Smart drugs reduce quality of effort, and slow decision-making
bps.org.uk
bps.org.uk
A much better test would have been to give all the study participants some new material requiring multiple hours of study to memorize & learn, then give them a test. The knapsack problem is fine to test some measure of "intelligence", but a bad choice to simulate academics.
Also notice as I take my "smart drugs" my ability to focus in meetings is increased, and therefore allows me to better recall information in subsequent days... vs when not on meds I'm constantly distracted and my memory is much more foggy, especially specifics or details.
I think you've confused "productivity" with "bulk". Do you evaluate engineers by how many lines of source code they write in a day?
Imagine if your brain refuses to do worthless uncreative work, that is ADHD, it is great for coming up with ideas but sucks for doing the work you often have to do.
Just look at the results
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5285601/table/T...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5285601/figure/...
https://ntp.niehs.nih.gov/sites/default/files/ntp/about_ntp/...
"This review finds, with moderate confidence, that higher fluoride exposure (e.g., represented by populations whose total fluoride exposure approximates or exceeds the World Health Organization Guidelines for Drinking-water Quality of 1.5 mg/L of fluoride) is consistently associated with lower IQ in children."
https://www.hsph.harvard.edu/news/features/fluoride-children...
https://pubmed.ncbi.nlm.nih.gov/25446012/
You don't seriously think that drinking fluoride is OK? It's been studied to death and it's obvious at this point that long term fluoride exposure causes developmental neurotoxicity. Multiple countries have sponsored these studies and they show negative correlations to IQ and an increase in fluoride. They've demonstrated this in rats with sodium fluoride as well.
Finally, there is probably a level at which it actually does become toxic. Like with many other minerals, too little is actually harmful, there is a right dosage and too much is again showing toxicity.
Why do the papers against do not mention this, do not mention any theorical model to explain their findings, do not correct for socio-demographics factors when we know that intelligence is generally very poorly related to any other variables except those ones which disproportionately explain it?
In groups of 100? What's the percentage of people that routinely consume toxic levels of fluoride from dental supplements (that study ran four months)? People don't generally eat toothpaste or drink mouthwash but I'm sure it happens. I just wouldn't assume that it would happen often enough to give you poison data.
" Like with many other minerals, too little is actually harmful, there is a right dosage and too much is again showing toxicity."
This is where I'm at on tap water...I assert that LOW-DOSAGE exposure over extended periods of time is bad and I assert that in the US there are area's that have incredibly high-doses of fluoride in tap water (at least 6 parts per million). Which is bad all around. Water is controlled at the jurisdiction level and there's NO guarantee that you're getting below the recommended dose of fluoride. I'm of the opinion that it's completely nuts to put this stuff in the drinking water and the Indian, Harvard, and recent NIH papers appear to back this up.
"Why do the papers against do not mention this, do not mention any theorical model to explain their findings, do not correct for socio-demographics factors when we know that intelligence is generally very poorly related to any other variables except those ones which disproportionately explain it?"
I agree with this...In the first study I could not tell if they controlled for socio-economic status. They identified villages with varying levels of fluoride and called it a day. The Harvard study did though. And the American study I linked to seemed to control for this as well...And they all came back with results that were similar...Repeated low-doses of fluoride have detrimental effects to development health.
Form the harvard study: "We carried out a pilot study of 51 first-grade children in southern Sichuan, China, using the fluoride concentration in morning urine after an exposure-free night; fluoride in well-water source; and dental fluorosis status as indices of past fluoride exposure. We administered a battery of age-appropriate, relatively culture-independent tests that reflect different functional domains: the Wide Range Assessment of Memory and Learning (WRAML), Wechsler Intelligence Scale for Children-Revised (WISC-IV) digit span and block design; finger tapping and grooved pegboard. Confounder-adjusted associations between exposure indicators and test scores were assessed using multiple regression models. "
>Reviewer comment (DocB1_Monograph, page 2): It would be helpful if the Abstract was clear in the Discussion that the conclusion about effects on IQ in children was derived from high human exposures (higher than US exposures) without getting into more hazard conclusions or assessments.
They repeatedly say that the current research is no where near comprehensive and results are weak.
I’ve watched several peers go down the path of trying to use stimulants for motivation starting in college and again later in my career. There’s no denying that it works at first. They are stimulants, after all, and they stimulate people especially well when they first start taking them.
The problem is that the motivation from stimulants is famously prone to tolerance and rebound effects. It’s also very prone to habit-forming associations. I’ve noticed several people try to use prescription stimulants in an “as needed” fashion when they need to get a lot of work done quickly and they don’t really want to do it. It doesn’t take long before it’s obvious to their friends and coworkers when they’re having an off day or an on day, even though they might deny any rebound effect. It gets scary when they do this so long that they forget how to self-motivate without taking stimulants because they’ve built such a strong mental association between “I have a lot of work to do” being a trigger for “I should take another pill today” or even “I’ll save this work until tomorrow when I can take a pill”. It gets even scarier when tolerance sets in (to the motivating/stimulating effect, not so much the intended attention-enhancing effect) and they’re now flirting with escalating doses, double doses, combinations with ‘nootropics’ to boost effects or ‘reduce tolerance’ and other slippery slopes.
The short-term productivity boost shouldn’t be denied, but I think it’s also short-sighted to hold these drugs up as a free lunch productivity boost. Let’s be honest: A little experimenting here and there isn’t going to show tolerance, extensive rebound, psychological associations, or other effects, but that’s also what gets people in trouble when they start to think it’s a free lunch. There’s a reason the traditional ADHD treatment approach involves taking the same dose every day rather than encouraging the patient to build psychological associations between taking the drug to alter their mood state.
The strange part about this conversation is that if I wrote all of the above text about drinking 2 energy drinks at the start of a work day, few people would argue with it. The tolerance, rebound, and dependence effects of caffeine seem to be well known in pop culture. For some reason people with a little exposure to prescription stimulants seem to think that the normal rules don’t apply to them, at least at first.
A lot of people who have minimal or sporadic experience with stimulants seem to think they’re no-strings-attached productivity boosts, but there’s no free lunch. The brain will adapt over time.
So I switched to decaf. I'll still enjoy regular coffee now and then as a special treat.
