Adderall really isn't fair.

[DesitnationMD]

Is prescription abuse that big a problem in med school? Don't really see much of it here at my undergrad, aside from coffee addicts. Do people suddenly start in med school?

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[redmen12]

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[mrowmrow]

Is prescription abuse that big a problem in med school? Don't really see much of it here at my undergrad, aside from coffee addicts. Do people suddenly start in med school?

Really? At my undergrad, everyone and their mom was on adderall, many of those people are now in med school and haven't stopped

 

[Holmwood]

Is prescription abuse that big a problem in med school? Don't really see much of it here at my undergrad, aside from coffee addicts. Do people suddenly start in med school?

Eh, alcoholism is more of an issue.

 

[bhb19]

I'll be blunt: If you are making sweeping conclusions based off adderall's effects from just your first five times youve taken it, you know very little about adderall and its function/effects. None of this shows any realization towards the issues with extremely small sample size, tolerance, side effects, how it affects different people entirely differently amongst a million other things.

MadJack's experience might differ from others(many ADHD people see their academic performance improve enormously after treatment) but the point overall is still the same he brings up: you will have to adjust to it, learn how to function without it at certain points/occurence etc at some point in your life. The effects it has on somebody taking it for 5 days vs 5 months vs 5 years are radically different.

This cannot be stressed enough. The effects of Adderall differ from person to person and prolonged use is necessary to truly understand how it affects your body. I suffered from ADHD symptoms and depression for a long, long time and it went completely untreated. I finally started taking Adderall in the hopes that I would finally be able to get myself to sit down and work like normal people can. I fell in love with how it made me feel at first, and if you had asked me how I felt after taking five times, I would have told you it was a miracle drug as well.

As time went on, however, it wasn't all rainbows and butterflies anymore. The loss of appetite and dehydration, which are common side effects of Adderall, began to cause serious problems. I was constantly physically exhausted, I lost a ton of weight, and I couldn't sleep without sleep aids. It got so bad that I was willing to take getting slightly lower grades and not take it anymore. Fortunately, the psychiatrist I saw at my university clinic is brilliant and got me on bupropion, which has helped both my depression and ADHD immensely.


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[osckey]

I was diagnosed with ADD back in elementary school. Used to take Ritalin then Strattera. Eventually I was prescribed Adderall but it was way too much. I felt agitated, high, and unfocused. So I stopped Adderall and focused on ways to manage my ADD naturally by creating schedules for myself, structuring my time, and exercising. I've read somewhere that individuals with ADD thrive in structured environments, but then again don't we all? Anyways, it's been years since I last touched any ADD medication of any kind. I'm not suggesting that everyone jump off the medication bandwagon because I am certain that ADD can be debilitating, however, those who have mild cases of ADD should look into effective lifestyle habits which can be used to improve their outcome. You can take the pill all you want but if you never sit down and do the work in the first place you're still not going to make any progress. Btw, the only people that I knew were abusing Adderall were people failing classes or the typical unmotivated type.

Is it easy? Nope. Fair? Idk. Possible to succeed without medication? Sure.

 

[familyaerospace]

Is prescription abuse that big a problem in med school? Don't really see much of it here at my undergrad, aside from coffee addicts. Do people suddenly start in med school?

Prescription drug abuse was huge at Emory 16 years ago among the pre-meds, it has only gotten worse I suspect. I also was told by one of the disability people at MCG (as well as the clinical psychologist who reupped my diagnosis) that a lot of people "find out" they have ADHD when they go to medical school. Sure they do... I personally don't believe 95% of them do, but if you know what the test is looking for, it is easy enough to fool the test which I think several organizations have already figured out which is why the testing requirements became more insane.

I at least have medical records going back to 1990 showing attention difficulties.

 

[Par4thecourse]

As I mentioned, not to be redundant, but this discussion is a fine example of what I previously identified. For some reason, when people talk about and analyze ADHD, controversy follows. They go hand in hand, unfortunately. Debate is healthy, to be expected, important and enjoyable. Within this context, it is harmful. Folks with ADHD strain to become self-assured. Having failed so many times at so many things, self-confidence is in the pits, likely pathological, certainly painful and often crippling. With proper treatment many of us feel we've been given a new life, literally. Comparing ADHD to being legally blind, effective treatment is like wearing corrective lenses for the first time at 18, 27, 46 or whatever age we happen to be. For me, it was as though I'd been walking around throughout life unable to see better than 20/500.

Having "20/20 vision" for the first time in my life, I was absolutely and totally blown away, completely astounded by what I could see, and what I'd missed all those minutes, hours, days, weeks, months, years, decades. I wasn't to blame, either, for my innumerable gaffs and missteps and total failures.

At the same time that the brutal reality of facing this baffling beast on our own is lifted, (including not knowing what was wrong with us) enjoying the thrill of having a brain that actually works, we encounter a debate that rages all over, denying our reality, denying ADHD is a biologically based disorder, criticizing the drugs we take to help us, casting accusations that our parents didn't parent us properly, that we lack discipline, on and on. These opinions are like rocks being hurled at our fledgling self-confidence. What this back and forth lacks is this: The simple, irrefutable facts that ADHD is real, terribly damaging, most of the time prescription medication works wonders in and for us and is safe, taken as prescribed by a competent medical doctor with a lot of experience in this field. Period. More of us need to speak out and tell our stories. We need to band together and with one clear voice announce to the world what happened to us and how medical intervention opened our eyes and gave life to the hopeless.

 

[Donthangme]

Absolutely no problem as long you obtained it legally from a legitimate pharmacy and received a prescription from a health professional. Just know that it's highly addictive, even more so than many "illegal" drugs.

