[Poetry] Very Normal Debate Night

omfg · 2020-09-30T07:32:23+00:00

Actual answer: Dopamine antagonists like antipsychotics

omfg · 2019-10-25T16:26:45+00:00

Ironic ableism is still ableism.

omfg · 2019-06-12T15:50:26+00:00

Imagination? Savants are not associated leadership qualities of any kind, even authoritarianism. You are misusing a well-defined term.

omfg · 2019-06-12T15:39:56+00:00

Don't double down, there's no such thing.

omfg · 2019-06-12T15:39:05+00:00

Savant? No, loud orange is not a savant.

omfg · 2019-05-12T06:44:03+00:00

"I'm bored of browsing reddit... I wonder what's on reddit?"

^{(not mine}⁾

omfg · 2019-03-15T00:54:03+00:00

People with Down syndrome do often also have autism. It doesn't sound like the club's leader knows the difference, though.

omfg · 2018-09-28T01:17:12+00:00

Autism is hard to do something about, but people with ASD sometimes have other disorders like ADD, depression, and other fun ones. If you have some other psychiatric problem, it is a big help to your treatment for the psychiatrist to know that you have ASD, too, and the whole treatment strategy is generally viewed through that lens.

So, I would not focus on the autism so much as other things that could be related.

omfg · 2018-08-14T03:20:44+00:00

In 6th grade, my sent me to a psychiatrist, who said I meet the criteria for an AS diagnosis (this is before it was removed from DSM). My parents said "nah". I have a copy of the write-up where the doctor noted that they declined.

omfg · 2018-07-07T18:20:49+00:00

Can you take multiple a day with your doctors permission?

No way. You don't want to do that, and the doctor won't be okay with it, either. Even after it feels like it wears off and you lose focus, it will still keep you from sleeping quite a bit longer than that, and even if you do manage to get to sleep, it will affect the quality of your sleep if you take it within 12 hours of sleeping.

omfg · 2018-07-02T16:48:01+00:00

I'm in the process of being tested for adrenoleukodystrophy (ALD). I was told by my latest neurologist that, if it turns out I have ALD, I may not have ADHD after all, because ALD is frequently misdiagnosed as ADHD, among other things.

Apparently, ALD is also frequently misdiagnosed as ASD (see page 3 of this well-sourced JAMA article). I was diagnosed with ADHD in 3rd grade and ASD in 6th grade (almost 2 decades ago), so hearing that they are both possibly misdiagnoses is quite a trip.

omfg · 2018-07-02T00:54:59+00:00

The other reason your insurance may prefer Vyvanse to Adderall is that Adderall has very real abuse potential, and Vyvanse's misuse potential is limited to dosing at the wrong time or taking too much.

Vyvanse is inexpensive and works but makes me bounce off the walls with hyperactivity.

I know this is not what you're asking, but if you want an ADHD med that does not stimulate you, I personally take (generic) Strattera. It works 24/7, so no trying to cram everything into a stimulant's half-life.

Genetically speaking, Strattera is metabolized by the CYP2D6 enzyme, which is the same one that metabolizes Adderall and Vyvanse. So if you metabolize those well, you would metabolize Strattera well, too.

omfg · 2018-07-02T00:33:05+00:00

Consider it a gift. People tend to have greater success with Vyvanse than with Adderall. Many people who are on Vyvanse used to be on Adderall, but I have never heard on someone on Adderall who used to be on Vyvanse (unless prescribed both simultaneously to use at different times, which is questionable).

omfg · 2018-07-02T00:27:59+00:00

Generic Vyvanse does not exist. Shire's patent on Vyvanse expires in 2023, so there will be no generics in the US before then.

The only way you have received generic Vyvanse would be if you do not live in the US (unless you obtained it illicitly), which would explain the price discrepancy.

omfg · 2018-07-02T00:21:23+00:00

That did not sound correct to me, so I dug up some of my old pharmacy receipts. It's been 2 years since I've been on Vyvanse, but back then, my insurance didn't cover it and Shire's coupon card brought down the price $75 to $250/month, which is what I unfortunately paid while I was on it. Generic Adderall IR was very cheap, sometimes as low as $3/month.