A very US-centric view I think, i never knew a single person in my University who took these 'enhancing' drugs, we just got wasted from alcohol and smoked weed. And I went through rather stressful University where 2/3 of people who started were thrown out of school in first 2 years in one or the other filtering hardcore courses with slightly psychotic professors (still not getting why by far the hardest course from 5 years for studying freakin' Software engineering had to be 'Theoretical electrotechnics' with some hardcore math way beyond our actual math courses, of course never used any of that, not even on rest of studies).
Anyway, any substance you abuse will eventually kick back quite hard, if it didn't yet give it some time (or take a bit harder look in the mirror next time). Same for bad habits.
Stimulants may be used by individuals with true deficiencies in an effort to get to baseline. Many people who start using stimulants in their 20's and 30's report being able to express healthy, practical behaviors that they couldn't summon themselves to express before: cleaning the house, making it to meetings on time, paying attention in conversations. The caution that you're expressing is warranted with any substance, but I'm sensing a bit of fearmongering which I think could possibly stop individuals from trying a substance through which they could possibly receive benefit.
I used to be completely mentally exhausted after a single meeting, modafinil fixes that for me. It makes me smarter in the sense of "crystallized" intelligence as a consequence of accumulating more knowledge, experience, mental models etc.
There's also the problem of getting used to the drug. When I first started taking it, there were various side effects (including perceived worsened short term memory), which subsided with time.
A bunch of strong serotonergics produce such effects. Normally SSRI are screened for it, but that's mostly for acute version...
Dose scheduling is underresearched part of the whole ordeal. Sometimes a pause is necessary to prevent the damage or recerse the tolerance.
After being on it for ~5 years it lost its magic and efficacy, so I ended up introducing lifestyle changes in the form of a 5-color-a-day smoothie, exercise & sleep. Lifestyle changes were helpful, but not quite enough.
When I recently started back up, I noticed that Provigil was a bit too stimulating for me. And I've found a good balance in doing a 1/4 to 1/2 a pill. About 50-100mg dose + caffiene (coffee/tea/energy drink) instead of the typical 200mg.
And that's been quite a nice boost.
Adderall on the other hand is a massive dump of dopamine and focus, so the focus is there, but it's easy to become a stimulated zombie.
Your ‘friend’ was probably into overdose territory and the Modafinil antagonized the d-amphetamine while also inducing a wakefulness effect.
I really hope your friend realizes how bad this was.
Amphetamine is primarily absorbed through the plasma membranes and not DAT since it’s lipid soluble.
Dopamine does not and thus relies on DAT. By inhibiting DAT (as both amphetamine and Modafinil do), you increase extracellular dopamine.
Next, DAT does not “transport amphetamine around the brain”. It only transports it from the post synaptic cleft into the cell.
Also Modafinil is a much weaker DAT inhibitor than amphetamine itself as far as we know.
Lastly, drugs don’t “antagonize” other drugs. That word is a specific term used for the action on the receptor level.
The dopaminergic effects of Modafinil aren’t well known and are thought to be mild. It’s simply misinformation to claim that modafinil was somehow blocking the effects of amphetamine on the dopamine receptors.
I’ve asked my doctor for a prescription so that I could use it to go on stimulant breaks, but since I already have a prescription for Vyvanse and Adderall he was concerned I’d get drug audited. The last time I tried to find a good online Indian source it seems it’s very hard to find anything legit.
People either love it or find that it does nothing for them, so don’t get your hopes up too high. However, for patients who respond it seems to be a great improvement. Be warned that it can take a long time for the positive effects to appear. Unlike stimulants that work well on the first day and decline over the subsequent months/years, it seems to do very little or have uncomfortable side effects on the first few days and then reveal the positives after a month.
And FYI, there’s a weird copayment reimbursement program from the manufacturer that makes it affordable for many. Dumb game to have to play, but it’s there.
They thought they had discovered a free source of motivation in a pill.
Of course, most people’s initial assumption was that they received fake pills. Not a bad assumption after ordering online with crypto from an overseas website, but most of the stories went the same way: It didn’t matter the source, it just wasn’t “working” for them any more.
I’m always surprised that people understand how tolerance works for energy drinks, coffee, and other caffeine sources. But then they get exposed to prescription drugs and assume it’s going to feel like that forever.
The second part of this problem is the misunderstanding about dosing. The prescription pill doses are set for continuous dosing of patients who need to take it every single day.
A Narcolepsy patient taking 400mg of Modafinil every day forever is going to get into a steady-state tolerance that, ideally, brings their function back to a normal adult. A non-Narcoleptic person who takes 200mg or 400mg of Modafinil without having a baseline tolerance is going to be zipping around with extra stimulation. However, tolerance will set in eventually as well, leaving them with some stimulation, but nothing like those early doses when they had no tolerance. Again, this is a well known effect for other drugs like opioids or caffeine or benzos, but for some reason people forget the laws of tolerance apply to prescription stimulants too.
I believe it's at least partially caused by incorrect expectations. When people start taking modafinil, the effects are quite strong and stimulant-like, sometimes even with mild euphoria. But then these effects disappear and people are like - what's happening, I can't feel it anymore? Tolerance or fake pills?
I fell into this trap originally as well and was comparing production batches etc. But the actual reason is that with a pro-longed use, Modafinil doesn't "feel" like anything. There's no altered state of mind, there isn't even a mild kick you get from a coffee. Modafinil isn't a stimulant which would kind of push you to do things. It doesn't "give" you anything, it only "takes away" the fatigue, and this is far more difficult to notice. On a relaxing day off, it doesn't feel any different if I take modafinil or not.
In fairness, tolerance management and mitigation is a component of prescription drug design and composition, unlike the others. It of course can't overcome pharmacology, but there are mechanisms with varying efficacies.
Isn't the point of doing that to get better results?
I mean, imagine if without drugs I can do a hard slog through the books for 6 hours before giving up; and with drugs I can spend 12 hours anxiously bouncing between tasks and feeling very busy; but I actually learn more by doing the former than the latter - nobody taking study drugs is hoping to spend twice as long for worse results.
Say unaided, you can get to 85% proficiency in 6 hours and that's about all you can sustain.
With smart drugs, you only get to 75% proficiency in 6 hours but can keep going and will hit 95% in 9 hours.
