needs a cane. I wouldn't judge them for using insulin or a cane; so why judge myself? I need medication to achieve the equivalent follow through and productivity as others. Stimulants help me do things like set up appointments, return emails, and keep calendars. I was living my life on hard-mode for so long without meds. It's nice to be able to function normally, I have so much catching up to do lol.
I had several family members and friends who encouraged me to try the medication. Here are some encouraging sentences that helped me.
- There's no evidence that it's addictive, so you can try it safely; if you don't like it you don't have to keep taking it.
- Stimulants are one of the best studied and most effective psychiatric medications. If you believe in drugs for depression, anxiety, or bipolar disorder, you should probably believe even more in the efficacy of ADHD meds.
- Ultimately words like addiction and dependency are just words since I'm not already struggling with addiction. What matters is the results, and there's lots of evidence that proves ADHD meds work. That's what matters.
This is a beautifully insightful comment, thank you :)
Can I ask you a question? You mention "I achieved a more significant level of alertness earlier on in the morning". In your experience, do you think this is a direct result of taking the medication on that day, or have you found that you already have alertness upon waking up, because of taking the medication regularly on prior days? I'm curious about this subtle distinction.
I've never taken a stimulant medication and still in a "curious" phase, so your comment about it is very appreciated!
@@seth_piano
The increased alertness is the direct result of taking stimulant medication on that day. If I do not take stimulants one day, then I do not benefit from the medication for that day. If I took simulants yesterday, they do not help me today; the affects are not additive. Medication like SSRIs (for depression) have what's called a "delayed onset of action"; they do work additively and can take weeks to kick in, and you benefit from their use throughout the whole course of the day. Stimulants are short-acting medications, like Advil or Tylenol; you only benefit from it the day you take it, and they wear off later that same day. However, science is great and they found a way to slow release stimulant meds into your body throughout the day, so even though they're a short-acting, they've been designed to work for 8 to 12 hours. This means you should only take an extended release stimulant once per day, at the beginning of your day. They help you stay alert, so if you take them too late in your day it can cause sleep issues.
When I take my stimulant medication, this is how I do it. Usually I'm a total zombie in the morning without medication. The night before, I set my meds up by my nightstand with water, and I set my alarm for 1 hour and 15 minutes ahead of when I actually need to be up. For example, if I know I need to start getting ready at 8am, I set an alarm for 6:45am. I take the stimulant at 6:45am, and then I go back to sleep. Usually 30 minutes later I start feeling it a little bit. 45-75 minutes after taking the pill, I am fully alert, and I can start getting ready for my day or for work. This has helped me a lot with getting to work on time, which I've struggled with all my life.
On my stimulant medication I am more alert, I have more follow through on tasks, I can manage my time better, I get distracted less, I can choose to focus on one thing, I procrastinate less, and I am less irritated by people. But it's not perfect. It helps me turn motivation into action, but if I have no motivation for a task, then stimulants don't help. The best analogy I've thought of is gas in your car as being motivation. Some people have gas in their car and some people don't. ADHD is like having gas in your car, but your accelerator is broken. Stimulants fix your accelerator, but they don't give you more gas and they don't upgrade your car. Basically, I think that stimulants are useful if you have ADHD, but if you don't have ADHD, it's probably not going to be that helpful. It doesn't give you motivation, and it doesn't make you smarter like college kids think it does. But, as a person with ADHD, I basically feel like 8-9 hours of my day are 30-50% easier on stimulants. I've heard that if you take your pill with food, especially protein, it lasts closer to 12 hours. I'm not sure if that's true, I want to test it.
My doctor said that I could take my pill with or without food. If your doctor says you should be taking your meds a certain way, listen to your doctor. Stimulant medication suppresses your appetite. That can exacerbate disordered eating or excessive meal-skipping in some people. Eating healthy snacks is important. One side effect of the medication that some people experience is called "crashing". Crashing is when the medication wears off for the day; you get tired and you have less will power than usual. Crashing for me lasts 30-60min. If I'm "crashing" plus I'm fatigued from accidentally skipping meals, the "crash" will last 3-4 hours and be more severe. The appetite suppression might seem like a bonus, but you risk wasting your entire evening if you skip all your meals. Eating healthy snacks throughout the day almost entirely prevents this for me.
These are just my personal experience. I think they're pretty standard for ADHD people who are prescribed stimulants, but people with ADHD can also experience medication in different ways. For example, stimulants can make anxiety worse. I'm not an expert on which meds are best, but I think it's important to be open to more than just stimulants. If you're convinced only 1 specific medication will work for you, it can be very discouraging if it doesn't work. Be open with your doctor about your experiences on meds, and be willing to make medication/dose adjustments. Non-stimulant medications can work better for some people.
That said, I have 0 experience with non-stimulant medications for ADHD. Basically everything I said here should be applied to stimulants only, specifically Adderall XR, though I've heard the other stimulants are similar. Also just understand that these are just my experiences which may or may not apply others. Some approaches I take may not be necessary or useful to others. For example, not everyone with ADHD has trouble with waking up in the morning, so for them it might be better to take their pill and start their day, instead of going back to sleep like I do. And maybe other people don't crash like I do. Working with your doctor is important, but I think self education and reading about other people's experiences can make it easier to identify how the medication is affecting you, so you can learn how to manage it better. Get lots of info from lots of different sources, don't trust just one person's recommendations. I think Dr. Barkley is an excellent source of info.
@@jamiejohnson5748 I'm really grateful for this thorough description. You really have outlined a really insightful first-person perspective of what this is like. Thank you so much
@@jamiejohnson5748This is an excellent depiction of how I experienced my 1st day on ADHD meds. However I took my pill too late in the morning and was unable to go to sleep that night also coming down with a cold too, so I will do it differently once I feel better. Waking up earlier to take them I definetley agree with and will try this. I'm keeping a diary which will help me track all the positives.
Hello, thank you for being out there on RUclips .❤️
I am a 64 year old female who has unknowingly survived life with undiagnosed ADHD.
