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Comment by caslon | Hacker News Reader

It's actually a big difference. One feels downright euphoric, according to Desoxyn users. The other is a boring study drug.

https://slatestarcodex.com/2017/12/28/adderall-risks-much-mo...

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>The other is a boring study drug

That's quite the mischaracterization. Stimulants even at low doses increase the dopamine in the brain and lead to a mild high. I don't think I've ever heard anyone ever call Adderall "boring" before either. That's like calling alcohol boring, maybe someone may not like the experience, but they both have immediate and noticeable effects and it's not just "I love studying" either.

Even Scott's article has examples of this, here's a story of a little girl becoming very high from a prescription stimulant:

"A spontaneous report from the manufacturer of Strattera (atomoxetine) described a 7-year-old girl who received 18 mg daily of atomoxetine for the treatment of ADHD. Within hours of taking the first dose, the patient started talking nonstop and stated that she was happy. The next morning the child was still elated."

In my experience people who take adderall while partying do it to stay awake longer to party with other drugs or booze. In practice for most people that “high” isn’t really a thing. At least not with anyone I know who is prescribed it or sometimes takes it recreationally. Meth on the other hand? Yeah that’s going to give you a very noticeable high.

Please browse https://www.reddit.com/r/StopSpeeding/ (probably nsfw) for many stories of people struggling with prescription stimulant abuse. These people aren't taking it because it keeps them up longer for drinking.

I'm not denying that you can abuse prescription stimulants by taking large doses to get high but most people aren't taking 10-30mg a day and experiencing meth like feelings of euphoria. Especially with extended release formulations. It's also much harder to maintain the regular abuse of a prescription stimulant without resorting to illicit acquisition since most psychiatrists avoid prescribing high enough doses to make that feasible.

I can't speak for every person who abuses prescription stimulants but I've met people that do and they always had a meth or other addiction in their past and were either buying from dealers or seeing multiple doctors/pharmacies. It's been a while since I've run into someone with that problem though so I don't even know if the latter strategy is effective anymore. I assume the feds maintain some kind of database these days.

Why are you conflating Adderall with all or any stimulants? Might as well throw in caffeine and sugar as things that "even at low doses increase the dopamine in the brain and lead to a mild high".

Not disagreeing with you wrt atomexetine but really should compare apples to apples.

You're right. I wasn't as careful as I could be, my intention was to cover common ADHD stimulants: adderall, ritalin, vyvanse, etc. Basically any of them that gives you a quick boost of dopamine and are addictive. I'm not a smart psychopharmacology guy, just have a lot of experience with stimulants. Perhaps ask for clarification instead of throwing out 'conflating' next time though?

Adderall is an amphetamine. It's a hard drug. And methamphetamine are closely related. Taking small doses of this, essentially macrodosing, it's not good in the long term.

The long term health impacts of taking prescription stimulants at recommended doses for on-label management of disorders is well understood and extensively studied/documented. There's not a psychiatrist that's not going to take this and other factors into consideration when prescribing it and any decent one is going to discuss medication breaks with their patients they prescribe them to. Prescription stimulants aren't perfect but it's currently the most effective treatment that's broadly applicable and well-tolerated.

A lot of people are critical of prescription stimulants without presenting a comparable alternative that will allow disordered people (particularly adults) to maintain the ability to function, be productive and maintain happiness in our current society with it's expectations and capability requirements.

The alternative is easting healthy organic foods, pasture raised meats, and exercise. Even weed/DMT/LSD is loads better than 'adhd' medication - and might actually change your way of thinking.

Strattera is not a stimulant, not in the same method of action that Adderall or Ritalin is.

Thanks for the clarification, was just quoting from Scott Siskind's article which focuses on Adderall. I was responding to the suggestion that adderall is a mundane drug and doesn't get a person high.

I don't think that would be that hard to disprove, but I was trying to pull a quote from the article they linked.

Wikiopedia says Strattera can lead to increases in dopamine, whether that's relevant to that case I don't know.

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