Think of it like a pick up truck with two gas tanks. It is less efficient than a small car but because of the larger tank it has more range.
Many people using this kind of drugs normally lasted maybe 1 hour or so before giving up (without the drugs). And it often took a long ramp-up to even get to that 1 hour of focus.
> and with drugs I can spend 12 hours anxiously bouncing between tasks and feeling very busy
I guess this is maybe the case when your body isn't yet accustomed to the drug. I don't have any such issue after I got used to the drug (in my case modafinil).
For many degrees, you’re absolutely correct though. I remember being envious of such workloads in college simply because of the idea that time spent studying directly correlates to your grade. Engineering degrees, in general, simply show that you know how to learn. Memorization is helpful but alone is not enough to understand concepts and apply them.
Memorizing formulas vs. being able to derive them is a good example here.
Obviously, I can't know if students from the bottom percentile also engaged in that, but all the students I knew that took drugs to perform better, were motivated students that wanted to maximize their grades. And they studied things that required lots of reading and memorization (law, medicine, and similar).
My take was that the kids that used those drugs, were the ones that wanted an extra push on the last 10% - to put it that way.
Even on them, a person will need to consciously make healthy choices. These drugs do not magically help you think smart. That still has to come from you.
If anything, I feel ever so slightly “dumber” on them. They dull my creative thinking and in return, I gain a bit of motivation. It does nothing to my willpower. So I still need to want xyz thing bad, but it makes the act of doing that more fulfilling. Even if it’s a waste of my time but something I must do. The experience is more fulfilling. I reckon it’s the extra dopamine at play.
Regardless, xyz is still my decision and I can very much pick an unhealthy thing. Drugs don’t aid your prioritization skills. They don’t improve your communication. Those are skills that have to be learned. Maybe not, if you won an organized parent lottery. Then at least you will know what good looks like, and can learn to emulate that.
I never considered motivation and willpower to be separate, but I think your breakdown makes a lot of sense.
I'm also not a big fan on emphasizing the "cognitively healthy" part of the equation. My understanding is that stimulants do exactly the same thing in a person whether they're "cognitively healthy" or not; they're not the sort of drugs that target a deficiency or clear up some specific problem. The only difference is that some people have more of a need in this area than others.
This reminds me of an old article I read about how psychedelics don't actually "increase connectivity in the brain" like users thought, as though that had anything to do with why people use psychedelics.
That's why some folks say they take psychedelics; they want to justify their drug use for 'fun' as something more beneficial. I wish people were more honest with themselves and others.
In fact a lot of people who have taken (and really cherish) psychedelics would not describe them as fun, and sometimes they're very actively un-fun/terrifying/unenjoyable, and yet can still be beneficial.
What exactly is going on at the level of "brain connectivity" is pretty much unrelated to all of that^
The article just scanned people's brains while they were on drugs and saw that the electrical activity was more erratic and scattered than normal, not more active and connected, and concluded that people were using psychedelics based on a myth.
Lying about efficacy will do nothing but only bolster what was never a legitimate rationale to begin with. This is a country that failed to learn lessons from prohibition, that managed to kept the Mann Act on the books even though the legislative intent - that of the fear over 'miscegenation' was hardly a secret, a country where congress never bothered to even get rid of the chapter in the US Code that contained the Chinese Exclusion Act and therefore leaving the ugly legacy plain to see for all. Why lie about your cause when the truth that undergirds the reality is far uglier and far more disconcerting to begin with? And of course, for once, Oscar Wilde was wrong and the truth may not be pure but certainly simple: prohibitionist policies began in racism and are sustained by moral panics while protected by the state agencies that now benefit financially from its existence. All this has a paper trail, both online and in print, in the federal register, in the US Code, in congressional records and archives. If that's not enough to justify resistance, your real reasoning will still be more persuasive than having to make up something to justify a position against a line of thinking that has goalposts with wheels built in from the start.
Marijuana legalization used the same strategy: medical first, then complete. The technique works. The other technique of "Oh yeah, I want it for fun so you should let me do it" has been tried for eons and got nowhere. You can come up with all the theory, but one technique worked and the other didn't, so I'm not interested in the theory.
Fake science it's going to be. The people who hate it don't have the ability to tell that it's fake.
And come on, healthcare requires you to lie. The head of the NIAID famously lied about mask efficacy in order to get what he wanted and people backed him for it. I don't see myself as any different.
The amount of half-braindead pot smokers earnestly talking about their medical need to get stoned is so irritating. Legalization happened despite them, not because of them.
When a drug is stigmatized in the United States, it is essentially impossible to get it legalized without showing there is a medical use for it. That's just how it is. If your goal is to get a drug legalized, it does not matter whether that's how it should be, or whether this is all rooted in systemic discrimination, or whether pharmaceutical companies push stuff that's just as bad under their veil of legitimacy. Citizens who are anti-drug are under the impression right now that ~100% of illicit drugs are extremely dangerous and a major threat to their community, and they are not going to sit around and listen to a history lesson philosophizing about how all their fears are a propagandized illusion.
Even if you got them to listen, they would just say "Why risk it?" The only way to start changing minds is to point out there are upsides to drug legalization beyond just "freedom is good." That's why all of the arguments for legalization focus on health/therapeautic benefits, either directly from the drugs themselves or in the ability to treat those who need help with addiction.
Yes the trip can be lots of fun, but really, "fun" is widely available once you cross the line and take drugs. MDMA is fun. Amphetamines can be fun. There is no scarcity of "fun" here and I have no issue admitting I've taken those to the possible detriment of my health and for fun.
The difference is that if I had to skip the "trip" part of psychedelics and retain the rest, I'd still do it.
I did a lot of psychedelics, I don't know if fun was ever the word I'd use to describe most of it, but I don't regret any of it. It opened up a lot of the back of my brain in a way I never could conceive and really allowed me to think and analyze things in ways that I wouldn't have access to without. That in itself is well worth the experience, in my subjective reckoning. When I no longer felt that psychedelics were able to provide me with what it once did, I stopped. That was that. That surely is enough, right?
I don't recall seeing anyone make that argument, but I do tend to avoid woo and pop sci. What is reasonably clear is that psychedelics increase neuroplasticity even in vitro, which is hypothesised as being one of the plausible mechanisms of action for psychedelics as a treatment for mental disorder - they potentially create a window of opportunity for habitual patterns of maladaptive cognition and behaviour to be unlearned.