PTSD was the diagnosis by a psychiatrist 4 years ago. I was given Sertaline , which i titrated down and discontinued after one year. There was no relief from the overwhelming symptoms.
After consulting with my psychologist, i followed up with my GP, i was told by them that testing is expensive and its a long wait list here. So i was given a low dose of methylphenidate to try for one week. What a difference one little pill has made in my everyday life! I am astounded at the focus and calm i am experiencing. Its been 3 weeks now, I am simply joyful .
Our lives are a journey and i am grateful to be able to live it more authentically.❤
Congratulations on your diagnosis even though unfortunately late in life. The studies of ADHD in the 1950s and 1960s included only boys, so several generations of girls, now women, were denied the opportunity for diagnosis and treatment. I hope you really enjoy your life.
I went undiagnosed until late adulthood as well. I was diagnosed at 47. My doctor said it’s likely because I was high functioning ADHD (not sure if insomnia, procrastination, chronic depression, and time blindness is high functioning though) and my higher estrogen levels masked the symptoms. Once I began entering menopause the estrogen drop revealed a myriad of other issues that I realized had been there all along, but the tricks I had learned to keep them in check no longer worked. They’re finding this is often the case with women who are diagnosed later in life. Loss of estrogen is problematic for female neurodivergents. I was on HRT and I think thats the only reason I was able to drop down to 10 mg of Vyvanse. I’m off it now and struggling. Will be back on it again soon. Good luck. ♥️
I've been taking my ADHD meds (both atomoxetine and methylphenidate) for over a year now and only just recently I've noticed a big improvement in my life.
If you've just started taking meds - don't give up!
Man, you've no idea how much this comment means to me. It's hard to have the patience sometimes, after months and months taking both and not seeing any meaningful improvements. Thanks
I feel I need them. I’m just curious. What is your age? I’m 52
@@AnnieandCC I'm 37 and was diagnosed as an adult
@AnnieandCC I’m 62, was in a deep downward spiral in recent years, and was just diagnosed and started meds this spring. I’ve had to stay very low dose so far, but I feel I am seeing what Dr. Barkley describes as an enhancing effect - I would actually describe it as rebuilding, because recent years’ stresses must have seriously damaged my prefrontal cortex.
I do have other things going on besides ADHD, and I think some changes this year (both good and bad) have been the effect of going off the SSRI I was on for a year and a half. But it really feels like the stimulant has helped improve my ability to reason and direct myself. If you’re 52 and female, I’ll note that I’ve heard a lot of women with ADHD, autism or both talk about what they view as a hit to their dopamine levels when they hit perimenopause. I think my mother was hit hard by this; I’m not sure if she had ADHD, but she certainly had executive functioning issues and real problems with what was then called PMS.
As I understand it, there is unfortunately almost no research to date on ADHD in older adults, and the idea that ADHD can get better but never gets worse as you get older is prevalent, and IMO based mostly on teenage to middle age. Dr. Barkley made a very helpful point in a recent video, that symptoms will remain consistent over time, but impairment may increase.
Assumihg you aren’t presently diagnosed: the critical thing for me in getting my diagnosis was that, even though I made it through to my fifties undiagnosed, I could in fact point to markers throughout my life indicating symptoms. This was important in that my parents were both deceased by the time I was diagnosed. If yours are still with you, having corroboration of childhood traits by an adult is very useful. If you’ve made it to 52, it may take some time to tease symptoms out; when I first looked at the DSM criteria, I could only identify about 4 hyperactive traits and almost no inattentive ones. I have a combined diagnosis, and by now I can see the traits in both categories very clearly.
Another consideration is that sometimes we don't build up the life skills that we need to succeed, and adding meds doesn't compensate for that.
Dear Dr. Barkley,
I want to write a simple thank you message here to you, thank you so much for opening this channel and sharing your knowledge and new development around ADHD. All your videos are insightful and valuable for me personally as a ADHD person, though I didn't watch these videos all.
I want to let you know I wrote this with tears in my eyes. Thank you from bottom of my heart for helping me improve my life, lives of my parents and my future children, it was lucky for me to get to know you and your work.
I wish you all the best!
You are so very welcome. And that was incredibly kind of you to say so. It touched me deeply especially now that I am retired.
Thank you for this. You have previously noted that ADHD meds are generally safer than other psychoactive meds, and based on my own experience I would be inclined to agree. What I have found is that certain medical professionals seem quite concerned about ADHD med safety, but can be almost cavalier about other meds. I do have a formal (and expensive) ADHD diagnosis, and lately have been trying to deal with a new prescriber who has repeatedly spoken in disparaging terms about a non stimulant ADHD med i take low doses of, yet pushed me to try an anticonvulsant med used mostly for epilepsy and bipolar. The drug in question did have siezure risks, but she seemed unconcerned about that.
Yea psychiatrists shit over adderall and then prescribe 5 anti psychotics at once. They don’t know what they are doing often.
I'd say the biggest issue is prescribing too high a dose. Often, parents see a big difference at a certain dose. When the parents see the big change, it should be backed off a bit, and the proper dose should be more subtle to the parents. I have been off and on stimulants my whole life, and I was 35 before I figured this out. Often going on to high a dose and saying the problem is the stimulants, not the dosage. Also, I regret all the years I went off stimulants as they were all wasted years where I accomplished nothing and had more drug and alcohol dependency.
Good indicator is if the kid says "I feel like a zombie" after taking Ritalin, you can take a few mgs off.
@FrankTaeger2021 ypu don't get that I have been a zombie feeling until you get off them. It's hard to have the insight while you are taking them. Especially for kids. And the right dose is so calming and peaceful too. I wish everyone could find the proper dose on this stuff. Like I said took me over 20 years to experience the perfect dose.
My son used to be able to take stimulants but now that’s he’s a teen he gets super anxious even on a lower dose….
On adderall and ritalin I've never gotten off the very smallest intro dose. They don't make 5mg adderall in extended release. But I'm hypersensitive and 5 mg in the morning and 2.5 at noon was the most I could handle before it caused serious sleep problems and was obviously too much. Non stimulants did nothing, or had me falling asleep standing up. So since I'm an adult, my dr wrote a narcolepsy med prescription for me.