 

[Par4thecourse]

Absolutely no problem as long you obtained it legally from a legitimate pharmacy and received a prescription from a health professional. Just know that it's highly addictive, even more so than many illegal drugs.

See what I mean? No offense to you, at all. It's just that your response is perfectly in keeping with what I suggested. Coincidence?

It would be like saying to a person who gets an all clear report 5 years out from cancer surgery and folks, friends and family say, "Well, wouldn't it be nice if that actually contained some scientific landmark data that you are likely out of danger now?"

 

[Azete]

Certainly not going to offer medical advice, but I had an experience similar to OP; undiagnosed ADD for a long time, got prescribed adderall and felt like a God.

After a short period, the side effects became unbearable. I honestly felt like a cocaine addict, periods of super highs with debilitating withdrawals when I didn't take it. Eventually I cut it off cold turkey and my ADD was 10x worse than ever before.

I considered dropping school altogether because I felt like if I couldn't keep up without prescription drugs then I didn't deserve to be there. The best thing that ever happened to me was a girl I met that happened to be a yoga instructor. She convinced me to attend one of her classes and it changed my life. Since then I've incorporated yoga as part of my daily life and I've also made drastic changes to my sleep routine (cut off ALL electronics an hour before sleep, use dim lighting at night, wear computer glasses, eat magnesium rich foods, minimum 7 hours sleep -- no exceptions).

I'm proud to say I'm a much better student now than I ever was on adderall; very rarely do I need to pass through material more than twice for it to stick forever. I imagine most of my problems were a cumulative effect of poor sleep and yoga was sort of the first domino to get it corrected. That girl? I married her.

 

[Rattus]

I am 18 years old currently. I had undiagnosed ADHD until I was around 16 years old. I was prescribed Vyvanse, which is pretty much Adderall that the body has to metabolize before using, which makes it be slower to act or something like that. I've read some really cool studies while also looking up any words I didn't understand in a medical textbook. One/a few (they blurred together) of the studies said that Adderall and Vyvanse usage over the long-term made parts of the brain that are different in ADHD become slightly more normal as time went on. Which means that Vyvanse and Adderall reduced ADHD severity, at least until we get a study that says otherwise.
Before I was prescribed Vyvanse, I started to go into a depression due to being unable to remember things even though I knew how to do them. With the Vyvanse, I can actually remember things. Which is really cool. I can remember simple instructions without constantly repeating them in my head now! Before I got the Vyvanse, I was actually considering dropping out and ruining my life. I have no skills that would be good in the real world, like heavy lifting and hand-eye coordination. Medical stuff is my thing. I know how to apply things and work things out if I could just remember them.
When my Vyvanse wears off, I end up coming off as a major butthole because I don't remember social skills and I am too impulsive to shut my mouth. I end up saying things that I regret when I remember them. Pretty much, without the ADHD medications, I am like the worst drunk person ever. I'm working on that but it is difficult because I literally can't remember much when I am not on the Vyvanse. With the Vyvanse, I can remember things and actually take part in conversations without accidentally insulting people!
I understand that how the medication works differs for everyone. But should someone with severe memory deficits as a result of ADHD be forced to go untreated? That is like saying that a diabetic shouldn't have insulin. My uncle can't afford insulin or regular doctor visits or anything because of his diabetes making him go blind and be fired. Untreated diabetes kills people. Untreated ADHD also can kill people or at least ruin lives. Impulsivity combined with a tendency to impulsively self-treat with things like alcohol and caffeine can make for an ugly combination.
Sorry if this is too much wordage for this post.

 

[Crayola227]

I am 18 years old currently. I had undiagnosed ADHD until I was around 16 years old. I was prescribed Vyvanse, which is pretty much Adderall that the body has to metabolize before using, which makes it be slower to act or something like that. I've read some really cool studies while also looking up any words I didn't understand in a medical textbook. One/a few (they blurred together) of the studies said that Adderall and Vyvanse usage over the long-term made parts of the brain that are different in ADHD become slightly more normal as time went on. Which means that Vyvanse and Adderall reduced ADHD severity, at least until we get a study that says otherwise.
Before I was prescribed Vyvanse, I started to go into a depression due to being unable to remember things even though I knew how to do them. With the Vyvanse, I can actually remember things. Which is really cool. I can remember simple instructions without constantly repeating them in my head now! Before I got the Vyvanse, I was actually considering dropping out and ruining my life. I have no skills that would be good in the real world, like heavy lifting and hand-eye coordination. Medical stuff is my thing. I know how to apply things and work things out if I could just remember them.
When my Vyvanse wears off, I end up coming off as a major butthole because I don't remember social skills and I am too impulsive to shut my mouth. I end up saying things that I regret when I remember them. Pretty much, without the ADHD medications, I am like the worst drunk person ever. I'm working on that but it is difficult because I literally can't remember much when I am not on the Vyvanse. With the Vyvanse, I can remember things and actually take part in conversations without accidentally insulting people!
I understand that how the medication works differs for everyone. But should someone with severe memory deficits as a result of ADHD be forced to go untreated? That is like saying that a diabetic shouldn't have insulin. My uncle can't afford insulin or regular doctor visits or anything because of his diabetes making him go blind and be fired. Untreated diabetes kills people. Untreated ADHD also can kill people or at least ruin lives. Impulsivity combined with a tendency to impulsively self-treat with things like alcohol and caffeine can make for an ugly combination.
Sorry if this is too much wordage for this post.

Loving this testimony from a hSDN member. more mature than some of the attending posts I see.

 

[JustAPhD]

I was prescribed Vyvanse, which is pretty much Adderall that the body has to metabolize before using, which makes it be slower to act or something like that.

Yup. Vyvanse is a prodrug, meaning that the form you take is inactive until your body converts it to dextroamphetamine (a potent stimulant) and L-lysine. This extra step provides the longer duration while also having the nice side effect of making the drug less likely to be abused (although it still is).

