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Posted on 5/23/20 at 12:22 pm to supadave3
Posted on 5/23/20 at 12:22 pm to supadave3
Vyvanse is by far the most sought after and preferred current stimulant by patients not looking to get high. Still though anyone can pop 120mg at once and it’ll probably do the trick. Addiction can’t be treated without trust the patient isn’t lying and trying/actively wants to get better but we also can’t let diversion stop legit medical use where it’s needed. It’s a tricky issue but as I’ve said Med school focuses more now on addiction than ever and my practice and many others have made changes to try to head it off.
This post was edited on 5/23/20 at 12:25 pm
1
Posted on 5/23/20 at 12:23 pm to td01241
Ok so the drug triggers receptors that decrease depression, temporarily.. What are the effects long term? You could shoot them full of heroine and trigger all kinds of receptors that decrease depression. Also how long does the 20 mg do anything before it needs to be upped to have the same desired effect?...
Posted on 5/23/20 at 12:29 pm to td01241
And I don’t give a shite what community you are a part of or who you trust. If you think giving an addiction patient adderall is anything but a laughably horrible as well as dangerous idea, you are wrong.
Posted on 5/23/20 at 12:29 pm to sabes que
Stimulant effects at therapeutic doses are really no less safe than many over the counter medicines in terms of body and mind even in long term patients. Issues with underlying heart conditions are rare but they do exists even though it’s almost always from taking too much anyway so I often have an ekg done first. Long term dosage and tolerance in stimulants is really no worse than many others especially benzodiazepines and adults will take 8mg of Klonopin a day without a second thought. It’s hasnt really been used enough to say it should 100% be first line yet though, which is why I don’t even though I often want to. SSRIs and other similar medicines are some of the most useless medicines we have.
Posted on 5/23/20 at 12:30 pm to td01241
quote:
td01241
Since you seem to know your stuff from the medical side, settle an on-going frequent argument I find myself in.
Many people claim that when they take Adderall it 'calms them down', therefore PROVING that they have ADHD and need it. My response is that that is a load of BS and stems from patients that need it take it on a daily basis which then overcomes the initial speed phase, hence why those legitimately on meds don't speed like those that take it recreationally once a week or so.
My belief is that anyone, whether ADHD or not, will 'speed' on their first few doses. This does not determine if ADHD exist or not. It amazes me how many people, especially females, have taken up this argument with me. I'm either right or very very wrong.
Posted on 5/23/20 at 12:34 pm to td01241
quote:
adults will take 8mg of Klonopin a day
Wow. I've been prescribed this med for years but only at 1 mg, twice daily and I sometimes take them both at night if sleep has been an issue, but I always ensure I only take 2 mg daily at the most.
I couldn't imagine taking 8 of those suckers, I'd be out for 3 days.
Posted on 5/23/20 at 12:36 pm to td01241
It’s dangerous because it will make an addict seek higher dosages and/or stronger drugs that have similar effects.
This post was edited on 5/23/20 at 12:37 pm
Posted on 5/23/20 at 12:36 pm to Iron Lion
quote:
I did the same thing
Trashy
Posted on 5/23/20 at 12:38 pm to supadave3
You’re most certainly not wrong but I don’t think it’s so much for the reason you think. The three receptors typically hit to a certain degree by stimulants are serotonin, norepinephrine, and dopamine. Every formation of every stimulant is going to hit every single person to a certain different degree. What caused the speed you’re talking about is the specific amount of dopamine released and over how long it takes to do it. I don’t like the diagnosis of ADD at all but not because I don’t believe it exists rarely, but because the DSM is freaking general I could diagnosis every patient everyday but I do feel stimulants definitely have other more important uses. People with “ADD” really mostly have other specific things as a major diagnoses and these conditions exist in part from lack of dopamine. Therefore the speed rush from stimulants will not hit them as hard and when the proper compound of amphetamine is found at the right dose after trial and error tbh it will not have near the same impact.
Posted on 5/23/20 at 12:39 pm to td01241
Just because one builds up tolerance to benzo’s rapidly as well, doesn’t change the fact that after 3 months of taking 20 mg of adderall daily, the dosage would have to be doubled to have the same desired effects... if not sooner.