Most adults I know that are taking adderall are taking something between 15 and 60 mg.
My whole point to all this is that you might want to talk to his dr and see if they can lower the dose or if there might be another option to try. And that there are more options that become available once he's an adult. @Intothelight72
I put off getting my son medicated for years because I was worried it would make his tourettes worse. Fortunately, his tics have decreased since starting his medication. What a relief. Wish I had started him sooner
I agree! Since being back on Amphetaminge based medication I feel far less pleasure seeking behavioural tendencies than when I had a desperation for Dopaminge.
Also if my mum had of let me be put on Amphetaminge when I was younger I know I would've done so much better at school because I absolutely love learning and since I've been back on it I have written an incredible amount of information and my subjects of interest considering previously I couldn't bare up a pen for 5 or 10inutes, let alone the 14 hours I've been known to be sat writing for! ADHD meds makes me feel like I've got my own hands on the wheel instead of being driven around by some maniac who learned to drive by playing Grand Theft Auto! Would still be nice to have a support worker again who has their own tools for incase I find myself driving onto the pavement, but at 32 years old I finally feel like I've got some level of control over my life instead of being dictated by the variety of symptoms that would turn this comment into a stupidly long essay.
I've thought about the risks. Of course, this was about an hour after I took my vyvanse. I'd rather be able to live a little before I do die. I wouldn't be able to even think about that without the vyvanse. Thank you Dr. B!
Dr. Barkley thank you for continuing to bring forth facts about the realities of ADHD and treatments for it. For those that still think it's "fake", what you are saying very much describes my life. I'm a 51 year old female with 4 grown children that within the last several years finally decided to try the medication method for myself, and I did not realize how badly I acted and paid attention until now looking back. I wish I had started medication when I was in 1st grade, or at least 2nd grade when I was first diagnosed. Again thank you for validation that I'm not just crazy.
I'm on Ritalin for 3 years now, 30 mg a day. To be honest I was afraid I developed some sort of addiction, because I feel that I struggle more on med-free days. I asked my psychiatrist about it and she said it is because I notice it more now, like when you need glasses and once you start using them, you feel like your sight is worse when you took them off.
Your work does so much more than any credit we or you or us could ever give you
Thanks again, Dr. B. I was JUST having a conversation with a friend about this very topic. I plan to send this to her to reinforce what I had shared with her. I am not a professional but a mom that has struggled for over 7 years with so much misinformation. I deeply appreciate the resources you provide. Grateful!
🎯 Key Takeaways for quick navigation:
00:00 🧠 *Introduction to ADHD Medication Myths*
- ADHD stimulant medications are often misunderstood.
- Addressing common misconceptions about stimulant medications.
- The need for a nuanced understanding of ADHD medication.
01:08 🚫 *Addiction Misconception*
- ADHD stimulant drugs are not addictive when taken orally as prescribed.
- Potential for abuse and misuse leading to addiction explained.
- Distinguishing between addiction and dependency on medication.
03:08 ⚔️ *Dispelling Aggression Claims*
- Contrary to popular belief, stimulants reduce aggressive behavior.
- Scientific evidence shows a decrease in criminal behavior.
- Addressing the misconception linking stimulants to aggression.
04:10 🧠 *Seizure Risk Clarification*
- Stimulants' seizure risk requires extremely high doses, not at prescribed levels.
- Studies demonstrate safe use with individuals having pre-existing seizure disorders.
- Clarifying the misconception about stimulants increasing seizure risk.
05:00 🤖 *Tics and Tourette's Syndrome*
- Stimulants may influence tick frequency, but not the development of Tourette's Syndrome.
- Recommending a cautious approach for individuals with tick disorders.
- Exploring the nuanced relationship between stimulants and tic disorders.
06:05 ☠️ *Suicide Risk Attribution*
- ADHD stimulants are not linked to an increased risk of suicide.
- Emphasizing that ADHD itself is associated with a higher likelihood of suicide attempts.
- Dispelling the misconception of stimulants causing suicide.
07:41 🎓 *Academic Achievement Improvement*
- Overcoming the misconception that stimulants don't improve academic learning.
- Longer-term studies show improvements in reading test scores and academic achievement.
- Highlighting the positive impact of stimulant medications on academic performance.
08:32 🚭 *Substance Abuse Risk Evaluation*
- More than 20 studies refute the claim that stimulant medication increases the risk of substance abuse.
- No evidence supporting the notion that stimulants lead to later substance abuse.
- Addressing and dismissing the misconception about stimulants and substance abuse.
09:25 🧠 *Long-term Use and Brain Damage*
- Oral use of prescribed stimulants does not show evidence of causing brain damage.
- Contrasting oral administration with studies involving direct injection into the brain.
- Positive findings indicating potential neuroenhancement with long-term stimulant use.
11:29 📈 *Prescription Rates and Overprescribing*
- Examining prescription rates nationally and debunking claims of overprescribing.
- Analyzing prevalence rates of ADHD and stimulant medication use.
- Considering variations in prescription rates across different regions.
13:03 💊 *Pediatric Dosing Misconception*
- Contrary to claims, evidence suggests pediatricians often use lower doses than experts recommend.
- Dispelling misconceptions about kids being overdosed on stimulant medications.
- Highlighting the importance of appropriate dosage for effective treatment.
14:14 🤯 *Medication as a Positive Intervention*
- Rejecting the notion that stimulants act as a "chemical straightjacket" or merely sedate individuals.
- Numerous studies demonstrate positive benefits, reducing various risks associated with ADHD.
- Emphasizing that stimulants contribute positively to individuals' well-being.
Made with HARPA AI
Thnx :)
I LOVE that someone is finally addressing ADHD myths! I would be really excited to see your take on Huberman’s episode on ADHD. I feel there were several inaccuracies in that episode.
what myths? All of these are true. I've experienced all of them.