I understand that how the medication works differs for everyone. But should someone with severe memory deficits as a result of ADHD be forced to go untreated? That is like saying that a diabetic shouldn't have insulin.

The analogy is a little off, but I think your point still stands. I don't think the issue at hand is about those who actually need the drug taking it, more so that it is abused by those who are "normal" without the drug. There's testament from various members about how it's possible to function fine without it, and then there's members like yourself who say that the medication is something that helps you a great deal. I think this just illustrates the complexity of treating the symptoms and that once a chemical is in the brain it can impact similar people in very non-similar ways.

Whether or not pumping someone full of amphetamines is the best treatment for ADD/ADHD is an additional can of worms.

 

[Rattus]

Yup. Vyvanse is a prodrug, meaning that the form you take is inactive until your body converts it to dextroamphetamine (a potent stimulant) and L-lysine. This extra step provides the longer duration while also having the nice side effect of making the drug less likely to be abused (although it still is).



The analogy is a little off, but I think your point still stands. I don't think the issue at hand is about those who actually need the drug taking it, more so that it is abused by those who are "normal" without the drug. There's testament from various members about how it's possible to function fine without it, and then there's members like yourself who say that the medication is something that helps you a great deal. I think this just illustrates the complexity of treating the symptoms and that once a chemical is in the brain it can impact similar people in very non-similar ways.

Whether or not pumping someone full of amphetamines is the best treatment for ADD/ADHD is an additional can of worms.

In my opinion, people who are "normal" without the drug shouldn't take it. If they can function without it, then the benefits don't outweigh the risks. People who need to take it to be at a level playing field shouldn't be denied it. But people who are already functioning good shouldn't be given it. Most people wouldn't give someone a wheelchair or prescription pair of glasses if they didn't need them, right?
I reread the OP's post and they said that it makes people without ADHD be able to perform way better and people with ADHD be able to perform at the "normal" level. I think I did misunderstand the issue at hand. Thank you for explaining it!
Brain chemicals are an incredibly complex thing.
Side note: Does anyone know if ADHD and ADHD medication or lack of medication is linked in any way to Parkinson's disease? Parkinson's relates to the degradation of dopamine producing neurons.

 

[JustAPhD]

In my opinion, people who are "normal" without the drug shouldn't take it. If they can function without it, then the benefits don't outweigh the risks. People who need to take it to be at a level playing field shouldn't be denied it. But people who are already functioning good shouldn't be given it. Most people wouldn't give someone a wheelchair or prescription pair of glasses if they didn't need them, right?
I reread the OP's post and they said that it makes people without ADHD be able to perform way better and people with ADHD be able to perform at the "normal" level. I think I did misunderstand the issue at hand. Thank you for explaining it!
Brain chemicals are an incredibly complex thing.
Side note: Does anyone know if ADHD and ADHD medication or lack of medication is linked in any way to Parkinson's disease? Parkinson's relates to the degradation of dopamine producing neurons.

No I do agree with you. People who don't need adderall/vyvanse/etc should not take it. At that point it's not a medicine, it's drug abuse.

 

[pithy84]

OP only took 5 pills total. It sounds like she/he was just high. Stimulants really boost your self-confidence.

It's like taking heroin once and saying, "Life is so unfathomably beautiful, I can't understand why anyone is ever unhappy." Try taking heroin three times a day for three years - you will be one of the least happy people on Earth.

 

[Donthangme]

See what I mean? No offense to you, at all. It's just that your response is perfectly in keeping with what I suggested. Coincidence?

It would be like saying to a person who gets an all clear report 5 years out from cancer surgery and folks, friends and family say, "Well, wouldn't it be nice if that actually contained some scientific landmark data that you are likely out of danger now?"

I don't understand your point. I'm only saying that adderall is addictive and should only be taken with a proper prescription. I'm not trying to accuse anyone especially OP of wrongdoing nor denying anything with regards to the symptoms and treatments of ADHD. Whats the issue here?

 

[Par4thecourse]

Yup. Vyvanse is a prodrug, meaning that the form you take is inactive until your body converts it to dextroamphetamine (a potent stimulant) and L-lysine. This extra step provides the longer duration while also having the nice side effect of making the drug less likely to be abused (although it still is).



The analogy is a little off, but I think your point still stands. I don't think the issue at hand is about those who actually need the drug taking it, more so that it is abused by those who are "normal" without the drug. There's testament from various members about how it's possible to function fine without it, and then there's members like yourself who say that the medication is something that helps you a great deal. I think this just illustrates the complexity of treating the symptoms and that once a chemical is in the brain it can impact similar people in very non-similar ways.

Whether or not pumping someone full of amphetamines is the best treatment for ADD/ADHD is an additional can of worms.

"Whether or not pumping someone full of amphetamines is the best treatment for ADD/ADHD is an additional can of worms."

Therein lies the rub. "Pumping" anyone full of amphetamines is an expression of contempt for this medical condition. Which is exactly what I said often happens when discussing ADHD, and it is harmful. We don't need people accusing us of being pumped full. Do diabetics get pumped full of insulin? The implication is degrading and it is incorrect (intentionally?) and it demeans those who suffer from ADHD.

 

[Par4thecourse]

Certainly not going to offer medical advice, but I had an experience similar to OP; undiagnosed ADD for a long time, got prescribed adderall and felt like a God.

After a short period, the side effects became unbearable. I honestly felt like a cocaine addict, periods of super highs with debilitating withdrawals when I didn't take it. Eventually I cut it off cold turkey and my ADD was 10x worse than ever before.

