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Comment by cynicalkane | Hacker News Reader

This isn't always true. Stimulants can -- for a subpopulation, at least -- meaningfully improve focus in ADHD individuals in long-term measurable ways and low risk of side effects. This contrasts starkly to ordinary people, who will quickly build up a tolerance to typical stimulants. The difference is measurable with clinical tests.

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> This contrasts starkly to ordinary people, who will quickly build up a tolerance to typical stimulants.

This isn’t really correct.

Everyone builds up tolerance to the euphoric effects. People expecting stimulants to make them happy, motivated, and energized forever are going to be disappointed, ADHD or not.

The concentration enhancing effects are more durable because they’re not re-regulated exactly the same as the euphoric component.

This is the real reason why ADHD people find long term value in stimulants but non-ADHD people do not. They were taking the drug for different reasons.

It’s also possible to overshoot the dose and get to the point where too much drug is counterproductive. This is a common problem for people chasing that euphoria who have doctors who don’t care and keep writing for higher doses. In many patients when the drug “isn’t working” a dose reduction can actually put them back where it’s effective as an ADHD medication.

That is what the parent is saying. Just because it no longer works as a stimulant, it doesn't mean treatment should be discontinued.

I am not sure why you are being downvoted. Stimulants work very well for long term treatment of ADHD. It's the gold standard with >90% success rate.

Being downvoted cause they werent paying attention to what the comment above them was saying. The Euphoria WILL always wear off, doesnt mean it doesnt continue to treat symptoms.

Also yes stimulants are the gold standard but I would argue that our metrics for success are bunk

Generally speaking (there are exceptions) ADHD people do not experience euphoria when taking stimulants. I never have, not even the first time. It’s known as the paradoxical reaction.

Some people do develop tolerance, but usually building an off day into the schedule is enough to counter that.

Stimulant tolerance means you aren't taking enough magnesium. Or for Vyvanse, your diet is too acidic.

that is absolutely just straight up untrue. Yes excessive stimulant usage depletes magnesium, mostly cause you forget to eat. And yes for both vyvanse and adderall, if your stomach is too acidic it will decrease bioavailability, but neither of things things have anything to do with tolerance, which accrues on a semi-permanent basis every time you take the drug.

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