Could you please make a video about the scientific literature on tics and its connection to stimulant medication and ADHD?
I'd like that as well!
Are the guidelines changing already?
Even if it is good in general that studies take their time, it's so important for individuals to get an adequate treatment sooner rather than later.
Thank you for the clarification. Can you please add the studies mentioned in the video description?
Thanks Dr Barkley for another highly informative and helpful video. Your videos are really important for those of us adults who have this condition and especially for those of us with the condition and who have kids with it too !
Thank you for talking about stimulant medications and talking about it from a factual research-based point of view. I talked a little about my experience with taking stimulant medications for my ADHD and it changed my life for the better.
There's a fine line between "addiction" and "dependency". There have been times when I haven't been able to get my medication for an extended period due to shortages or insurance, and I can tell you I definitely looked into acquiring it illegally.
Atomoxetine has made a significant impact in my ability to complete household care tasks, such as doing the dishes and managing laundry. These are tasks that are necessary but not stimulating, and so it was so hard to get myself to do them. Now they are no big deal. Also my anxious energy around holiday planning is gone, such as for menu planning, gift buying, decorating. I can just enjoy the task in front of me without my brain spinning out on all that is left yet to do. These feel like small but significant quality of life improvements.
I don't notice a lot of differences in my work, but I suspect there are improvements that I am blind to.
Just be aware, atomoxetine is not a stimulant, but comes with it's own set of risks and benefits. It is related, but not the same. I'm glad it works for you!
I'm so glad I found your videos.....very helpful so far
Thanks. It would be good to see a video on diet and adhd
I’ve been on Adderall for 20 year and although this isn’t technically “brain damage”, a SPECT scan showed that I had extremely low cerebral blood flow which is a known side effect of norepinephrine. Adderall also damages your natural dopamine pathways, causes oxidative stress and decreases acetylcholine which can cause dementia.
❤Thank you DR. BARKELY. As always your focus on science and data are immensely helpful. Your presentations are communicated so well that they are useful to share with people who are not knowledgeable about ADHD.
Do you have a video on non-stimulant meds? (Those in the cardiovascular ATC class). Asking because of interest in patient with EDS / autonomic issues (eg POTS, Raynaud's). Patient has inattentive type ADHD.
Thank you so much for your videos. They are a breath of fresh air!
I have a seizure disorder and it barely came up in my first appointment with my psychiatric care provider. She's under the same roof as my primary physician and they view the same records. Good to know why it was deemed irrelevant.
Seizure threshold is unlikely to be altered with ADHD medication, with the exception of wellbutrin (bupropion) which definitely does lower the seizure threshold
he answers this just after the 3 min mark. did you watch the video?
i'm surprised to hear you say that stimulants aren't addictive. I was diagnosed with ADHD when i was 27 and prescribed adderall 20mg, which made me euphoric. i said what i needed to say to my physician's assistant (who was already writing up the scrip before i got the words out) to increase my prescription to 30, 40, eventually 60mg, and soon was taking it in significantly higher dosage than was prescribed. in my opinion it seems odd and misleading to claim that stimulants aren't addictive "when used as prescribed." for many, stimulants - even at prescribed doses - provide a pleasurable effect that, when it starts to dissipate, can quickly lead to taking more than prescribed. if the prescribed dosage of a stimulant leads a number of people to abuse it the point of addiction, is it not addictive at the prescribed dosage? what do you make of all the addiction centers specializing in the treatment of stimulant addiction? why do i know so many people who have had similar experiences as i have? i also don't understand the relevance of the distinction between dependence and addiction. it is utter bullshit to argue that someone can't develop a physiological dependence on stimulants. when i inevitably ran out of my month's prescription of adderall after 2-3 weeks, the crash would be wretched... nasty, nasty depression, a voracious, insatiable hunger, total fatigue and lethargy... the bulk of these symptoms could perhaps be attributed to the lack of sleep, loss of appetite, and dehydration that tend to accompany stimulant use, and not, i guess, the drug itself. but what does that matter? i'm not at all arguing that stimulants have no place in the treatment of ADHD. but to gloss over the many people who are prescribed stimulants, come to abuse them, and develop an addiction/a dependence/whatever you wanna call it - to the point that it significantly interferes with normal functioning far more than the neurodevelopmental disorder it was prescribed to treat does - is irresponsible. it is an erasure of the very real experiences of many people who respond quite negatively to stimulant prescriptions, and it ensures that nothing will be learned from those experiences or done to prevent them from recurring. what percentage of patients who are prescribed stimulants need to respond in this manner for you to recognize these experiences as 'real'?
The risk of addiction does depend on several factors, including the person's individual response to the various substances, and whether there's a history of addiction to stimulant drugs prior to the ADHD pharmacological treatment. In these cases, it's usually better to try a low dose of an extended release formulation (ex. vyvanse instead of adderall for the amphetamines; concerta or foquest instead of ritalin or focalin in the case of methylphenidate). There's also the option of using a non-stimulant targeting norepinephrine / noradrenaline, as those indirectly contribute to increased dopamine concentration at the synapses.
The responsible thing to do is documenting pre-existing addiction behaviors (substance-based or otherwise), followed by trying the pharmacological sequence with the lowest addiction potential first (non-stimulants, then extended release stimulants, and finally the short-acting stimulants), and documenting the side effects to stop the use before they become too problematic.
I had an interaction between Concerta and Escitalopram causing 4-hour episodes of tachycardia. No such episodes since switching to Adderall, but be aware of potential side effects while taking ADHD meds and SSRIs at the same time.
Just curious, which medication were you on first and which was added (if they weren't started at the same time)? Tachycardia could potentially be the concerta alone but its def warranted to monitor for symptoms of serotonin syndrome whenever you add serotonergic agents on top of SSRIs
isnt tachycardia normal with stimulants
@jleahul interaction between vyvanse and pseudophedrine warning
I doubt that I'm addicted to Concerta when I frequently forget to take it on time. I AM addicted to caffeine though.