I considered dropping school altogether because I felt like if I couldn't keep up without prescription drugs then I didn't deserve to be there. The best thing that ever happened to me was a girl I met that happened to be a yoga instructor. She convinced me to attend one of her classes and it changed my life. Since then I've incorporated yoga as part of my daily life and I've also made drastic changes to my sleep routine (cut off ALL electronics an hour before sleep, use dim lighting at night, wear computer glasses, eat magnesium rich foods, minimum 7 hours sleep -- no exceptions).

I'm proud to say I'm a much better student now than I ever was on adderall; very rarely do I need to pass through material more than twice for it to stick forever. I imagine most of my problems were a cumulative effect of poor sleep and yoga was sort of the first domino to get it corrected. That girl? I married her.

Glad you are doing well without meds. If yoga, nutrition and proper sleep habits took care of your struggles with ADHD, you were misdiagnosed. Adult ADHD doesn't go away, ever. The symptoms can be treated and made less intrusive, but the disorder remains. There are degrees of ADHD, too, but if the symptoms got 10 times worse after stopping the meds, that is not ADHD, at least there is nothing in the literature to support your point of view. Just the contrary.

Structure, exercise and a healthy daily routine are the most important non-medical tools to use to help a person with ADHD. None of those things, even combined, is sufficient to enable a person with ADHD to function properly, without compensating.

 

[Par4thecourse]

I don't understand your point. I'm only saying that adderall is addictive and should only be taken with a proper prescription. I'm not trying to accuse anyone especially OP of wrongdoing nor denying anything with regards to the symptoms and treatments of ADHD. Whats the issue here?

I am saying it is time to rejoice. These drugs turn on a part of our mental apparatus and give us the chance to engage in a full life. Of course there are risks. That is a given. What is often overlooked and minimized, is the improvements the meds make. I am not ashamed to announce to the world how drugs have made an incredible, ongoing, positive impact on my life. For those who've suffered with this disorder, it is almost miraculous, to be able to direct our focus where we want it to go?! I didn't know what that was like most of my life.

 

[Azete]

Glad you are doing well without meds. If yoga, nutrition and proper sleep habits took care of your struggles with ADHD, you were misdiagnosed. Adult ADHD doesn't go away, ever. The symptoms can be treated and made less intrusive, but the disorder remains. There are degrees of ADHD, too, but if the symptoms got 10 times worse after stopping the meds, that is not ADHD, at least there is nothing in the literature to support your point of view. Just the contrary.

Structure, exercise and a healthy daily routine are the most important non-medical tools to use to help a person with ADHD. None of those things, even combined, is sufficient to enable a person with ADHD to function properly, without compensating.

Sorry if you misinterpreted, but my point was that I was obviously misdiagnosed -- as I'm sure many others are.

 

[Par4thecourse]

My PCP prescribed me a 5 count bottle (referring me to a psychiatrist for a full diagnosis/prescription) and here's my experience with it.

Firstly, let me preface this thread by saying you shouldn't take this drug illegally and I am not encouraging anyone to go out and get a prescription. This drug is dangerous and can create a terrible life-long dependency.

That being said, I have a high GPA with only average focus/concentration and I consider myself a fairly smart individual. Here's my experience with it after the 5 pills, summarized: This drug is stupidly unfair. It turned me into a machine and demigod. Had any smart individual with average focus been taking this drug since day 1 of college, they'd graduate with a 4.0 easy. I have pre-med friends who've been taking it the entire time and now I don't even question why they pop this pill. Medical students would be silly not to get a prescription for adderall. It makes absolutely everything significantly easier if you don't have ADHD.

I am absolutely astonished that this drug can even be legally prescribed despite it being a strong therapy for ADHD patients. As a weightlifter, non-adderall users and adderall users are analogous to a natural lifter and a steroid-using lifter - the two are usually on entirely different levels. The steroid user recovers quicker, drastically increases their genetic capacity to build muscle, and even builds muscle without even lifting. Sure, you can be prescribed steroids if you have muscular dystrophy or some testosterone issues (ADHD) in order to reach normal levels, but if you're already at normal levels or are above normal, you turn into a freak of nature. This is what adderall is like. Works great for people with ADHD issues, turns men into gods when you take that issue out of the equation. I honestly can't believe I was competing with people who used this drug during my entire time in college.

Has anyone else had similar experiences with adderall? What are your thoughts on it?

"My PCP prescribed me a 5 count bottle (referring me to a psychiatrist for a full diagnosis/prescription) and here's my experience with it."

What is a "full diagnosis"? Did you get a "half diagnosis" from your PCP? Never heard of an M.D. prescribing a controlled substance to anyone based on a partial diagnosis. I think your doctor acted unethically and should be reported to your state medical board.

 

[Crayola227]

"My PCP prescribed me a 5 count bottle (referring me to a psychiatrist for a full diagnosis/prescription) and here's my experience with it."

What is a "full diagnosis"? Did you get a "half diagnosis" from your PCP? Never heard of an M.D. prescribing a controlled substance to anyone based on a partial diagnosis. I think your doctor acted unethically and should be reported to your state medical board.

they were not incorrect to say that, they may well have been given a *preliminary* diagnosis based on the symptoms reported to his PCP in the context of a short visit, but needing to see a specialist for a "full" diagnosis is not incorrect lingo, and said "full" diagnosis implies that more firm exam/text results are to be pursued

it can take ages to get in to see a psychiatrist, and the PCP very well could have gathered enough data to conclude that a short trial of Adderall was safe to try to see what benefit the patient might get to support the diagnosis. sometimes response to treatment is part of making a more firm diagnosis! (more lingo for you). this would in turn be valuable information for the the psychiatrist to be able to obtain from the patient in their first assessment.

are you an MD? if not, you are the last person who should be screaming foul play here and demanding to bring this to the medical board
the medical board is made up of gasp! doctors, as doctors are best able to judge if another doctor's course of action was appropriate in a medical sense
you didn't see any other more qualified person shocked that a controlled substance was prescribed in a short trial for the OP to try

some may have expressed that they would act differently but no one is saying this is outside the standard of care

 

[JustAPhD]

"Whether or not pumping someone full of amphetamines is the best treatment for ADD/ADHD is an additional can of worms."

