Ritalin and similar medications cause brain to focus on benefits of work (2020)
sciencedaily.com
sciencedaily.com
For all I know it could mean the person gets to believe more in their capacity to do the hard tasks. Or it could mean that the person feels less distracted and more willing to engage. Or many other things... Am I missing something?
Iirc there were studies done trying to assess the same thing with regards to Adderall (aka amphetamine salts, which is used for adhd similarly to Ritalin). The researchers came to that exact same conclusion, that the drug didn’t actually make people smarter, but it gave them an illusion of being more capable, and they ended up performing better due to confidence.[0]
0. https://www.sciencedirect.com/science/article/abs/pii/S03768...
You can see this in parents who marvel at how great their children are at x, seems to be how kids are pushed. If kids are designed to be pushed to develop their skill sets by the dopamine inducing praise it could be that these drugs work because they tap into that pathway.
Yet, i have had younger people join, that didn't really know how to play, get really good. Their talent: They were super fast. Track athelete fast. They knew nothing about soccer, but after a year or two of playing, they became better than the players that had been playing for over 10 years.
Their advantage: Sheer speed, and fast reflexes. At some point the mantra 'if you try hard enough you will became great', becomes sheer lie. Some people, with given the same amount of training, or even less, became much much better...
But, hey, the '10k' hour rule type of books that give false hopes do sell, so the fradulent authors will keep em churning.,
Goes a lot into the studies on the matter and he argues it they paint a pretty clear picture.
Adderall and Ritalin can be addictive and are widely abused. Many studies show that these drugs are relatively 'safe', but we are only beginning to understand the long-term effects on the brain from chronic abuse [2][3].
To anyone out there who is needlessly abusing these drugs, it would be prudent of you to look for alternative and natural ways to massage your mind into a state that is conducive to productive work. Exercise, diet, and sleep are incredibly important.
> Higher dopamine synthesis capacity in the caudate nucleus was associated with greater willingness to allocate cognitive effort. In addition, methylphenidate and sulpiride increased subjective values and motivation to work specifically for people with low dopamine synthesis capacity.
> Collectively, our results support that striatal dopamine enhances motivation for cognitive effort by amplifying the effects of benefits versus costs attended early in a decision.
[1] Dopamine promotes cognitive effort by biasing the benefits versus costs of cognitive work https://science.sciencemag.org/content/367/6484/1362
[2] Acute and long-term effects of adolescent methylphenidate on decision-making and dopamine receptor mRNA expression in the orbitofrontal cortex https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5404501/
[3] Chronic methylphenidate treatment during adolescence has long-term effects on monoaminergic function https://journals.sagepub.com/doi/pdf/10.1177/026988111880549...
Absolutely. It's a really frustrating experience too when you're denied access to these life-altering (not an exaggeration) medications for these reasons even when you have years of medical records detailing your condition and your treatment needs. I went to community college in a small town for the first two years of my degree; I had a great doc there who was happy to make sure I was getting the right doses for my condition and would check in with me every few weeks to see if anything had changed. After getting my associate's, I moved to a much larger city to transfer to a college roughly 10x the size of my community college for my bachelor's degree. I found a reputable local doc, got my medical records transferred, and made an appointment (required for a controlled substance) to continue my prescription.
You know what he told me?
"Oh, since this is a college town with several colleges and a lot of students looking to abuse 'study drugs', our policy is that we don't treat your condition here. But I have some resources on meditation and mindfulness that you should look through."
I got the same kind of answer at two other offices before I got fed up and asked my original doc to get me a referral to a psychiatrist who wouldn't blow me off like these quacks had.
I'm not saying that substance abuse isn't a problem, but I also don't think that treating everybody like children and drug seekers is the right call. But hey, n=1 and I'm just some guy with a beard- YMMV.
To me the key is changing the way I think about it - It's not an illness, I'm different. It's not a curse, I'll figure out how to make it a blessing. I don't need meds, I'll work it out.
People with these kinds of problems reach a point of desperation after having tried everything you could possibly think of. So when the hundredth person comes along and says "you don't need meds, you just need X," where X is one of the many, many things they've already tried, it's exasperating.
Anyone aware of literature confirming or explaining this phenomenon?
Isn't part of it due to dosage? From what I understand, medical doses are lower than recreational doses, sometimes by a factor of 5-10.
