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bcjdjsndonyesterday at 11:41 AM11 repliesview on HN

Meanwhile half the world's on some kind of ADHD amphetamine with absolutely no plan for what to do when their tolerance starts degrading the quality of the high.

There is a fundamental problem with taking happy pills to treat anything... Tolerance. They work less and less and your own body begins to lessen its own production of whatever molecule in the interests of homeostasis.

If doctors have the wisdom to realise cocaine might feel good in the short term but has obvious damaging effects in the long term, then why can't they apply that logic to anything but illegal drugs? How can 7+ years in higher education still produce such illogical thinkers?


Replies

dangyesterday at 5:50 PM

"Eschew flamebait. Avoid generic tangents."

https://news.ycombinator.com/newsguidelines.html

drakytheyesterday at 2:58 PM

Diagnosed with ADHD as an adult, and on stimulants (went through 3 kinds before we found one that seemed to help).

What "high"? Our brain chemistry literally works differently than neurotypical people and the stimulants don't get us high. In fact they often have a calming effect. I had to fight not to fall asleep at my desk two days this week (Not entirely the medication's fault, lotta family stress wrecking my sleep).

Does tolerance eventually cause the dosage to increase or the medication to cycle? Yes. But as others have mentioned taking the weekend off (or hell, just forgetting periodically in my case) mitigates that to a large extent. And, since there is such a hard time acquiring the medication even with a prescription skipping weekends or vacations has the benefit of seeing people through the inevitable shortage their pharmacy will have.

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pasyesterday at 11:52 AM

people whose life is amazing don't go through the process of getting stimulants (or even SSRIs) prescribed to them. psychiatrists know about this. the plan is usually to cycle the meds. is this great and works every time? no. is this better than the alternative? yes.

ADHD is not great. and in many cases it's so bad people die from "not paying attention", and Ritalin (methylphenidate) is visibly helping people avoid those early deaths.

https://pmc.ncbi.nlm.nih.gov/articles/PMC10901868/

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cynicalkaneyesterday at 2:59 PM

One characteristic of ADHD is that many people don't build up tolerance, or only minor tolerance, to therapeutic doses of some stimulants including amphetamines.

It's really not the same as what's being discussed here.

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MSFT_Edgingyesterday at 12:48 PM

I think this is a very different problem. I'm prescribed those "happy pills" as you call them. I forget to take them regularly, in fact I think you may have just reminded me to take mine as long as I remember by the end of this comment.

There isn't a high, in fact if I don't modulate how I eat and hydrate, I don't feel it. But if I get the timing just right, with the correct breakfast and everything, I can just barely manage to do the boring tasks that normally my brain will do nearly anything to distract me from.

Eventually tolerance does build, I manage that by taking weekends off and every 6 months or so, I'll take 1-2 weeks off cold turkey.

I need this shit to remotely participate in the bullshit gauntlet we call an economy. Without it, I'm essentially disenfranchised. I can get a job by channeling some hyper-focus long enough to show I'm not incompetent, but once the daily grind sets in, the rent payments don't stop.

These medicines are a by-product of the society we produced. We refuse to refine the society so we medicate the incompatibility.

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moduspolyesterday at 1:52 PM

I'm sure everyone's different but for me, weekdays on and weekends off seems to handle avoiding the tolerance. I don't need to be nearly as focused when I'm off work.

SkyeCAyesterday at 4:32 PM

I don't get any "high" from ADHD meds, at least not in the way any sane person would interpret the word "high".

They help me focus at work, but they aren't enjoyable.

dullcrispyesterday at 1:33 PM

You’re upset that they banned the illegal drugs but not the legal ones? They probably just need more education to reach your level of logical thinking.

FatherOfCursesyesterday at 7:13 PM

"Happy pills?" Are you kidding me? Are you anti-vax as well?

wat10000yesterday at 3:46 PM

I'm so sick of this moralistic attitude toward psychiatric drugs. "Happy pills"? Come on. There are ways to work around tolerance. Even if there aren't, what's so terrible about a temporary improvement?

I'd wager most of us use some sort of vision correction. This does nothing to fix the underlying problem or even halt the progression, and most of the treatments leave us with a lifelong dependency on them. And yet nobody goes around derisively referring to "happy lenses" and talking about how stupid optometrists are.

There are legitimate doubts about the effectiveness of some psychiatric drugs. I don't believe ADHD drugs are among them. Regardless, that should be framed as a need for better education and dissemination of the information, better studies to determine effectiveness and better treatment regimens, and new drugs that do a better job. It should not be framed as "happy pills" with this derisive attitude just because the condition I take medication for is a brain condition rather than something like a heart condition.

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chownieyesterday at 12:46 PM

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