Therein lies the rub. "Pumping" anyone full of amphetamines is an expression of contempt for this medical condition. Which is exactly what I said often happens when discussing ADHD, and it is harmful. We don't need people accusing us of being pumped full. Do diabetics get pumped full of insulin? The implication is degrading and it is incorrect (intentionally?) and it demeans those who suffer from ADHD.

My apologies, did not mean to offend. Like I've stated before I have no problems with people taking adderall/vyvanse/etc to treat their diagnosed ADD/ADHD. It's ironic you mention diabetics, because that's where I first heard someone use the expression "pumped full of" in reference to his insulin pump. Didn't mean any negativity by the usage and obviously I wasn't using it in a literal way.

 

[Par4thecourse]

they were not incorrect to say that, they may well have been given a *preliminary* diagnosis based on the symptoms reported to his PCP in the context of a short visit, but needing to see a specialist for a "full" diagnosis is not incorrect lingo, and said "full" diagnosis implies that more firm exam/text results are to be pursued

it can take ages to get in to see a psychiatrist, and the PCP very well could have gathered enough data to conclude that a short trial of Adderall was safe to try to see what benefit the patient might get to support the diagnosis. sometimes response to treatment is part of making a more firm diagnosis! (more lingo for you). this would in turn be valuable information for the the psychiatrist to be able to obtain from the patient in their first assessment.

are you an MD? if not, you are the last person who should be screaming foul play here and demanding to bring this to the medical board
the medical board is made up of gasp! doctors, as doctors are best able to judge if another doctor's course of action was appropriate in a medical sense
you didn't see any other more qualified person shocked that a controlled substance was prescribed in a short trial for the OP to try

some may have expressed that they would act differently but no one is saying this is outside the standard of care

Prescribing a controlled substance to see if it has benefits for a condition not properly diagnosed is not the way to practice medicine. Regardless how long it takes to see a psychiatrist, prescribing a controlled substance for a non-life threatening disorder is not medical care. It is malpractice.

Who would do the follow up and how would a person taking five pills given to her from one doctor assist another doctor to evaluate its efficacy? Would 5 pills sustain a person until he could see a properly trained M.D.? Would the doctor prescribe more in the meantime?

Where in the literature do you find support for a partial DX of ADHD and prescribing 5 pills as a testing platform?

 

[Crayola227]

Prescribing a controlled substance to see if it has benefits for a condition not properly diagnosed is not the way to practice medicine. Regardless how long it takes to see a psychiatrist, taking a controlled substance for a non-life threatening disorder is not medical care. It is malpractice.

Who and how would a person receive follow up care to test the impact of this experiment? Would 5 pills sustain a person until he could see a properly trained M.D.? Would the doctor prescribe more in the meantime?

Where in the literature do you find support for a partial DX of ADHD and prescribing 5 pills as a testing platform?

you show your ignorance
opiates are "controlled substances" that are frequently prescribed for post-op pain, which is not life threatening

I'm clearly arguing with someone who doesn't even have a basic understanding of how medicine is practiced
there is far more ambiguity in medicine than you know to give credit to
and if you expect there to be a paper to guide the particulars of every 15 min encounter you're bound to have, you will be sorely disappointed

the OP clearly said they were referred to a psychiatrist for more in depth testing to more firmly establish a diagnosis of ADHD
the 5 pills are not meant to "sustain" the OP but to give him 5 opportunities to test its effect on his reported symptoms

 

[Par4thecourse]

you show your ignorance
opiates are "controlled substances" that are frequently prescribed for post-op pain, which is not life threatening

I'm clearly arguing with someone who doesn't even have a basic understanding of how medicine is practiced
there is far more ambiguity in medicine than you know to give credit to
and if you expect there to be a paper to guide the particulars of every 15 min encounter you're bound to have, you will be sorely disappointed

the OP clearly said they were referred to a psychiatrist for more in depth testing to more firmly establish a diagnosis of ADHD
the 5 pills are not meant to "sustain" the OP but to give him 5 opportunities to test its effect on his reported symptoms

A partial DX for ADHD doesn't exist. Prescribing amphetamines for something that isn't recognized in the literature is malpractice.

 

[Crayola227]

A partial DX for ADHD doesn't exist. Prescribing amphetamines for something that isn't recognized in the literature is malpractice.

again, you are showing your ignorance

I already told you, a preliminary diagnosis of ADHD *does* exist

you can have preliminary diagnoses of just about anything

you see preliminary diagnoses in mental health *frequently*, as well as in neurology, just as two fields that come to mind, due to the potential heterogenity of presentations, and symptom overlap between various diagnoses, and the potentially slow development of additional symptoms that can serve to help differentiate more specific diagnoses, and in both fields you often need to follow patients over time and conduct tests over time to come to firm conclusions

response to treatment is frequently one way that diagnoses are more firmly made!
one must balance the harm of the treatment should the diagnosis not be confirmed vs the benefit if the diagnosis and treatment are correct

I can tell you are not a physician, which is why it is ridiculous that you are trying to say on this board what constitutes med mal, and that your overall judgment about this case based on what little the OP shared is way off

 

[ridethecliche]

Methylphenidate holidays are a thing. If you don't like how you feel when you're on them, you can always not take them for a short amount of time if it doesn't totally impair your day to day function.