Amphetamine helps with my ADHD a ton, i also found that i can even sleep after taking 0.25-0.35g of amphetamine if am actually tired before taking it. No side effects so far. Maybe slight "addiction" but not physical to be exact. Addiction from the fact that it brings mental focus and clarity which leads to improved productivity which leads to being able to prolong gratification and work hard on any subject that i choose to. And this "relief" syndrome can be quite addictive. Because you finally find something that is actually working.
There is way more to add but this comment would have been too long and too tiring for me at the moment.
I just find it extraordinary that solution to such complex problem as ADHD is so simple.
Could it be the case that children diagnosed and medicated may show fewer symptoms as adults as they could have 'rewired' their brains (i.e. learned) to more effectively learn habits, behaviours and thought processes as opposed to those undiagnosed until adulthood?
Atomoxetine was causing me to experience testicular pains required an ultrasound to rule out any conditions, eventually once I quit taking the drug, the pains went away. Thank you doc!
Myself, I receive a calming effect when I drink coffee. I spoke with a Neurologist that would rather patients take their prescribed stimulants rather than consume copious amounts of espresso/coffee.
Hello, and thank you for sharing your amazing knowledge with the world! I have heard Prozac and Paxil can adversely react with adderall, vyvance, and dexedrine. Has there been studies that have reliably proven this? If not, have you seen this in your practice to make you believe there is a relationship? I love everything you do, and as a nurse practitioner, person with adhd, and 2 sons with ADHD, I am so inspired by you and grateful for what you give back to your ADHD community! Thank you, thank you, thank you.
Dr. Barkley, thank you so much for your work. Do you have any video on BPD and adhd or any article? I would appreciate if you can make a video on this topic. It’s really confusing when it comes to diagnosis for adults. Thanks again!
Yes, I agree on the aggressiveness, the meds make me more calm and relaxed, I drive much less stressed
is sublingual absorption of methylphenidate comparable to nasal? Studies suggest sublingual dosage is up to twice as bioavailable as taking it orally, and it certainly enters the bloodstream faster
Having been on lisdexamphetamine for almost a year now, one hundred percent I believe it makes people less aggressive, not more aggressive. The FIRST thing I noticed at even the LOWEST dosage was a huge drop in impulsive anger. That SEARING RAGE I would feel tear through my skull at the smallest interruption or annoyance went pretty much entirely away. I still feel angry at things that would make anyone angry, but that horrible white hot rage at the smallest of small shit? Good fucking riddance to that and thank you Vyvanse.
Same...I noticed I don't feel super irritated by work emails and interruptions like I used to be. I'm much more even-keeled with my work now. (Also on Vyvanse)
Many things here speaks to the tragedy that when a 16 year old had been made to quit his ADHD-medication quite abruptly at the same time as he was moved to an abusive environment where most people didn't share his language. He ended up tragically killing someone innocent who also was controlled by under this abusive culture. (I'm talking about Scientology).
As far as I understand this boy was not seen as competent to stand trial and he was placed in a psychiatric facility. I can't help but being worried about if he is lucky enough to have competent and caring professionals or not. If not he must be att great risk of spiraling downwards with no or little chance of increased quality of life.
The latest I heard of this was four days ago on the channel of Mike Rinder. The videos name is" Scientology's Big "Blood on Your Hands"
Lie Exposed".
I've never really had much or any tics with stimulant meds during its time of effect. Instead I do sometimes have A LOT of tics for about 15- 30 minutes 30-90 minutes or about 12 hours after taking the meds. In between there's nothing at all. More interesting to me is that I had less or less noticeable tics before trying bupropion. It's been 2 years since I stopped using it and I'm still not entirely sure if bupropion caused or worsened the tics or just made me notice them consciously. I suppose the latter seems more likely, because the former would mean the meds caused possibly permanent side effects.
But at the end of it, the only way tics have really bothered me was when I felt ashamed of them. Once I stopped caring what others think about it, they're really nothing but a way to recognize the adhd freeze as overstimulation rather than under.
On aggression: I personally have found since beginning adhd meds in adulthood (as a mid-20's male), I have had a serious tendency to yell. I take no other medications. I'm very soft spoken, and this external anger seems to solely occur when I take adhd meds.
Thank you so much for dispelling these myths - thank you 🙏
He didn't provide any evidence for his claims lmao but ok
I will also note that many of the documented benefits or potential benefits of stimulants are less known for the nonstimulants - as just one example, the recent Israeli dementia study showed dementia being fourfold more common in those with adult diagnosed ADHD, but people with ADHD returned to average rate if treated with stimulants - it wasn't compared for the very different nonstimulants, for whatever reason. If dementia can be prevented, that elevates the human and financial cost of lack of treatment significantly. When we experiment with other medications, we are possibly eliminating a possible risk, but may be eliminating a possible benefit.
how did they show that? Did they do a lifetime long study?
@@TheDavveponken used general population data for a group in Israel that is better tracked and with more available data than other places. So, you look at everyone diagnosed in a population of a few thousand or hundred thousand and everyone diagnosed with ADHD x number of years ago, how are they doing now with different treatments - various issues that means more studies are needed, but that is true for everything - you can Google Israel ADHD dementia study JAMAnetwork and that should find it.
Sounds kinda sketchy not gonna lie
Thank you for these valuable information, can you please share what are your thoughts on the medications limiting hight growth at preteen/teen age years , is that true or is it a myth ?
I hope that Dr Barkley can share some of the down sides to stimulant meds.
You seem to forget Richard Fee's Adderall addiction. Where's he these days? Adderall is a drug and can be addictive if taken anyway. Snorted, or orally. Fee was smashing plant pots, threatened to run his parents over, drilling holes in walls, talking to stars, thinking cameras were spying on him, was committed. So it can increase aggression. Causes suicide. Did in Fee's cause or John Edwards III.
Richard Fee was diagnosed with ADHD in August 2009.
Do we have any information if and how the time necessary for long term improvement alters, when taking medication with off days? I for example take it Mo-FR and leave it out at the weekends, based on the prescription and recommendation from my Psychiatrist.