Posted on 5/23/20 at 12:41 pm to WaydownSouth
Cause most of these losers are on the chit themselves
Posted on 5/23/20 at 12:42 pm to supadave3
Dosage escalation in benzos is a really big issue. They’re very effective medicines but you would not believe the absolute crazy coprescription and insane doses I see all the time. In inherited patients I will tell them that something will begin taper immediately, it’s usually the opioid there on, or they can find another doctor. Long term benzo use is a way way bigger issue than stimulant use in any age range.
Posted on 5/23/20 at 12:45 pm to sabes que
Stimulants have no where close to dosage increase requirements and tolerance escalation in the % of patients as benzos. In benzos it is 100% of people will require higher doses and increase amounts rapidly. No one is different in this area. Many stimulant patients I know have been on 20mg Xr adderall for 10 years. There are ways to mitigate stimulant tolerance, there isn’t with benzos. Benzos are super effective for many things though just way over prescribed and for too long.
Posted on 5/23/20 at 1:12 pm to td01241
It may not have the dosage increase requirements of benzo’s. But one absolutely builds a tolerance rather rapidly. Someone that has been taking 20 mg of adderall for 10 years isn’t getting anything but a placebo effect. Also adderall and meth build a tolerance for each other. This is not true of other stimulants like cocaine or caffeine. Someone who doesn’t do meth will have a higher tolerance for its effects if they have a tolerance to adderall and vice versa. The same person that takes adderall will not have a built up tolerance for cocaine or caffeine however.
Posted on 5/23/20 at 1:15 pm to Errerrerrwere
quote:
Errerrerrwere
Whenever you reply to me I feel like a homeless guy bumped into me and I need an immediate shower. frick off.
Posted on 5/23/20 at 1:17 pm to td01241
quote:
You’re most certainly not wrong but I don’t think it’s so much for the reason you think.
The three receptors typically hit to a certain degree by stimulants are serotonin, norepinephrine, and dopamine. Every formation of every stimulant is going to hit every single person to a certain different degree.
That makes complete sense. So people with a lack of dopamine will see a more 'normal' response than one without. So, both myself and my debaters are correct to a degree.
I'll be sure not to tell them that.
Thanks for all the insight.
Posted on 5/23/20 at 1:19 pm to sabes que
It depends on your definition of rapid. If benzos are the standard for the medicine that builds tolerance the fastest needed to continue justify it medically (it is and should be) stimulants are no where close. Getting high and getting medical effect intended aren’t same and we shouldn’t confuse them in a conversation like this. It’s also easier to have patients mitigate tolerance longer by how easy they are to start/stop compared to the extreme difficulty and even life threatening danger in some when quitting benzos/alcohol cold turkey. It’s pretty much community standard at this point to do this as much as you can for each individual. Someone for ADHD might take weekends off. Someone taking for depression can’t do this obviously so I often set aside a month or so 6 months in advance to prepare them for what they may need like lithium or maybe an atypical antipsychotics everyone is different. There is really no medically justified reason to prescribe benzos long term except in seizure patients and it’s not good for the patient. It takes me years to taper most people off benzos.
Posted on 5/23/20 at 1:22 pm to supadave3
There can be some expected consistency. For instance you would expect to see a quick more intense rush in anyone taking Aderral IR than a drug like Vyvanse or Focalin. But yes, the physiology behind types of medication like this becomes balancing those chemicals. It’s the same with SSRIs they just suck and are 90% never raised to a dose that might have a possibility of working.
Posted on 5/23/20 at 1:38 pm to Iron Lion
quote:
Whenever you reply to me I feel like a homeless guy bumped into me and I need an immediate shower.
They probably turned homeless because their beloved father hooked them up with some weed, man!
Posted on 5/23/20 at 2:50 pm to td01241
I definitely agree with you that benzos shouldn’t be prescribed long term. Also it’s true that it’s easier to cycle on and off of stimulants than it is benzos. Stimulants really don’t cause withdrawals other than temporary fatigue. And you have a point about getting high vs medical effect, but I have a hard time believing 20 mg of adderall after ten years is doing anything at all for anyone. Also if you prescribe an addict 30, 20 mg adderalls, they would be gone in a week tops, leaving them searching for something on the streets.
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