Some people are very attached to the idea that the qualitative experience of the "trip" is integral to the therapeutic effects of psychedelics, but that is by no means a universal belief; many groups are working on non-psychedelic drugs that exploit this mechanism.
I think it's entirely reasonable to be wary of people justifying their recreational drug use with outsized claims of therapeutic benefits, but in the case of psychedelics there is definitely something of clinical interest happening. I'm quite circumspect about the clinical use of psychedelics, but I think it's highly likely that we are going to see a generation of novel and useful psychiatric drugs emerge based on what we have learned from psychedelics research.
I don’t know a lot about stimulants in general, but I know for caffeine in particular this is not true. As an anecdote, I have a friend that caffeine puts to sleep, she just can’t take it. I’ve come to find out (partly from knowing her) that part of why the FDA doesn’t regulate caffeine, is that it has a very wide range of varying effects on different people.
Contrast with, say, SSRIs, which might have some effect in a healthy person but you're looking at a different range of effects compared to someone taking it for depression/anxiety/OCD/whatever.
At some point during debugging you might throw your hands up and wonder who created this tangled web of complexity but adderall delays that moment for awhile.
There's a nonzero chance that it was your predecessor on a 2am Adderall binge ;)
I also feel "dumber" while on ritalin, but at the end of the day the job gets done. Also a lot of frustrating stuff, the kind of stuff that would easily derail me, just becomes easy to overcome.
Progress is just happens, but you can also be motivated to do dumb/useless work, for stimulants dosage is key.
https://www.reynoldsclinic.com/why-french-kids-dont-have-adh....
> Numbers in America show that at least 9% of the children that are school-age are diagnosed with the disorder
That percentage seriously makes me think that we might be overdiagnosing based on personality type instead of just diagnosing based on underlying disorders. Either that or US schools are very different than French schools.
> There’s also the differences in how children are brought up in America and in France. For example, French parents have set strict limits from the time they are born. The children are raised with limits such as not being allowed to snack whenever they want. They have four strict meal times and they know those are the times they are allowed to eat, not before. While they love their children just as much as others do, they do believe in forced strict limitations to help the children grow up in guidelines and feel safe and secure.
Really?
I have also had a number of friends with "ADHD" for whom the solution was "cut sugar, sleep enough, go into a room with no electronics (or a user account with nothing else installed), do some cardio".
I am not denying the existence of ADHD, but as a society, we look for shortcuts to problems that have real solutions and are therefore more likely to just pop a pill. See the sister comment, it addresses this too.
And furthermore - yes, cutting screen time in children dramatically increases their ability to focus later in life.
The reason parents are holding sugar back from kids is they think they're hyper due to a "sugar rush", which is completely placebo i.e. they're just acting like that because they heard you're supposed to.
https://www.sciencedirect.com/science/article/abs/pii/S01497...
I am not trying to move goalposts with the next statement, but I always assumed sugar has a similar effect to caffeine, in that you get a temporary boost that you pay for later. Study pointing to this quoted/linked below.
For me personally, energy drinks very much do seem to improve alertness, at the cost of crashing later. This is especially evident if drinking them two days in a row, where on the third day you absolutely have no energy left. And that's not even mentioning the absurd blood pressure spikes.
Anyway, this isn't an "argument" - I don't have one other than "that seems inconsistent with my experience." Though your own link seems to be pretty inconsistent as well*
* "Caffeine consistently improved marksman reaction time but did not improve marksmanship accuracy. However, there is some evidence that caffeine attenuates performance decrements in marksman accuracy caused by stress and fatigue if optimal dosing strategies are employed. Dosing strategies timed according to hours of wakefulness and time before testing could prevent performance deterioration. Doses of 100-200 mg every 2 hours may effectively improve accuracy during extended duty; however, further research is needed."
https://pubmed.ncbi.nlm.nih.gov/31045484/
* "The literature on CHO effects on cognition suggests that CHOs can improve cognitive functioning, particularly under circumstances where participants are asked to perform cognitively demanding rather than easy tasks (Mantantzis et al., 2017, Scholey et al., 2009, Sünram-Lea et al., 2002). In a similar manner, studies have found the protective effects of CHOs on mood to be more robust when participants perform demanding physical and cognitive tasks. In fact, whereas participants in control groups experience higher levels of tiredness after performing a cognitively demanding task, consumption of CHOs seems to protect subjective ratings of energy against a potential drop-off after high cognitive exertion (Benton and Owens, 1993, Owens et al., 1997). Additionally, exogenous energy supply in the form of CHOs has been shown to increase vigor and reduce fatigue under conditions of increased physical stress (Ali et al., 2017, Lieberman et al., 2002, Markus, 2007, Welsh et al., 2002) and cognitive demands (Owens et al., 1997, Smit et al., 2004). Therefore, it has been hypothesized that, similar to cognition, mood improvement following CHO administration is stronger when participants have to perform demanding cognitive or physical tasks (for a review, see Benton, 2002)."
I think it’s ridiculous to make a blanket statement about how kids are raised in America vs France with zero evidence to back it up. There are plenty of strict parents in the US, and I’m sure there are plenty of lax parents in France. Plus, as the article states:
> The American psychiatrists believe that ADHD is a disorder based on biological issues.
So the way a kid is raised has nothing to do with whether or not they have ADHD.
According to the article, the real reason “Why French Kids Don’t Have ADHD” is because the doctors avoid that diagnosis:
> Basically the French community has decided to focus more on fixing the underlying causes of the problem behavior instead of giving it a wide range diagnosis.
Looking for underlying causes and fixing problem behavior sounds great, I just feel like the article is confuses having ADHD and being diagnosed with ADHD.
Despite my problems with the article, I actually do think that ADHD in children is over diagnosed in the US. And even if the disorder itself isn’t over diagnosed, I think ADHD medication are over prescribed to children. Those medications have can have negative side effects, like reducing appetite and therefore growth, but that’s not even my main problem with it. As other posters have described really well, ADHD medication can reduce creativity and problem solving skills. If a kid is medicated too young they might obey the rules a little too much and develop into a less creative, interesting, and dynamic person as a result.
