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Comment by goodside | Hacker News Reader

"Why do stimulants like Ritalin turn ADHD kids normal but turn normal kids into hopped-up screaming meamies?"

The second half of this, that normal kids on Ritalin and Adderall will be overstimulated and unable to concentrate, is just plain false. Both have been shown to improve concentration in healthy controls (with the notable exceptions of people with anxiety, OCD, or other hyperglutamatergic problems, and especially not people with schizophrenia). That's why it's prescribed to pretty much everyone: because it works for pretty much everyone.

Some studies:

http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=R...

http://www.ncbi.nlm.nih.gov/pubmed/18522689

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I'm sure mild doses improve productivity for most people, but I would bet their behavior would turn manic at a lower threshold than people in the ADHD spectrum.

Living with ADHD is extremely frustrating. Without medication there were many days where I'd go to work, get side-tracked for a moment, and accomplish absolutely nothing. Operating that way in college is fine, since you can usually find time to cram, but in the real world every day is finals day.

I also tend to engage in lots of negative novelty-seeking behavior: cheating on girlfriends, speeding since I can hardly pay attention to the road at 55, drinking too much, etc. I'm vaguely anhedonic and insatiable, which has led to great success in my career, but I never enjoy it much.

I wonder if that is generally true, that the most successful people are the least likely to appreciate their success. Seems to make sense per what you write - these people are likely to be successful and driven because they are insatiable. But, if you are insatiable that means you can't be satisfied, and don't appreciate what you have.

Ironically, it is the more satiable people, i.e. the less driven, who often envy the successful.

Maybe. If you think about successful serial entrepreneurs or executives, they could easily leave the game and live on a tropical island. There are many reasons to stay, like having an interesting life or wanting to change the world, but I think most have an innate desire to win.

I doubt it's a positive trait overall, but some outliers manage to channel it into something productive.

Really? Ritalin makes me calmer and helps me sleep a lot better. Does it do that for pretty much everyone?

I'm an Aderal person. If I want to work at 3 AM. I take some Aderal and I will have the ability to think and not fall asleep no matter how tired I get. So it(slightly different it) definitely does not do that to everyone.

On a side note: I have ADHD (and dyslexia but not really important) and Aderal can sometimes make me more active that before-Yes it depends on how much I take at one time, but still. I wouldn't say it calms me down. Meh

Same here - almost exact reaction. I remember as a kid that Ritalin used to calm me down but, as an adult, these are definitely stimulants to me today.

Ritalin, like most stimulants, boosts the dopamine levels in the synaptic cleft. This is the same basic mechanism of caffeine, nicotine, methylphenidate (Ritalin), amphetamine (Aderol), cocaine and methamphetamine. It shouldn't be making you sleep better. ;-)

There's a lot of hyperactive brain activity in an ADHD person, caused by a need for mental stimulation. And medication probably slows that activity down by satisfying that, allowing him/her to sleep.

If memory serves me, the operating hypothesis for ADHD is actually that it's due to reduced activity in a portion of the brain that regulates and directs the rest, the theory behind most ADHD drugs being to increase activity in that portion of the brain in order to let it better regulate the rest of the brain.

Hence, the seemingly paradoxical effect of a stimulant making someone calmer. Someone with ADHD, unable to relax because of too much distracting, chaotic activity in their brain, may thus find that the drugs help them relax.

By crude analogy, it's the inverse of the way moderate doses of ethanol (a depressant) can make someone seem more active due to reduced activity in parts of the brain that provide inhibitions and impulse control.

It's not a reduction in activity, but rather disinhibition. The PFC fails to inhibit activity that is regularly controlled in normal brains.

From personal experience, I feel reduced amounts of gratification from doing mundane things. Mental stimulation is reduced, therefore I'm driven, in some cases like a motor, to find more stimulation. Activity in the brain , in the form of thoughts, is one way to increase stimulation. Stimulant drugs satisfies this need for stimulation, so we don't need to keep on thinking about stuff, like the meaning of life. My theory is that this need to race through thoughts is the mechanism for bad short term memory. Running through more thoughts means old thoughts are forgotten.

There are also different types of Adhd by the way. There's inattentive and hyperactive. My explanation probably fits inattentive ADHD since that's where my personal experience lies.

Thanks for the references. Only the first, rather old, study refers specifically to the active ingredient in Ritalin. Ritalin is proven to be helpful. But Ritalin has its downsides.

http://en.wikipedia.org/wiki/Methylphenidate#Adverse_effects

The second refers to the active ingredient in Adderall, which is also helpful, and also has downsides.

http://en.wikipedia.org/wiki/Amphetamine#Overdose

Both medicines do indeed have helpful effects on concentration for many people. But they have sufficiently narrow therapeutic dose ranges and sufficiently dodgy safety profiles to be put on Schedule II under federal regulation in the United States. (Once amphetamines were an over-the-counter drug. That didn't prove in practice to be a good idea.) Dosage matters with these drugs, and should be checked by a physician regularly, preferably a physician familiar with the symptoms of mania.

http://ajp.psychiatryonline.org/cgi/content/full/163/7/1149

P.S. See

http://norvig.com/experiment-design.html

by Google's chief researcher for tips on reading research reports.

So is your conjecture that Ritalin, as a common street drug, with well known stimulating effects on the non-ADHD user, is merely a case of a placebo effect? They think they should go and dance for 18 hours rather than the effects of the drug?

Stimulants stimulate people with ADHD, too. I'm not sure where people get the idea that they don't. The fact that they stop trying to stimulate themselves means they act calmer, but if you gave someone with ADHD a bunch of Ritalin or a few lines, they certainly aren't falling asleep unless they have a huge tolerance.

I don't just simply fall asleep, but Ritalin and Adderall have had relaxing effects, enough to make sleeping easier.

And I've never felt as calm as when I took basic uppers (black beauties, i.e. Adderall without that annoying timed release thing).

So, anecdotal evidence tells me different brains react differently to stimulants.

I'm just responding to this.

>The second half of this, that normal kids on Ritalin and Adderall will be overstimulated and unable to concentrate, is just plain false.

Not that I've taken Ritalin, but some folks I know have taken it particularly for the off-the wall overstimulated feeling they get on it. Perhaps it's false. But then it would just be a placebo effect and they may as well have taken cod liver oil.

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