This is an urban legend doctors used to tell parents to get them ok with the idea of their kids taking stimulants. Amphetamines are “go pills”; they make you more productive in low doses and get you high in high doses whether you have ADHD or not.
I ask because your sources don’t really serve your point, and are part of a broader body of literature that you’re not contextualizing: there’s a robust body of evidence, primarily based around MRI studies in real humans, showing that stimulant-based treatment of ADHD in childhood and adolescence does cause significant changes in brain structure. In a good way. Normalizing deficits in areas of the prefrontal cortex associated with executive function relative to controls.
I realize your comment itself is focused around abuse of these drugs rather than genuine treatment, but your citations don’t make much sense in that context, and there’s an *immense* body of research studying the long-term effects of amphetamine and MPH (especially amphetamine abuse). The assertion that we’re “just beginning” to understand this stuff is quite an overstatement.
I was on amphetamines for ADHD for nearly 30 years. Toward the end it got really hard to tell the difference between “amped up and focused” and “active psychosis”. My behavior was erratic and people around me were worried, despite these being drugs I had taken my entire life. They worked well and helped me get to a certain point in my career where soft skills become more important, when they suddenly became a hindrance.
I switched to Strattera / atomoxetine (a non-stimulant drug approved for use with ADHD) and it’s been great. I can’t rely on the drugs for motivation anymore, but it does seem to remove the roadblocks to focusing on something when I really need to.
I’m never going to have great attention to detail without amphetamines, and I’ve had to accept that and adopt a more “visionary” outlook. But I no longer feel like a square peg trying to force herself into a round hole. Amphetamines are good if your working style is to disappear into a hole and come out with a whole lot of productivity, but for anything collaborative I find they can be more of a burden than a boon.
I've seen the literature showing evidence of reduced depression and suicide rates in at-risk adolescents who undergo long-term treatment with Ritalin and closely related drugs.
Are you aware of any literature beyond that? If so please cite the sources here so we can all learn.
I have yet to see any conclusive evidence that the induced changes in brain structure and function are always 'good', and the previous citations I provided present evidence that counters your claim.
> if administered to a healthy child who has inappropriately been diagnosed with ADHD, our data indicates that administering the drug may induce persistent changes of dopamine-dependent behaviours that can have detrimental consequences [3]
FWIW we're in agreement that long-term treatment with these medications can be helpful for people who genuinely need it. But diagnosing ADHD isn't an exact science [4][5], hence the caution I've been advocating.
[4] ADHD: Is Objective Diagnosis Possible? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2993524/
[5] Prevalence of Parent-Reported ADHD Diagnosis and Associated Treatment Among U.S. Children and Adolescents, 2016 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5834391/
The [3] source you’re quoting is basically demonstrating that chronic exposure to a dopamine agonist leads to downregulation, which isn’t exactly surprising. The sentence immediately before the one you’re quoting is a very important qualifier as well.
No snark intended, there’s so much out there that the best resource I know to recommend is the citations section of the Amphetamine Wikipedia page (ex: https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...).
This way we could look at our athletes, business leaders, politicians, friends, and everyone else and see all the things they consume to get things done.
Things go a lot better if people get to know me as me before they find out just how much I struggle with day to day. I don't want to be defined by my illness.
Not to get a tin foil hat-y, but it easy to see a darkside to this, as well as there being those who would seek to exploit it.
But for therapeutic applications it sounds hopeful.
Consider that most people who are diagnosed with ADHD (especially if it was in adulthood) are well aware on the metacognitive level that they should think in terms of the benefits of work and its importance, and they do want to. Their problem is a difficulty to actively decide to think in those terms when it truly matters, in practical day-to-day life. So stimulants do indeed change how they think, improving the effectiveness of their desired thought process.
This is great for ADHD and such but perhaps we're within spitting of distance of things less benign?
FWIW, this is a fairly accurate description of my experience with ADHD. It’s not that I have trouble focusing; quite the opposite, I can focus for hours on the smallest detail. The problem is that without medication I don’t get to choose what that detail _is_. I could end up (and _have_ ended up) spending countless hours on inconsequential stuff because I can’t get it off my mind otherwise while I watch my life fall apart around me, unable to do a thing about it.
"1 in 5 medical researchers reports pressure from funders to change study results"
Well sure. In the same way that fentanyl is not heroin.