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Comment by ericmcer | Hacker News Reader

I love stimulants for my ADHD, but totally agree that my friends taking them while we were growing up had pretty negative outcomes. One friend was taking 2 20mg pills a day as a 100lb 13 year old while I am taking 10mg a few times a week. The idea of pumping that much into a developing person and never letting their brain have a break from it is insane.

They are noticeably spacey as an adult to the point where I am not super comfortable driving with them. Running stop signs and red lights is a frequent occurrence.

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> my friends taking them while we were growing up had pretty negative outcomes.

Or - hear me out - maybe severe ADHD, the kind that leads to diagnosis and treatment with stimulant medication at a very young age, is correlated with negative outcomes in general. You know, like a disability.

The number of people willing to believe - contrary to actual peer reviewed studies - that stimulant medication is harmful to people with ADHD, based on nothing more than a gut feeling, is astounding. People don't assume they can just intuit the proper treatment for other medical conditions, why do they think they can do that with mental health related issues?

I mean look, I can see it with my own two eyes. The gauntness in their face, the effect it has on their emotions over years of use. Knowing someone and seeing them go down hill and struggle, and then be better during the summers when they are off it.

I'm not asserting stimulant medications have no side effects.

I am asserting that decades and decades of peer-reviewed medical literature indicates that stimulant medications are a net benefit for people with ADHD.

This is not a controversial perspective among informed researchers or clinicians.

I agree but I also acknowledge that the approach psychiatrists use can be damaging by over-relying on medications. I have adult-diagnosed ADHD and are aware on how easy it is for a psychiatrist/parent to up the dose just to make the person more "compliant". These medications are powerful but also need other kinds of supports, such as socially and intellectually. These supports can be a nurturing environment, intellectual group to bounce ideas off and feel belonging there.

> to the point where I am not super comfortable driving with them. Running stop signs and red lights is a frequent occurrence

You're almost certainly right about that. Accidents in general [1] and car accidents in particular [2] are more common for people with ADHD.

The part you're missing is that the stimulant medication _improves_ the situation.

Quoting from the results of the second study referenced above:

> Compared with individuals without ADHD, male ADHD patients [...] had increased risk of serious transport accidents. In male ADHD patients, ADHD medication was associated with a 58% risk reduction [....] Estimates of the population attributable fractions suggested that 41% – 49% of the accidents in male patients with ADHD could have been avoided if they had been on treatment the entire follow-up.

[1] https://pubmed.ncbi.nlm.nih.gov/33582234/

[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3949159/

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