Comment by lumost | Hacker News Reader

Comment by lumost | Hacker News Reader

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I went to university at a time that Adderall was commonplace, and am now old enough to see how it turned out for the individuals. At college, it was common for students to illicitly purchase Adderall to use as a stimulate to cram for a test/paper etc. It was likewise common for students to abuse these drugs by taking pills at a faster than prescribed pace to work for 48 hours straight amongst other habits.

In the workplace, I saw the same folks struggle to work consistently without abusive dosages of such drugs. A close friend eventually went into in-patient care for psychosis due to his interaction with Adderall.

Like any drug, the effect wears off - Cognitive Behavioral Therapy matches prescription drugs at treating ADHD after 5 years. As I recall, the standard dosages of Adderall cease to be effective after 7-10 years due to changes in tolerance. Individuals trying to maintain the same therapeutic effect will either escalate their usage beyond "safe" levels or revert to their unmedicated habits.

The person you're replying to asked for a source, not an anecdote.

In my experience, Adderall does lose effectiveness but Vyvanse is much hardier. I’ve been receiving treatment for ADHD for about 4 years. My current Vyvanse dose is marginally higher than my original Adderall dose, but I’m considering reducing it down to below my original Adderall dose.

Cognitive behavioral therapy does excel at treating ADHD! But 5 years of therapy is what, 16 times more expensive than 5 years of medication? Maybe more? Not to mention the time commitment.

But adderall and vyvanse aren’t the same drug at all. You cannot directly compare dosages. 50mg of vyvanse is roughly equivalent to 20mg of adderall. As a prodrug, Vyvanse must be processed by the liver for it to function.

Indeed. That's why I'm underscoring that my Vyvanse dosage (20mg) is only midly higher than my Adderall dose was a few years ago (15mg).

I prefer to cycle between addictions of modafinil and caffeine, you shouldn't chronically use 1 drug forever

You get addicted to modafinil? I've tried it. It doesn't cure ADHD but it is remarkably like if those boomer newspaper comic jokes about coffee were actually real.

But… it's not addictive at all. Taking it made me not want to take it again. I was just like damn, I kind of smell like sulfur now.

> Cognitive Behavioral Therapy matches prescription drugs at treating ADHD after 5 years.

Apropos of anything else, 5 years of weekly CBT to get to the same result is a _lot_. 260 hours of therapy that, on my current health insurance would cost nearly $12,000 in copays. And during that 5 years you're still dealing with your ADHD to some heavy extent.

Adderall doesn't particularly have long-term tolerance. If you're developing tolerance to it, you have a magnesium deficiency and should take magnesium threonate supplements. (Not oxide, the cheap ones, that doesn't work.)

And then remember to drink water, exercise and get enough sleep.

Lmao, imagine saying this kind of slop to someone with diabetes.

“Cognitive behavioral therapy matches insulin after 5 years”

(because they die - so they’re no longer counted)

The results seem pretty clear that CBT can be quite effective in helping with ADHD.

Unlike insulin, which cannot be produced with any sort of therapy, it does seem that ADHD can be significantly improved.

I'm sorry though that the facts seem to bother you so much.

https://pubmed.ncbi.nlm.nih.gov/22480189/

https://pubmed.ncbi.nlm.nih.gov/28413900/

https://pubmed.ncbi.nlm.nih.gov/32036811/

Imagine posting “sorry that the facts bother you” and then linking to

- A study with a sample a size < 50

- A study that says that medication improves outcomes over CBT

- A study that says that evidence for CBT improving ADHD symptoms comes from studies with such small sample sizes that the conclusions could be the result of bias

The only way someone could conclude “CBT has the same outcome as medication” from the studies you linked to would be to not read them. The first two don’t really say that and the third one literally refutes that position.

>The only way someone could conclude “CBT has the same outcome as medication” from the studies you linked to would be to not read them.

Fortunately for them, that's often the case. I've seen at least a couple internet arguments with LLM-generated "sources" that didn't actually exist.

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