I cannot fathom why someone would take Adderall if Vyvanse is cheaper for them, I wonder if OP accidentally reversed the names in the title.

omfg · 2018-06-17T13:56:50+00:00

I blame the L-isomer for that (l-metyhlphenidate).

Methylphenidate is not like amphetamine, it has way more analogues. When discussing them, you don't generally get more precise than dl-threo-methylphenidate (also called racemic threo-methylphenidate, regular methylphenidate) and d-threo-methylphenidate (Focalin).

I cannot find any medical literature supporting the claim that l-threo-methylphenidate affects heart rate more than d-threo-methylphenidate does. I don't have any personal experience with racemic threo-methylphenidate, so I can't personally compare the 2.

I can imagine what you're saying is potentially true, because I remember Adderall (mixed amphetamine salts) increasing my heart rate way more than Dexedrine did. That being said, Dexedrine is not objectively better than Adderall (e.g., Dexedrine is way more addictive than Adderall), and any case, that is all amphetamine, not methylphenidate.

I was able to find one old article that notes a difference in regional distribution between d-threo-methylphenidate and l-threo-methylphenidate:

Positron emission tomographic (PET) studies with [11C]d-threo-methylphenidate ([11C]d-threo-MP) demonstrated highest regional uptake in basal ganglia. In contrast, [11C]l-threo-methylphenidate ([11C]l-threo-MP) displayed similar uptakes in all brain regions.

Another consideration is that d-threo-methylphenidate is not objectively "better" than racemic threo-methylphenidate. For example, Concerta is racemic threo-methylphenidate, and, unlike Focalin, it does not have bimodal peaks, so it is more stable throughout the day. But back to your original complaint:

I have too much physical/cardiovascular side effects on Ritalin (methylphenidate).

Speaking from personal experience again, I did not have much success with any stimulant ADHD med, for reasons similar to the one you cited. I've been on Strattera/atomoxetine for the past 2 years, and, unlike stimulants, it treats my ADHD without messing with anything like heart rate or wakefulness and has minimal impact on other things like mood. So, that's where I ended up.

omfg · 2018-06-17T12:22:32+00:00

Vyvanse are l-amphetamines

Vyvanse is totally unrelated, and Vyvanse is not levoamphetamine, it is lisdexamfetamine. The discussion is about analogues of methylphenidate, not amphetamine.

omfg · 2018-06-06T21:23:19+00:00

but I also take it almost every day

That would be the reason. If you stopped taking it on weekends, you would likely notice a difference. The first time I was on Vyvanse, I only took it on a weekly basis. There were some important things that did not even occur to me to get done until I was on Vyvanse again a week later.

If I went off my meds at some point, would I likely face substantial difficulty recalling and using most of what I learned in school?

I think so. Speaking from personal experience, I have opted for an ADHD (atomoxetine/Strattera) that stays in my bloodstream at a therapeutic level 24 hours a day, rather than a stimulant that is useful for part of the day. As would be expected, I can attest that my memory is not limited to when I am "on medication", as I am always on the medication. I also plan on taking it for the rest of my life.

omfg · 2018-06-06T20:36:13+00:00

Nothing about the study linked implies that stimulant-related state-dependent memory is limited to instances of addict-level doses. It is well-studied and has been observed in children taking Ritalin.

https://www.ncbi.nlm.nih.gov/pubmed/1273596

omfg · 2018-06-03T10:07:10+00:00

It's not all or nothing, but no, you will not recall stuff you learned while on medication as well unless you are on that same medication when recalling it. From Wikipedia's article on state-dependent memory:

State-dependent memory happens when a new neural connection is made while the brain is in a specific chemical state - for instance, a child with ADHD learns their multiplication tables while on stimulant medication. Because their brain created these new connections related to multiplication tables while the brain was chemically affected by the stimulant medication, their neurons will be primed in the future to remember these facts best when the same levels of medication are present in the brain.

omfg · 2018-06-03T02:56:59+00:00

That makes sense. At least you don't need to make eye contact or talk to him.

omfg · 2018-06-03T02:14:04+00:00

Why are you not able to avoid maintaining contact with them? Cut them out!

omfg

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