Taking a neurological imbalance and turning it into a morality thing is abuse. Even if unintentional. This is real. Parents look for simple answers like "give em the strap" but how is that less reductive than "give em the pill"?
In addition, when able to focus, the quality of work still suffers from several factors such as sleep deprivation and the fact that you forgot to eat or even drink for the last several hours.
I've never seen code written in one of these stimulant fueled all-nighters that didn't create more work than it took to write.
The only exception I've found is for doing housework and other mindless, repetitive tasks.
[0] https://twitter.com/carolinecapital/status/13790363463003054...
imo, that's kind of a dangerous assertion. I'm an adult in his thirties. I take Adderall because I have a genuine loss in executive function at times. A small dose of Adderall (read: less than 2mg) puts me back on track where I can deeply focus, understand, and interpret things. There's certainly people I've seen abuse the drug, but I don't think it's safe to say that the results of Adderall are quantity over quality and frankly the abuse of the drug often doesn't occur in a vacuum. It happens in people that aren't very substance aware in the first place.
Ideally, I’d have unmedicated days where I just sit and think through problems, and then medicated days where I’d work on the actual implementation. Unfortunately, I just spend all of my time on HN and youtube on my unmedicated days.
but i also work out 5-6 days a week and that + meds have been a huge boon than just meds because it keeps the depression down too, which is what you might be afflicted with because on my rare off days i still can do some work & be motivated
I often wonder about this with me. I've got various hallmarks of ADHD (especially after my SO was diagnosed), but generally i'm productive.
In this specific case, i can't figure out if it's something like ADHD that drives this behavior _or_ just normal human avoidance of work i dislike.
Ie i of course don't have this problem when it's an interesting problem. I also tend not to have this problem after i get started, since most larger domains have interesting subdomains. Difficulty (read: vagueness, scope issues, etc) definitely lead to more of this for me though.
Human brains are weird.
Stimulants basically help regulate the dopamine levels so you can context switch easier and spread your attention to more things.
Imagine a top of the line TV. Fantastic image quality. The only catch is... you can't choose what content it's playing.
That's ADHD. At least for some people. Like me.
The first times I tried stimulants, after 2-3 hours of euphoric productivity, the effects would wear off but the residual stimulation would be enough to make me continue working and I would always think "hey, I can do this no problem without the stimulants, I just need to push over the hump", but never seemed to work.
A few years in, and yes, I can do without stimulants on easy tasks, but not really on complex stuff.
I also can drive wile not on stimulants and not be a complete nervous mess afterwards, which is a big permanent gain for me.
Also the "OMG, OMG, I'm so screwed by this messup at work, they're going to find me, things are going to crash because of it" changed to "it's going to be ok, things always work out in the end"
When I spoke to people who took these drugs in university (almost all w/o ADHD) sleepiness or calmness never reported by them as a side effect. I avoided coffee and 'energy' drinks in the past because I had this effect, and didn't really understand how people took caffeine to keep themselves awake - I thought it was kind of a meme and I wouldn't understand why my coworkers would drink it during night shifts.
I don't think dehydration adequately explains these to me, as I do take care to try to stay hydrated.
After stopping, even one cup makes me jittery and I no longer feel like I need to drink coffee to feel awake.
Caffeine dependence is terrible and widespread.
There are plenty of reasons to not want to be dependent on caffeine, but I wouldn't put its dependence in the terrible category.
I regularly give up either (a) using caffeine only pills and breaking them to linearly decrease caffeine dose, or (b) measured reduction of instant coffee over time.
Start at your current caffeine intake, every morning take one dose (might start high) and reduce slowly over say 3 weeks. It requires significant patience and self-control, but it has worked for me. My main problem is ensuring I don't have social coffees: it is easy to fall back into the habit of drinking coffee if I don't follow the titration regime.
https://hn.algolia.com/?query=robocat%20caffeine%20quit&type...
I have certain foods that seems to dramatically change the way stimulants like caffeine affect me. For whatever reason if I eat bananas and nut butter (maybe I have an allergy or food intolerance?) I find that caffeine makes me feel like I crash. When taken on an empty stomach I can get very "wired" but it also depends heavily on my sleep schedule and the time of day I take it.
I've noticed I can get an incredibly productive boost from caffeine when I take it at a time that disrupts my current circadian rhythm. I (used to) usually drink coffee in the morning and it rarely felt like it helped at all. I knew if I was desperate I could drink it around noon and see a big boost but then I wouldn't be able to go sleep on time and would pay for it the next day
Genetics, diet, microbiome, epigenetics, sleep habits, study habits, social health, seasonality, etc all likely play some role in the way people metabolize caffeine.
There is no published evidence that stimulants universally make people ADHD more tired or calm.
And personally I believe given the right conditions anyone might get to experience the effect of caffeine actually making them sleepy.
> And personally I believe given the right conditions anyone might get to experience the effect of caffeine actually making them sleepy.
There was a 6 month time in my late 20s when I was averaging 3.5 hours of sleep during the week while working two jobs and going to school. The third energy drink of the day seemed to signal my body to be tired.
Years later with a much better life balance and fully off of caffeine for months at a time a single 12 ounce can of Coca-Cola at lunchtime was enough to keep me wired until late into the evening. Some time after that, while fully off of caffeine for about a year, 80 mg accidentally ingested from caffeinated protein bars disrupted my sleep deep into the night and took a couple of days to recover from.
I could definitely do better with procrastination, and sometimes have trouble focusing, but am pretty sure I don't have ADD/ADHD.
The euphoria is a negative side effect in my opinion. That’s what leads to abuse and addiction. Don’t chase it!
I’m sure you’ve heard all this before, but make sure you’re getting enough sleep and exercise. Also, avoid acidic drinks in the morning like coffee and OJ when taking your medication. The acid can break down some of the medication before your body has a chance to absorb it.
> The euphoria is a negative side effect in my opinion. That’s what leads to abuse and addiction. Don’t chase it!
Yeah that's so not what I'm talking about.
When they worked, I was able to practice art, take regular showers, get chores done and stay focused without getting bored and compulsive. It doesn't help with any of those anymore. I can't use it to draw, can't take regular showers, can't get chores done even if they're staring me in the face, and boy do I get extremely, painfully bored all the time. And this happens whether I am on or off stimulants.
