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Comment by throwasquirrel | Hacker News Reader

How long does someone have to be on stimulant medication before you consider them qualified to comment on its effectiveness?

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You can comment anytime, but people who have been using it less than a decade won't be able to comment on the medications post-tolerence decrease in effectiveness and side effects.

If it takes a decade to build up tolerance and a month to completely get rid of it then sustainability seems clear, no? The problem isn't physical dependence but mental dependence, ADHD forces you to become super strict with yourself to get anything done at all, medication makes you lazy since you just pop a pill and get things done, if you stop trying after getting the pills you will start having problems again just like normal people, but if you keep working as hard as before you took the pills then their effects doesn't go away.

Tolerance to the euphoric and motivating effects builds much faster than a decade. More like a few weeks.

It’s a common problem with new ADHD patients. They mistake the euphoria and motivation for the therapeutic effect, then complain that it isn’t “working” any more and ask for progressively higher doses. Some eventually start doctor shopping to find someone who will prescribe higher doses when their provider refuses.

On the decade time scale the negative effects I've heard reported are mostly clustered in the amphetamine psychosis category

Have searched Google scholar for quite a while for long term studies (I believe vyvanse was FDA approved 2009), could you help guide on this?

Warning anecdotal but a close neuro doc friend sees 70+ Year olds who took their medication as prescribed still fine when adherence was high. But much more interested in your link if at all possible, I believe there’s maybe 8 million prescriptions outstanding in the USA so any large cohort would be helpful.

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