 

[Par4thecourse]

again, you are showing your ignorance

I already told you, a preliminary diagnosis of ADHD *does* exist

you can have preliminary diagnoses of just about anything

you see preliminary diagnoses in mental health *frequently*, as well as in neurology, just as two fields that come to mind, due to the potential heterogenity of presentations, and symptom overlap between various diagnoses, and the potentially slow development of additional symptoms that can serve to help differentiate more specific diagnoses, and in both fields you often need to follow patients over time and conduct tests over time to come to firm conclusions

response to treatment is frequently one way that diagnoses are more firmly made!
one must balance the harm of the treatment should the diagnosis not be confirmed vs the benefit if the diagnosis and treatment are correct

I can tell you are not a physician, which is why it is ridiculous that you are trying to say on this board what constitutes med mal, and that your overall judgment about this case based on what little the OP shared is way off

It is malpractice for a doctor to prescribe amphetamines to treat ADHD to someone who does not have a diagnosis of ADHD.

 

[Par4thecourse]

Methylphenidate holidays are a thing. If you don't like how you feel when you're on them, you can always not take them for a short amount of time if it doesn't totally impair your day to day function.

For sure. As long as the patient has a diagnosis of ADHD by a D.O. or an M.D.

 

[ridethecliche]

For sure. As long as the patient has a diagnosis of ADHD by a D.O. or an M.D.

I never said otherwise, but thanks for making your opinion known ad nauseum on this thread.

 

[Par4thecourse]

I never said otherwise, but thanks for making your opinion known ad nauseum on this thread.

Thanks for reading my ad nauseam posts!

 

[ridethecliche]

Thanks for reading my ad nauseam posts!

Shhhh.

 

[Crayola227]

It is malpractice for a doctor to prescribe amphetamines to treat ADHD to someone who does not have a diagnosis of ADHD.

we are going round and round because you insist on a black and white view of how diagnosis and treatment occur

for example, as a PCP one could see a patient who appears according to patient interview and physical exam, to have Parkinson's
however, there are multiple diagnoses that can have a similar presentation, not to mention that the PCP is not as experienced with differentiating between all the possibilities as a neurologist, AND *part of the diagnostic criteria itself* includes response to medications that treat Parkinson's
therefore, once the PCP has determined that there are not serious contraindications to prescribing carbidopa/levidopa, may prescribe a low dose along with a referral to a neurologist
the reason for this is 2 fold: it will take a long time to see the neurologist and meanwhile the patient is suffering and may find relief with appropriate treatment aimed at a preliminary diagnosis, AND this approach is typically what the neurologist themselves would do to help diagnose, by doing this as the PCP in anticipation of the consultant's visit, you are helping to provide the consultant with useful information used in the *process* that it is to diagnose such a condition, thereby helping to speed things along in a way that is safe, good for the patient, and a good use of limited resources (neurologist hours), because the neurologist will know on visit #1 what the response was, rather than having to prescribe and then wait until visit #2. Diagnosis of Parkinson's is what we call a "clinical" diagnosis, in that there are no fancy blood or imaging tests to confirm the diagnosis, it is done by patient presentation and response to treatment.
now, what can happen, is that 6 weeks go by, the patient sees the neurologist, and is able to report that the meds helped/did not help. This, plus other information, may help support the diagnosis and perhaps, steer treatment. Or, a non-response to treatment in addition to other clues, may point to something else.
It will partly depend on how fitting the initial presentation was, as well as the individual experience and comfort with treating Parkinson's whether or not a PCP will make a preliminary diagnosis and initiate a trial of treatment.

You will see PCPs initiating therapy in addition to making a referral to a specialist quite often. That is part of their very job and for a whole host of conditions it is standard of care for them to take this approach.

I use this example, to try to break your black and white thinking of how diagnosis and treatment occurs.
There are "firm" diagnoses, "presumptive" diagnoses, "preliminary" diagnoses, and "full" diagnoses. Patients may be prescribed a "trial" of medication vs a "course" of medication. Doctors "practice" medicine.

I hate to break the news to you, that part of the diagnostic criteria for ADHD is response to therapy, which can include other modalities but can also include amphetamines.

The PCP may well have felt confident giving a preliminary diagnosis to the OP based on whatever data was available, and as *part of the very process of diagnosing the condition* gave the OP a short trial to gauge response to therapy, all of which is useful data for the *diagnosis AND treatment* of ADHD, and would help a specialist at a later date who would in turn gather even more data points by doing more testing.

You simply are both unfamilar to medical thinking and not open to learning, that you keep saying the same thing over and over.

You are either stupid, or a stupid troll, or just have an irrational aversion to the use of amphetamines that you look for any reason to scream malpractice here.

I didn't mind writing this so others could learn a little bit about medical thinking.

 

[Par4thecourse]

we are going round and round because you insist on a black and white view of how diagnosis and treatment occur

for example, as a PCP one could see a patient who appears according to patient interview and physical exam, to have Parkinson's
however, there are multiple diagnoses that can have a similar presentation, not to mention that the PCP is not as experienced with differentiating between all the possibilities as a neurologist, AND *part of the diagnostic criteria itself* includes response to medications that treat Parkinson's
therefore, once the PCP has determined that there are not serious contraindications to prescribing carbidopa/levidopa, may prescribe a low dose along with a referral to a neurologist
the reason for this is 2 fold: it will take a long time to see the neurologist and meanwhile the patient is suffering and may find relief with appropriate treatment aimed at a preliminary diagnosis, AND this approach is typically what the neurologist themselves would do to help diagnose, by doing this as the PCP in anticipation of the consultant's visit, you are helping to provide the consultant with useful information used in the *process* that it is to diagnose such a condition, thereby helping to speed things along in a way that is safe, good for the patient, and a good use of limited resources (neurologist hours), because the neurologist will know on visit #1 what the response was, rather than having to prescribe and then wait until visit #2. Diagnosis of Parkinson's is what we call a "clinical" diagnosis, in that there are no fancy blood or imaging tests to confirm the diagnosis, it is done by patient presentation and response to treatment.
now, what can happen, is that 6 weeks go by, the patient sees the neurologist, and is able to report that the meds helped/did not help. This, plus other information, may help support the diagnosis and perhaps, steer treatment. Or, a non-response to treatment in addition to other clues, may point to something else.
It will partly depend on how fitting the initial presentation was, as well as the individual experience and comfort with treating Parkinson's whether or not a PCP will make a preliminary diagnosis and initiate a trial of treatment.