Again, they used to work. That is, actually treat the ADHD. And now they don't.
This has nothing to do with euphoria.
I was recently diagnosed with severe ADHD by several doctors (something I've been treating as anxiety/depression for my whole life), and was prescribed lisdexamfetamine.
It makes me super calm and my thoughts organized. When I'm tired, I feel tired. If I'm sleepy, I'm sleepy. My productivity isn't insane, it's just more stable and predictable now.
I wish I had been diagnosed many decades ago.
After starting I really just didn't need my anxiety meds anymore. Turns out being able to keep your shit together makes you less anxious. Who knew!
Paranoia about the cardiac side effects have led me in to caring a lot about my overall cardiac health, which has meant that I've largely countered side negative effects with the obsession over HIIT and less medication overall. Giving up alcohol has been kind of sad but I'm getting to the age where hangovers are starting to get brutal so maybe it's for the best.
It's also been nice to keep certain aspects of ADHD that I like, like my hyperfocus on certain subjects.
I wish I could tell teenage me to investigate this sooner.
Exactly. I'm currently slowly going off antidepressants.
I've been able to control my focus so much better which seems to make me less tired. When I sit to get work done and inevitably get distracted, I can recover instead of go down a spiral of unproductiveness. I'm also better at prioritizing my focus on the things that are important, such as a must-have feature for launch, rather than a nice-to-have that I just enjoy working on more.
And surprisingly, I've been getting some of the best sleep of my life so far on a pill designed to keep you awake. Who knew?
It's my experience as well. I used to wake up really tired. I still get the same hours of sleep but I wake up feeling... normal? which is an improvement. Very unintuitive.
To be clear: I can't sleep well at all for about 8-12 hours following a dose. It has killed my ability to take a lunchtime nap.
But as long as I don't take it after noon, I get great sleep at night. I fall right to sleep in minutes. Plenty of dreams as well, which suggests to me I'm getting in some good REM sleep.
I've been thinking about moving in the opposite direction, actually. ADHD meds like lisdexamfetamine/adderall have been moderately helpful.
But I am starting to think that I might do better treating this from an anxiety/depression angle. ADHD is so comingled with anxiety for me that I can't tell them apart. When I'm falling behind on tasks I get anxiety, which is the literal worst thing for my ADHD, so that exacerbates the ADHD, which increases the anxiety.
I'm curious (if you're open to sharing) if you're still treating the anxiety/depression side of things?
I didn't have that same experience with methylphenidate. That one was a much more pronounced effect. I felt pretty locked in and it was easy to focus. The downside was I was getting headaches, stomach cramps, I would sweat more and my heart was always racing like I had too much coffee.
The amphetamine feels much different. It's more of a chilled out effect where all the noise seems to go away. It doesn't make me feel any smarter, but I do feel less distracted and I'm able to complete boring routine tasks. I wonder if that's why I sometimes get sleepy with it. It's like a relaxation spa for my brain.
This "measured as the average gain in knapsack value per move" is an unusually chosen metric. Why would it not simply be the best/total score in the allotted time. This preemptively punishes sustained effort which is one of the increased behaviors. I'd like to see this done again with a different problem, a different metric, or simply their raw data.
Now that I think about it, all of these types of reports should include the raw data or GTFO. This one seems to provide some on the referenced https://www.science.org/doi/10.1126/sciadv.add4165
> MATLAB code that generates the statistics and figures, along with underlying data, can be found in the notebook “figures.mlx” and “SOM.mlx” of the GitHub repository bmmlab/PECO (https://zenodo.org/badge/latestdoi/592775835).
Real smart drugs = nootropics = piracetam and piracetam-like molecules. Stimulants generally decrease performance, increase false positives, and lead to worse performance as this study showed (especially in a first time user).
Most nootropics take about 14 days to hit their stride and the effect isn't discernible immediately (though can be detected in an EEG)...
See study: "Increase in the power of human memory in normal man through the use of drugs"
"Nootropyl (Piracetam) a drug reported to facilitate learning in animals was tested for its effect on man by administering it to normal volunteers. The subjects were given 3x4 capsules at 400 mg per day, in a double blind study. Each subject learned series of words presented as stimuli upon a memory drum. No effects were observed after 7 days but after 14 days verbal learning had significantly increased."
https://pubmed.ncbi.nlm.nih.gov/826948/
Study: "Single-dose piracetam effects on global complexity measures of human spontaneous multichannel EEG"
"The results indicate that a single dose of piracetam dose-dependently affects the spontaneous EEG in normal volunteers, showing effects at the lowest treatment level. The decreased EEG complexity is interpreted as increased cooperativity of brain functional processes."
https://pubmed.ncbi.nlm.nih.gov/10555876/
Study: "Single doses of piracetam affect 42-channel event-related potential microstate maps in a cognitive paradigm"
"U-shaped dose-dependent effects were found; they were strongest after 4.8 g piracetam. Since these particular ERP segments are recognized to be strongly correlated to cognitive functions, the present findings suggest that single medium doses of piracetam selectively activate differently located or oriented neurons during cognitive steps of information processing."
Noopept should be a bit lighter on the liver and kidneys.
We have an interesting system - final year exams are essentially a one-shot thing in the UK. If you are lucky enough to able to retake a final exam, your mark is capped at 40% - a third class mark. An upper second class degree is required for PhD entry.
Little wonder people will do _anything_ to pass those exams.
Where I studied (Norway), university students would regularly fail on purpose on the first exam, so that they could get two-ish months more time to read on the subject, as the re-take/postponed exam would be around August/September, or January/February - depending on semester.
It was/is called "strategic re-take", and unsurprisingly, you'd always see a bunch or A grades on the re-take.
Same thing happens in the high-school level. People that want to study wildly popular majors, like medicine, will spend YEARS re-taking HS classes/exams to polish their grades. Those studies are so competitive that you could get almost straight A's, but still not be good enough.
There're days and situations when having uninterrupted focus for 10-14 hours does make a big impact. Condensing certain workloads into one day can save a lot of time in a longer run. For example going through huge refactoring with a lot of moving parts can be very draining to work through if you need to load in the context every day. Striking the iron while it's hot can help a great deal.