Good to see this mentality isn´t a problem just where I live. Rural eastern Germany pretty much still lives in the medieval age when it comes to such issues.
Thank you so much for this video
"Sedating into submission" would indeed be very out of place with a stimulant that makes one "more awake" than baseline, as it is the polar opposite of sedation.
Also a lot of success is about productivity, and lack of productivity leads to poor outcome. Should be undeniable that increase of productivity is helpful in someone's life in the society with its demands, and the endless procastination can ruin it.
In younger children with ADHD, the stimulants are often effective to curb out hyperactive behavior. With them, the most noticeable effect is enhancing inhibition of motor impulsivity. Now, a problem is that toddlers / pre-schoolers specifically are prone to overdosage with ADHD meds, and specifically those with methylphenidate as the active ingredient. Excessive doses of this medication cause flat affect and emotional blunting, on top of the inhibition of motor impulsivity. This is what's being described as making the toddlers 'doze off' or act as zombies.
The caveat here is that official drug regulation bodies (ex. the FDA) specifically advise against using ADHD stimulant medications on children younger than 6 years of age, because the ratio of side effects to intended effects is less favorable (too many side effects for the intended effect).
Thank you Doc👍
Thank Uuuuu Dr. Barkley!
Thanks for the very informative video!
I myself am on dexamphetamine (adderall), I've been on the same dosage for 4 years, 2-3 pills a day (10-15 mg).
It's a relatively low dosage, especially for such an extended period of time but taking more I experience side effects, at this level it's helpful for me and it makes me able to concentrate and function better than without the medication.
Unfortunately health insurance doesn't cover this particular stimulant so I pay for it myself, that's honestly the only real complaint I have.
Great info!
Thank you
Where I can find the full list of ingredients in Ritalin? So far impossible to find.
I believe that can actually vary between which manufacturer your med is from.
@@SecretSqrlGrl007 That makes sense, it's probably proprietary information. We can know exactly what food products contain, but not drugs.
I’m curious if Ritalin is more neuro-protective to the brain than Adderall due to the fact that it increases neuronal firing…aren’t Amphetamines toxic to the brain??
We don’t know which drug is more neuroprotective but amphetamine is not toxic when taken as prescribed. Only when abused. Be well b
Your videos are compelling. However - how do we get a diagnosis that is accurate? Doctors do not seem to know what adhd even is…..
I spoke to two lifelong Cardiologists who said that stimulants caused cardiac damage in their patients. Thoughts?
Recreational stimulant abuse, or therapeutic dosages for treatment of adhd? if it was for the treatment of adhd with no med misuse, then the literature is very clear that adhd medications is most likely to be noncontributory to cardiac health, unless comorbidity is present
@@Nazula236 Therapeutic. These were not drug abusers, but middle-upper class types with health insurance.
@@RuthlessandDisciplined Interesting. If someone already has a history of cardiovascular disease, such as high blood pressure, certainly stimulants can worsen those conditions and further increase cardiac risk. The marginal increase in heart rate and blood pressure from therapeutic doses of ADHD medications aren't likely on their own to cause harm in an otherwise healthy person, if anything the ADHD itself would be more contributory to negative cardiac outcomes independent of stimulant use. Of course the physicians knew their patients background, history, etc. so its impossible to draw conclusions over the internet
Even non-stimulants made my BP increase significantly. I've tried Wellbutrin and Straterra. Straterra gave me significant chest pain and tachycardia. My research on how these two meds can impact other organs, including the heart, was concerning to me.
I'm not an expert or anything, but I'm pretty sure I've heard Dr. Barkley mention in the past that properly dosed stimulants might actually contribute to a decreased cardiovascular disease risk in people with ADHD through indirect means. So the medication would help you manage other lifestyle factors such as having a healthy diet, exercising, managing stress, lower rates of substance abuse, etc. which those then have a more direct impact on CVD risk.
I'm pulling this from memory from a lecture of his I saw a while ago, titled, "Special Presentation: Health and Life Expectancy in ADHD. Treatment Matters More Than You Think" you can search on youtube if you're interested.
How about amphetamines when are used along side other medications like SSRI or SNRI?
Good morning from the UK 😊 I hv lately been diagnosed with ADHD ( I suspected it for about a year but got full on l diagnosis in November 23' ) I am an entry level academic myslef ( ecologist /naturalist ) and I'm very greatful for your scientific based free education on social media.
I wonder would you be interested in pointing me into right directions as per the neuro-enhancement.
I'm taking concerta for about 4 weeks now but I have discovered and interesting side effect - if I could call it such. Even when the medication wears off ... my nervous-system seems to be calmer overall ( I'm happy to explain more in a DM if you wish)
So my question here is : are there any studies that have been done in this area .... as this to me sounds like the neuro-engancement, neuro-protection that you have mentioned in today's presentation. Perhabs 4 weeks is just a placebo effect ( I was really hoping for this meds to work 🙂) but I'd love to read some research about that.
I'll be most grateful for any info from yourself.
Have a great day Sir and thank you for your work !!! 🙏🏽
Looking at the package insert of lisdexamphetamin it clearly states "aggression" as a side effect of unknown quantity.
Furthermore there are other side effects that could be viewed as connected to aggressive behaviour (e.g. mood swings).
Looking at the package insert of atomexetin it includes suicidal thoughts and other related symptoms as side effect.
So would be nice if you could clarify.
At the wrong dose yes. But an adjustment will fix these.
@@matt.108
That's not the point. When a medication prescribed by a doctor can cause those side effects you cant call these side effects a "myth".
A myth is something that is not true but commonly believed in. But these side effects are true and known and thereby not a myth.
These are too absolute to be considered as a solid fact. Addiction isn't limited to snorting and injection. Reported aggressive behaviors are usually due to a sudden drop in dose of medicine, which would be known as a withdrawl. Which would be a symptom of addiction.... Because the anger burst is a result of a physical change in chemical levels which causes physical stress I would say that it qualifies as a physical reaction to the lack of the drug.