You will see PCPs initiating therapy in addition to making a referral to a specialist quite often. That is part of their very job and for a whole host of conditions it is standard of care for them to take this approach.

I use this example, to try to break your black and white thinking of how diagnosis and treatment occurs.
There are "firm" diagnoses, "presumptive" diagnoses, "preliminary" diagnoses, and "full" diagnoses. Patients may be prescribed a "trial" of medication vs a "course" of medication. Doctors "practice" medicine.

I hate to break the news to you, that part of the diagnostic criteria for ADHD is response to therapy, which can include other modalities but can also include amphetamines.

The PCP may well have felt confident giving a preliminary diagnosis to the OP based on whatever data was available, and as *part of the very process of diagnosing the condition* gave the OP a short trial to gauge response to therapy, all of which is useful data for the *diagnosis AND treatment* of ADHD, and would help a specialist at a later date who would in turn gather even more data points by doing more testing.

You simply are both unfamilar to medical thinking and not open to learning, that you keep saying the same thing over and over.

You are either stupid, or a stupid troll, or just have an irrational aversion to the use of amphetamines that you look for any reason to scream malpractice here.

I didn't mind writing this so others could learn a little bit about medical thinking.

"It is malpractice for a doctor to prescribe amphetamines to treat ADHD to someone who does not have a diagnosis of ADHD."

 

[Crayola227]

"It is malpractice for a doctor to prescribe amphetamines to treat ADHD to someone who does not have a diagnosis of ADHD."

Par4thecourse, I went and read the only other thread you have posted in, which is the thread entitled, "ADHD" from April 2016.

If you did more than just place your personal testimony there, you would have read the same information I did, which is that it is a difficult diagnosis, and it is hugely variable whether or not a provider pursues neuropsych testing, which in itself isn't magically definitive, before giving a diagnosis or treating.

Again, you have no understanding of psychiatry, or that one might be given a "preliminary" diagnosis for any number of psych conditions and treated accordingly.

So the OP didn't have a "full" diagnosis. What you refuse to recognize in all of your "wisdom" as a non-physician, is that he likely was given a preliminary diagnosis. What you probably don't know as well, is that for every visit we have to put down a billable diagnosis, and in every computerized system I have used, an indication *must* be assigned for every prescription written. I would be willing to bet my diploma "ADHD" was listed for the OP's script and visit.

I don't know where you are getting that the OP did not have a preliminary diagnosis or that a preliminary diagnosis would not be suitable to try a short course of treatment to help support the diagnosis. But I wonder if you repeat yourself nonsensically again.

Did it ever occur to you as well, that the OP misunderstood why they were being sent for neuropsych testing? Perhaps the physician was 100% confident in diagnosing them with ADHD but still referred to CYA.

so stfu with your malpractice soapbox, it's really stupid especially given your level of understanding and what's been explained here as well as the only other thread you've written in

sounds like you need to take your medication and try doing some reading

 

[Par4thecourse]

Par4thecourse, I went and read the only other thread you have posted in, which is the thread entitled, "ADHD" from April 2016.

If you did more than just place your personal testimony there, you would have read the same information I did, which is that it is a difficult diagnosis, and it is hugely variable whether or not a provider pursues neuropsych testing, which in itself isn't magically definitive, before giving a diagnosis or treating.

Again, you have no understanding of psychiatry, or that one might be given a "preliminary" diagnosis for any number of psych conditions and treated accordingly.

So the OP didn't have a "full" diagnosis. What you refuse to recognize in all of your "wisdom" as a non-physician, is that he likely was given a preliminary diagnosis. What you probably don't know as well, is that for every visit we have to put down a billable diagnosis, and in every computerized system I have used, an indication *must* be assigned for every prescription written. I would be willing to bet my diploma "ADHD" was listed for the OP's script and visit.

I don't know where you are getting that the OP did not have a preliminary diagnosis or that a preliminary diagnosis would not be suitable to try a short course of treatment to help support the diagnosis. But I wonder if you repeat yourself nonsensically again.

Did it ever occur to you as well, that the OP misunderstood why they were being sent for neuropsych testing? Perhaps the physician was 100% confident in diagnosing them with ADHD but still referred to CYA.

so stfu with your malpractice soapbox, it's really stupid especially given your level of understanding and what's been explained here as well as the only other thread you've written in

sounds like you need to take your medication and try doing some reading

Speculating is fine. However, a doctor prescribing amphetamines to treat ADHD to someone who has not been diagnosed with it is malpractice. If you'd like, I'd be happy to review examples from the literature proving otherwise. If you are unable to do so, regardless what your opinion is, it is malpractice.

 

[Crayola227]

your assertion is still nonsensical, if a physician is prescribing Adderall for ADHD, then they have made the clinical diagnosis of ADHD
it's as simple as that

Your statement is just so obvious that it's stupid.

"A doctor prescribing antibiotics to treat a sinus infection to someone who has not been diagnosed with it is malpractice."

But who in the **** does that? No one.