How often do you use it and have you found any side effects? (or long term effects for that matter)
Some of the days I may not take it and not notice it, there's definitely no cravings. But during a break I felt slightly hazy when getting off it. I do notice an increase in typical stimulator tell-tale symptoms (like some jaw clenching), but i do have that from coffee as well (which i drink too). There can be days when i'm too wired up to fall asleep fast, so i may drop a 5-htp pill.
The upside is that there's a lot of times when I manage to really concentrate on some activities. Doing 8 hours shifts is trivial. People note that I am pretty responsive at the end of the working days. Quite often I manage to do some personal hobby work after a full working day too.
Modafinil doesn't have the ecstatic effects of Adderall and its friends, so working a lot can make me feel overly emotionally invested into some things that are not important in a grand picture. The stress can add up if not managed well. So I do not recommend working a lot for working's sake, there has to be a cause to pull heroic stunts like this. My excuse is to save up the money to enable myself to do other activites not related to programming later.
In my experience, it doesn't matter if you have multiple psychological evaluations and 10+ years of success with a consistent dosage of an ADHD medication. Most doctors just won't write the prescription because of this sort of bunk.
The article specifically says:
> More work will be needed to establish exactly why these drugs have these effects in those without a medical need for them, as well as to explore the potential impacts of other so-called smart drugs.
Nobody is going to have issues with attention/motivation during the one, short task they were assigned at some study. It's a very novel, motivating environment.
And then of course if you're feeling the effects of a new drug, you'll be "off" a bit.
This doesn't really prove anything about kids who take it for a few nights during exam week to study.
Yes, but the conclusions drawn by this study and others are frequently wielded against people who do have ADHD. The very term "smart drugs" comes from this mindset - the belief that these drugs don't paper over an ailment, rather they make the user "smarter."
I can't help but think that since the knapsack problem is NP-complete, any attempt to fill the sack could subjectively appear "more random." Certainly the participants could use certain heuristics, but since in general there is no known way to systematically solve the problem, this study seems to enable some confirmation bias on the part of the experimenters.
It means that it's hard to find the best solution, but easy to verify.
I have a long history of experimenting with both legal and illicit drugs and the only one I found to actually significantly increase my cognitive ability to solve complex problems is low dose Ketamine. Low dose lsd/shrooms as well but to a much lesser degree.
That being said, if you are ADHD, stimulants can essentially make you more efficient, which will make you appear smarter.
From experience, the different drugs available can feel wildly different on me - so I'm going to assume that would also be valid for the non-ADHD users?
But, anyway, looking back - the playing field def seemed uneven. How on earth are unmedicated neurodivergent going to compete against "enhanced" healthy people - it's like playing football with crutches, while your opponent is not only healthy, but also using steroids.
EDIT: And, yes, I'm sure some % of the students that perform better when using meds may have some underlying/undiagnosed condition.
https://www.healthline.com/health-news/if-you-dont-have-adhd...
My point in including it was to show how variable (and generally lacking) research results are about the effects people feel from these substances.
It’s definitely possible to reduce this threshold too far! If you do you’ll end up jumping into the first project you come across and tackling it with gusto, whether or not it’s high value. Having too much caffeine with Adderall makes this effect much worse for me.
A little bit of laziness is good! You need to be able to power through the tedious stuff you have to do in life, but you never want to stop thinking, “this is tedious and boring, do I really have to do this? Is there a better way?”
It’s easy to lose the forest for the trees.
As others note, the ADHD-type drugs just let you work longer without needing sleep, although the bill must eventually be paid with interest, which is why people who take a lot of stimulants tend to go through boom-bust cycles over time. Such drugs also have a kind of jangly nervous side effect which inhibits the creation of complex mental architectures of the kind that mathematicians rely on, so I'm not surprised by the study's results. They're more suited to rote learning (unfortunately common in today's academia) and repetitive tasks (factory work etc.).
SBF (and all those in Alameda+FTX who got scripts from their in-house psych) in particular having the biggest boom-bust cycle in stimulant history. Though that doesn't count world leaders alleged to have stimulant use history.
This forced me to develop skills and discipline over the years to achieve self control, and this has more than paid off. I find I can work a 12 hour day, and then go in the next day and do the same. It doesn't seem like a huge deal to me - especially when I consider family members who are/were farmers where this is quite a normal work day and used to be quite normal for everyone until about WWII.
Am I an outlier? I don't know, but I know others who have taken the same path with similar results.
I've worked with many people who cannot function without caffeine, let alone other substances. They will often claim how it enhances their abilities, but it doesn't come across that way in my observations. They seem to be dependent on a substance for normal, or even sub-normal performance.
By far the easiest to obtain and abuse, though it's as yet unclear what abusing it looks like
Modafinil can't really be abused in this way, it doesn't get you high and increasing the dose is usually counter-productive.
Another element of abuse is addiction and Modafinil has no physical addiction and IMHO minimal to non-existent psychological addiction.
If the above examples sound beneficial, they may be - in part. But I'm sure clinicians and mental health practitioners can see how such a substance embedding itself in your life can yield undesirable outcomes, perhaps mirroring addiction.
Personal experience plays some part: I've been a regular user since 2016. Initially weekly, for a while daily, then back to weekly.
It hit me that what was initially a minor perceived upgrade to my chaotic workflow had become an almost regular part of my life. I'm still not entirely sure if I would call myself addicted - I seem to be able to walk away from it but among ADHD crutches it is the most desirable at present. That said, I've been careful to never exceed 200mg a day and to take breaks from it if I've taken it for more than 3-4 days at a time.
In terms of its actual benefit, it seems to be quite hit and miss. I find it just puts me in a more conducive state for focus, but only 3/10 times.
I don't think medical or media coverage has quite documented how much modafinil is used these days by working professionals and people without narcolepsy - situations where modafinil can be used in endless combination of 'other things that we don't yet understand an interaction with'.
What is the effect of 3 days disturbed sleep with 200mg modafinil daily? What effect on people with other mental health comorbidities? What is the effect on the liver and kidney for frequent use (the foul-smelling urine it results in is honestly anxiety-inducing).
What worries me is that since 2016, there appears to be a scarcity of research on modafinil, even though anecdotally its use has exploded.