Suicide.... I'm 34, diagnosed at 6. I haven't had any suicidal thoughts in my life.... Until I started medication as an adult. I only have ever had one moment in my life where that thought crossed my mind and it was when I was starting the meds as an adult, 9 days in. You can't say that the drug doesn't induce or encourage the chemical imbalance that leads to suicide or suicidal thoughts. You simply cannot. Show me the MRI that backs this up. Map the brain and show me how it's the ADHD and not the meds. You can't.
It's well known side effects of the meds, so do understand either.
I have developed clinching and unclenching of my teeth during the day now, but before Vyvanse I was only a night time clincher, grinder. I also purse and pucker my lips now both day and night and did not do that before Vyvanse. It’s so bad that I get spasms and locking. When I’m off of vyvanse I do not clench during the day unless there’s severe stress. I do still purse and pucker my lips but if off of Vyvanse for a significant time that symptom decreases significantly. It’s honestly the only annoying side effect. I have tachycardia due to POTS so had to reduce from 50 mg to 10 mg Vyvanse. The clenching and puckering is the same on 10 mg as it was on 50 mg.
my guy, i hope you are reading this. the solution to your problem might be this: drink one glas of salt water in the morning, one in the evening. doesnt have to be vomit inducing, but so that you can drink it without to much bother. try it 3 days, the effects will be pretty immiediate. you are down on elektrolytes, this has a huge effect on the heart and the brain.
@@grummelameise No I’m not. I add very balanced Electrolytes to my water regularly and I also take salt/electrolyte tablets. I’m not dehydrated or lacking anything. Having POTS I have to make sure everything is good or low electrolytes are the least of my worries. It’s due to the Vyvanse. I appreciate the response, but I know the issues that I grapple with and why. When I stop taking Vyvanse it goes away. I grind at night due to TMJ, and have done that my whole life. I wear a night guard, but daytime clenching is due to medication. It’s an unconscious clamping up and then down like a nervous habit. Almost like chewing but it’s just clenching and unclenching the teeth. Unfortunately lots of people have that type of side effect with these types of medications, some even with antidepressants. Google clenching on Vyvanse or on ADHD meds.
I think you need to re-read Dr Matés book I did not get the impression he was saying ADHD is caused by generational trauma. He was saying trauma puts them at a predisposition for development of ADHD
What about liver damage?
I’d love to know the science behind why Elvanse, Concerta and Equasym made me either very depressed and zombie like, or angry. It’s been such a rollercoaster year trying all 3! Now onto Intuniv - it certainly doesn’t help executive function 😂 but enjoying the sleep! Thanks for your videos!
Idk, but the mystical science leads me to revisit the song concertina by Tori Amos. Channeling objective information from correlated streams.
Clouds descending…
This I swear you're the fiercest calm l've been in.
Love Her lots! What a sweetheart!!
What about tics that are induced by the medications?
Good question. It’s about 3-5% have a tic reaction that should subside in a week or less after discontinuation.
I find that dexamphetimine can help me get certain things done but can also cause me to focus more intensely and even ruminate on negative thoughts, trauma and grief. Whereas ADHD makes it difficult to remain focused on negative or positive thinking which is like a pendulum so I never get stuck very long in either types of thinking. I was thinking of trying Adderall instead, any thoughts from anyone??
Do they have an affect on Body Focused Repetitive Behaviors? I have dermatophagia and also bite the inside of my mouth. And i have panic disorder. But my adhd had a pretty stong effect on my driving and handling my kids. So we feel i need to be on stimulants, but its hard to tell of its making my anxiety/panic/BFRB worse.
Try no caffeine, no cigarettes on meds, try your best to stay away from stress.
What about anxiety? I already sleep about 5 hrs/night, how would that further affect my sleep.
Honestly, it depends on you yourself as a person.
Starting or altering meds I've found does affect my sleep - but these are short term and it wears off after a couple of weeks.
Longterm (so once the sleep sorted itself out), my amount of anxiety decreased massively as it was the ADHD that was causing most if not all of this
I wouldn’t say I have been addicted to my prescription adderall, but when I take time off of taking it(sometimes from forgetting to refill my prescription in time 😂) but I also just take breaks from time to time just because, I definitely have some withdrawal symptoms. They start on the second day after stopping and continue usually to the fourth day. Low mood and energy levels for me.
That’s normal but does go away pretty fast. The withdrawals from SSRI’s are far worse and last much longer.
@@matt.108 dang, what are they like if I may ask?
Interdose withdrawal from ADHD stimulants can increase aggressive behavior, apparently. Rage upon waking is seen until the stimulant dose takes effect. Time off the drug reduces morning rage, but morning rage doesn’t go away completely.
What do you mean, morning rage doesnt go away completely? So if I went off my meds forever, I would just have permanent morning rage?
@@sarahsalom5452 well, this guy claims that morning rage is a feature of ADHD itself and not a feature of drugging people with ADHD - whereas I’m just observing my gf’s behavior on meds
Vyvanse and Adderral XR both made me very aggressive and anti-social even at 15 mg and 10 mg, respectively.
Does ADHD medication effect your aging?
Like smoking could make look older quicker.
Is this true for Stimulants though?
Has anyone experienced something like this or regret using them for any other reasons?
That medication (stimulants) are not additive at all. But one pill a day (like Vyannce XR) can make a difference, make you more efficient and creative at work, alleviate even the anxiety of making mistakes or forgetting deadlines, and increase the PSTD of being a failure to society and risking your financial situation losing the job. But what I blame is BIG Pharma for the high cost of medication and in Costa Rica, the poor or absence of the knowledge of adult ADHD. At my last appointment, my psychiatrist told me to avoid any medication and have a healthy life because that medication was harmful.
Mate tee strong!
DOC...WILL YOU DO A TEDX TALK????????
With respect to addiction vs dependence, when I stop drinking coffee, I crave it. When I don't take my Concerta, I feel like shit, but I don't crave it, nor do I have any impulse to take it.