 

[Par4thecourse]

This cannot be stressed enough. The effects of Adderall differ from person to person and prolonged use is necessary to truly understand how it affects your body. I suffered from ADHD symptoms and depression for a long, long time and it went completely untreated. I finally started taking Adderall in the hopes that I would finally be able to get myself to sit down and work like normal people can. I fell in love with how it made me feel at first, and if you had asked me how I felt after taking five times, I would have told you it was a miracle drug as well.

As time went on, however, it wasn't all rainbows and butterflies anymore. The loss of appetite and dehydration, which are common side effects of Adderall, began to cause serious problems. I was constantly physically exhausted, I lost a ton of weight, and I couldn't sleep without sleep aids. It got so bad that I was willing to take getting slightly lower grades and not take it anymore. Fortunately, the psychiatrist I saw at my university clinic is brilliant and got me on bupropion, which has helped both my depression and ADHD immensely.


Sent from my iPhone using SDN mobile

As you began to lose tons of weight and couldn't sleep, did your doctor decrease your dosage or reduce the times per day to take it?

 

[JustAPhD]

I think the above conversation what happens when an unstoppable force meets an immovable object.

 

[Turkishking]

Don't hate the player, hate the game OP.

 

[tdod]

My PCP prescribed me a 5 count bottle (referring me to a psychiatrist for a full diagnosis/prescription) and here's my experience with it.

Firstly, let me preface this thread by saying you shouldn't take this drug illegally and I am not encouraging anyone to go out and get a prescription. This drug is dangerous and can create a terrible life-long dependency.

That being said, I have a high GPA with only average focus/concentration and I consider myself a fairly smart individual. Here's my experience with it after the 5 pills, summarized: This drug is stupidly unfair. It turned me into a machine and demigod. Had any smart individual with average focus been taking this drug since day 1 of college, they'd graduate with a 4.0 easy. I have pre-med friends who've been taking it the entire time and now I don't even question why they pop this pill. Medical students would be silly not to get a prescription for adderall. It makes absolutely everything significantly easier if you don't have ADHD.

I am absolutely astonished that this drug can even be legally prescribed despite it being a strong therapy for ADHD patients. As a weightlifter, non-adderall users and adderall users are analogous to a natural lifter and a steroid-using lifter - the two are usually on entirely different levels. The steroid user recovers quicker, drastically increases their genetic capacity to build muscle, and even builds muscle without even lifting. Sure, you can be prescribed steroids if you have muscular dystrophy or some testosterone issues (ADHD) in order to reach normal levels, but if you're already at normal levels or are above normal, you turn into a freak of nature. This is what adderall is like. Works great for people with ADHD issues, turns men into gods when you take that issue out of the equation. I honestly can't believe I was competing with people who used this drug during my entire time in college.

Has anyone else had similar experiences with adderall? What are your thoughts on it?

Two problems with what your saying:

1. it is not "unfair" if everyone has access to it.
2. research generally shows no long-term academic benefit to adderral use (feel free to look it up). This is presumably because the energizing effect of adderal wears off over time, so eventually its only beneficial if you legitimately had problems with ADHD.

 

[Rattus]

Two problems with what your saying:

1. it is not "unfair" if everyone has access to it.
2. research generally shows no long-term academic benefit to adderral use (feel free to look it up). This is presumably because the energizing effect of adderal wears off over time, so eventually its only beneficial if you legitimately had problems with ADHD.

I support your statements.
ADHD isn't "fair". It is a disorder. And long-term Adderall usage can cause slower height and weight growth if started in youth and a couple other health problems that can be pretty annoying/debilitating.

 

[Crayola227]

Both a someone that raised me for 10+ years, and a live in bf of 5 years that I tutored in math & other classes, had ADHD.

I *know* what debilitating ADHD looks like and what it's like to deal with a sufferer and how it can ruin lives(I lived with them, I can't claim to be able to pick out sufferers in a 15 min office visit) but people I spend lots of time around I can often guess.

I've seen both the improvement from meds and the side effects

It sucks

 

[milk95]

Sorry to butt in suddenly, but I have just recently been diagnosed with ADHD and prescribed Adderall XR. While it does chill me out a bit (since I tend to babble and jump from topic to topic when speaking) and help me focus enough to finish a chapter or an assignment and better remember something I had just looked at three seconds ago, it isn't exactly a 'miracle drug' and I didn't suddenly get a 4.0 and all A's in everything. Quite a few of my classmates think that Adderall will suddenly boost your grades and you'll be able to study for twelve hours straight and wake up the next day and remember everything, and that may be the case for some people, probably depending on your dosage and other fun stuff. But for me, it reduces how much I stutter and I'm not as anxious and jittery as I used to be, like my leg doesn't obsessively shake as much anymore. The medication combined with me changing my study habits and hiding all of my electronics helped me get better grades, or better-ish grades. They still aren't all that fantastic. It's a work in progress.

 

[Par4thecourse]

Two problems with what your saying:

1. it is not "unfair" if everyone has access to it.
2. research generally shows no long-term academic benefit to adderral use (feel free to look it up). This is presumably because the energizing effect of adderal wears off over time, so eventually its only beneficial if you legitimately had problems with ADHD.

Sorry if you misinterpreted, but my point was that I was obviously misdiagnosed -- as I'm sure many others are.

Didn't you say you were, "undiagnosed ADD for a long time" ? Then, you never were diagnosed.

 

[DrFizition]

Anyone ever try rhodiola? Is it any good (for medical school)?

 

[Par4thecourse]

My friend is prescribed Adderall XR for his ADHD and let me try one before an MCAT practice test we did together. Gave me terrible anxiety and I did not do any better or worse than I usually do.

From the research I have read the improvement in test scores in normal people is mild at best and the drug is actually damaging to your brain long term-- reduces functional connectivity, decreases grey matter etc. Only really useful if you have attention issues and even then I think Ritalin is a better long term option.

would you offer references?