Hacker News Reader

Comment by nick__m | Hacker News Reader

It's somewhat more subtle, pure medical grade methamphetamine (desoxyn) taken orally is theoretically the best ADD medicine available but it's almost never prescribed for political reasons.

Meth has lot less sympathetic side effects than dextroamphetamine per unit of dopaminergic stimulation, this simple difference enables abuser to consume ridiculously large dose and those high doses are destructive.

https://astralcodexten.substack.com/p/know-your-amphetamines

View on HN

Amphetamine-like drugs are used as pills or capsules, powder, or fluid, and can be ingested orally, smoked, insufflated, or injected intravenously. They cause euphoria but tolerance develops rapidly. Clinically evident effects of the two drugs are nearly indistinguishable, but methamphetamine appears to be a more potent stimulant. Amphetamine and methamphetamine induce euphoria, increased energy, alertness and libido, agitation and anxiety, increased locomotor activity and stereotypical movements, as well as hyperthermia, increased heart rate and blood pressure, vasoconstriction, bronchodilatation, hyperglycemia, and suppress appetite. Psychosis, hyperkinesia, seizures, and coma have been described in emergency patients. Chronic users may develop behavioral disorders, impulsivity, punding (non-goal directed repetitive activities), hallucinations, tremor, choreoathetosis, dystonias, ataxia, and gait disturbances (41–43). Stereotyped involuntary choreoathetotic hyperkinesias are characteristic in arms, neck and head, and usually disappear during sleep, while teeth grinding (bruxism) may occur during day and night. Movement disorders may develop during abuse or abstinence, and though they a usually resolve within few days, they may remain for a long time in some cases, even after the abuse of amphetamines is stopped. Treatment with benzodiazepines or neuroleptics may be of benefit (43–45). Choreiform movements have developed as an adverse effect in the therapeutic setting of amphetamine used in the treatment of ADHD in adult and pediatric patients (46, 47).

[41] https://www.ncbi.nlm.nih.gov/pubmed/23688691/

[43] https://www.ncbi.nlm.nih.gov/pubmed/3355623/

[45] https://www.ncbi.nlm.nih.gov/pubmed/7299411/

[46] https://www.ncbi.nlm.nih.gov/pubmed/22883290/

[47] https://www.ncbi.nlm.nih.gov/pubmed/15254949/

Yes, the dose makes the poison and yes medicl amphetamines are sometimes abused but the literature you cited¹ isn't really about the medical use of amphetamines. Those papers are about the abuse of amphetamines.

From my experience with Vyvanse I find that amphetamines have a dose response function with linear and exponential steps. 15mg is barely perceptible, 30mg is like a coffee without the anxiety but it last 8 hours. 45mg is like 30mg but a little longer. 60mg in 2 doses (first pill at 7am and next one at 9am) is a perfect treatment against my ADD. Once I tried 90mg and it was terrible, I experienced bruxism, anxiety and hyperacidity for 18 hours. I am sure that I would develop the problems you listed if I were to take 90mg a day but 90mg of Vyvanse is supratherapeutic...

1: Link 41 is about abuse (supratherapeutic and frequent doses). Link 43 I can't comment as I don't have acces but it's an old paper from 1988... Link 45 is about abuse again. Link 46 is about accidental ingestion by a baby. (a therapeutic dose for a teenager is clearly supratherapeutic in a 8months infant) Link 47 is probably about abuse (the abstract talk of reversible consequences of dose escalation) but I don't have acces to the paper.

You can't avoid capillary vasoconstriction at any dose and that's what makes your teeth rot and gums go bad. Nothing you can do about that. I've used Adderall and Vyvanse many many years ago for "ADHD" as well. Bad breath and increased gum issues made me stop well before any damage occurred.

I was prescribed desoxyn for adhd - didn't seem particularly hard to get...

Reply on news.ycombinator.com