How much does your average person benefit from using ADHD medication? I hear people talking about it as a performance enhancer.
There are problems with these drugs that those who perscribe them don't want to talk about. It is their business and how they make money.
Is it a myth that stimulants improve everyone’s performance?
I don't know about him??
ritalin 10mg does nothing to me. i just sit quietly lol
Why would the method of consuming a drug affect its addictive nature, if you drink opium you still get addicted , including withdrawal symptoms.i know this from personal experience, opiates are addictive regardless of which method of ingestion. I would have thought this was the case with any addictive substance.
The faster onset of a high (and potentially stronger high) of injection/snorting/smoking is much more reinforcing to the brain than the slower onset of a high via oral route-- higher peaks of dopamine are more rewarding and reinforcing
I'm guessing that there being a natural obstacle ( pill, injection or liquid) adds to an effect delay? The faster it work the quicker you get addicted?
I'm no one important who's throwing guesses.
The way you consume it has massive influences. Let's take cocaine as a great example: It is drank in Peru daily, as coca tea. The leaves are somewhat harmless. Invaders/conquerors tried to ban the leaves, but workers simply became lazy. So they allowed the leaves again. You drink the tea, little bit of long term dopamine hits and that is fine. NOthing that bad happens.
Now you take it out of the plants, create somewhat of power that can be snorted. Uptake and dosage is now much higher. Rather than taking 30-40 minutes, it now takes mere 5-10 minutes and the amount entering your system per minute is much, much higher. Your dopamine receptors get hit by a much, much higher flood than before. Also, no digestion, no liver first pass. Your dopamine spikes go way up. Now you see not only laziness, but a true depressive comedown, and within 45 minutes. So people go up and down and up and down and their personality is affected. The more often they go up, the harder they come down. And since dopamine is somewhat depleted, that down can last a day, or two, or even a bit longer.
Now, enter the two worst ways to consume it: Injection and creating a smokable form, crack. Both allow you to get a very high amount of the substance into your system, in a very short amount of time. Your dopamine system is hit so hard, so fast, you get a massive euphoric situation. The peak of dopamine is off the charts. And then you repeat it. Your basal ganglia and d-receptors are overworked and once it goes down - boom, that heavy peak you just felt, it comes as a massively dark valley. You are instant depressed and likely, if you did it enough, your nervous system will be out of whack and you get other side effects of withdrawal.
And that is all with the same substance. Route of administration and speed of uptake massively influence how someone is affected by a substance.
Oh wtf. I had the addiction and dependence definitions switched around in my mind.
So addiction isn’t inherently psychological?
there’s no difference, you’re just accepting addiction and calling it dependence because you’re choosing it and accept the side effects
@@I_SEE_RED Pretty sure the clinical definitions are different.
@@I_SEE_RED I would put it differently. When you are "dependent", it is like having glasses. I know i can live without my glasses. I just won't see that much. I can switch to contact lenses or do LASIC, but in the end, without aids, i will simply be shortsighted.
With ADHD medication is quite similar. You can easily live without it. And since I donate blood, i get off it quite frequently. We require at least 72h of abstinence, so i usually make it a week. There is no "addiction" tendency where you really need that thing. At day 1, things are basically almost like the day before, a bit more chaotic. You sleep well. At day 2, when there shouldn't be any active trace anymore in your body, the chaos slowly returns. And tiredness. At day three, you are chaotic and tired, but it is like you have never taken anything and things really are... fine. Of course the reasons why you took it in the first place are there, but that is about it.
I think one factor to take into consideration is that pop-up online "prescribers" of ADHD are doing 20 minute meetings, usually with a nurse practicioner, to diagnose ADHD. This recent phenomenon likely has made the stimulant shortage worse as people who don't have ADHD (but may be slightly or moderately below average in EF domains) try to get these medications to help cope, thus making it harder for people who have been adequately assessed to get the medication they need to function.
Thank you! This was a huge worry of mine before starting meds!
damn I'm almost jealous. They took about 4 hours of tests to diagnose me
Russ, can you disclose how much money and benefits you received from pharmacological companies? Did you pay for your international travel and hotels out of pocket yourself?
Do you cite your sources anywhere?
Adderall seems to cause my gf to curl and uncurl her toes repeatedly.
😂 i wish my adhd got me pregnant more 😅
Adderall: Both useful and fun
Neurotypical people do not fair well at all
All studies are highly influenced by conformation bias. The all or none approach is and always has been the standard.
Either your with or against. This leaves no room for nature (life) ebb and flow. We give a lot of lip service to individuality but in practice it's not recognized. I don't believe that we are deficient in a chemical however I do believe we are deficient in nutrients and over ingested with toxins. I would like to see us resolve this human induced biological shit storm but not by totally removing the crutch we developed before real alternatives are available.
I appreciate your work in this area of behavior medicine. The desire to separate every little nuance do everyone in medicine can be a specialist is so short sighted. The synergy is paramount. Stay well!!!
I like how you give a tutorial on how to misuse the drugs to get high
14:50 I love your work but saying adderall reduces pregnancy is absurd. You know how horny you get on that?
Sorry but isn't absurd. That's what the scientific data resoundingly shows and personal anecdotes do not overturn results from controlled studies. See the International Consensus Statement on ADHD for references.
@@iliyanovslounge 🤓🤓🤓 Why don’t you explain why?
@@iliyanovslounge I looked it up myself and it reduces fertility. However what I said is still true due to the fact that amphetamines increase sex drive and men on it will get more people pregnant.
@@willissudweeks1050 I just referenced you the global scientific consensus which summates bodies of research showing why (primarily due to alleviation of disinhibition). It seems you either didn’t want to or couldn’t read it, but that’s not my problem.
Not everything that appears herritable is genetic; like generational trauma. Generational trauma can look like genetics. Until it's proven that my adhd is genetic, i'll try Mate's way and make a few trips to Oregon ;)
How much money do you get as a KOL shilling for pharmaceutical industry? These are very dangerous meds for kids over prescribed for very weak diagnostic methods to inform treatment. You know it!