It feels safe in much the same way I imagine aspartame may have seemed safe when first synthesised. It may be a 'safer' smart drug than alternative medications, much like how aspartame is probably still 'safer' than abusing sugar. But the truth is that perhaps we still do not know.
This one does miss some important variables:
1. Dose-dependent effects
2. Naive vs experienced users of a drug
3. Novel vs familiar task
Though the authors spend a lot of time showing these stimulants reduce work efficiency, their central finding seems to be: "There was no significant effect of drug on performance"
And here, they are not giving you a big dose of MDMA so you can dance until sunrise, they are giving you a moderate dose of amphetamines to (tentatively) boost your ability to solve a maths problem.
Unless you have already trained yourself, don't overestimate your ability to discriminate, the placebo effect is really strong here.
And this was a bit before the current FAANG pressure to spend lots of time on Leetcode memorizing and rehearsing, in addition to coursework -- CS students only needed to get through their time-consuming lab-heavy courses, and then they could get a good job. (This was slightly before CS became one of the very high paying upper-middle careers, like medicine and law, which seemed to put high-stakes demands on undergrads' school performance.)
Large numbers of people drugged-up for years, simply to pass status-career gatekeeping, doesn't seem like a great situation.
I have to assume that everyone who has taken these drugs could have predicted this, yeah? No one gets this drug and thinks "I will literally be more intelligent", they get them so that they can grind out 12 hours of work without being distracted by anything. 12 hours of work at 90% efficiency is way better than ~2 hours of work at 100% efficiency.
> Not only that, but they spent substantially more time working on their solution while on the smart drugs than they did after taking the placebo. In fact, participants spent almost as much time on the easiest presentations of the knapsack task while on methylphenidate (Ritalin) as they did on the hardest instances of the task after taking the placebo, without any corresponding improvement in performance.
As expected! One of the "traps" you have to be aware of when taking these medications is to be sure to not overfocus on things that don't matter.
> The results have clear implications: healthy people who take these drugs hoping for cognitive gains may work harder and longer at a problem, but without any benefit.
No way lol that is a ridiculous conclusion to draw. Without any benefit? Seriously? The benefits are massive.
The issue with smart drugs is that high tolerance leads to psychosis much easier than you’d think.
Humans make better decisions when in a state they've been pretty much their entire lives than in an altered one, more news at 11.
The study seems useless - it's like giving the participants their own, long used car, asking them to set a time, and then comparing that to the time they would set in the same car, but with a slightly different clutch. I'd very gladly read a similar comparison for long term regular users.
This effect of amphetamines on creativity and work quality is expected and has been described in the literature before. It gets worse when sleep deprived.
They are best for repetitive boring work that requires alertness, not learning.
Ah ah! ADHD'ers including me have double the amount of DATs and NATs you guys and gals do not! Its why I will not get addicted taking Ritalin, Adderall, etc and yet you in fact will!
I mean it depends on what the goal and situation is, but I strongly believe that in general, fast thinking prioritizes heuristics over analysis and comes at an enormous (often unrecognized) cost.
Two of the three tested drugs were amphetamines though, very similar to those you listed[0].
0. https://bocarecoverycenter.com/treatment/understanding-add-a...
Piracetam was also developed in Romania in the 60s. I don't like communism or anything, but the complete ignorance of the U.S medical system about drugs developed outside the United States that are now out of patent is just a tragedy. Luckily, in the 80s and 90s AIDS patients lobbied to let foreign drugs be imported because many of them worked better than the domestically developed AIDS drugs.
What's weird is illegal drugs are vastly more popular and studied in the U.S, with the recent hallucinogen microdosing trend, than drugs that have been used safely for decades overseas.
(1) When studying, the extra time spent could outweigh the reduced quality of thought.
(2) Not a new point but it's strange how you can take a drug and think it has one effect when it has another.
https://slatestarcodex.com/2017/12/28/adderall-risks-much-mo...
>The problem with both is it requires other people to also take those drugs to be competitive.
Writers..
Lumping all of the medications in question into a single study is disingenuous, and seems biased towards concluding their ineffectiveness.
All three of the drugs in question have different mechanisms of action, which means that they will have a different effect on people with different brain chemistry. My read here is that if everyone takes all three and a placebo, performance may be enhanced in one case, but the remaining three cases can make the study come across as conclusive that on the whole, this course of treatment is ineffective.
Not a lot of detail on the placebo and why it performs so much better, but I'm curious about the "nocebo" effect and subjects' prior exposure to the non-placebo dosage. In other words, is the feeling of being on a new "smart" drug too distracting to successfully take the test in question for the first time?
The sample size is incredibly small at only 40 people, and skewed in terms of population. These were self-selecting individuals who responded to campus advertisements. This has been the modern critique of psychological experimentation in academia for decades, and I find it a little disparaging that we still have to suffer through it. I wish the HRB would ban things like campus advertisements as a means of recruiting test subjects -- we all really ought to know better by now.
While the sequencing of studies on each individual helps to avoid some amount of sequence-based confounding variables, and the spacing of seven days between studies allows for a pretty decent return to homeostasis, the number of study participants is still too low to be conclusive. I'd need to see this study get repeated numerous times, at a larger scale, over individuals with a more consistent neurological history to be considered conclusive.
I don't entirely buy the efficacy of working on individuals without any history of psychotropic medication or illicit drug use -- remember that this will rule out participants who have taken things like fluoxetine -- ruling out nearly 20% of adults in many countries -- or slightly skirted Australia's drug laws. These are people answering an ad on a college campus, likely for compensation. I don't think it's likely that all the subjects truthfully self-reported.
If anything I'd expect the neurological variability of a fully unscreened or undiagnosed population to make it really truly hard to measure these drugs effectiveness. Given the mechanisms of action, I'd expect that the likely 20% of subjects with undiagnosed depression and additional likely 5% of individuals with undiagnosed ADHD would really throw a wrench in any conclusive numbers.
I'm not trying to say that smart drugs are the answer to performing better at work. In fact, I'd expect a good night of sleep to make a bigger bump in these kinds of test scores. But I found the BPS is really jumping to conclusions based on what looks to me like very flimsy evidence.
Testing on people is hard, but publishing summaries of articles that don't entirely stand on their own and drawing authoritative conclusions is incredibly easy.