Seeking treatment for ADD myself, I discovered this forum in an effort to better inform myself about medication treatments - particularly in regards to the stimulants, and primarily Adderall. What I’ve found in the posts here has been very informative and useful. I’ve summarized a few of my observations about stimulant medications, and have posted it below. Are my observations generally accurate? Or am I way off? Comments are most welcome.


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The postings on this forum paint a far more subtle and detailed picture of stimulant treatment than anything I’ve found in ADD books for general readers. Typically, in the treatment chapters of those books, a few cases are briefly described, and they often conclude with something like this: “After appropriate treatment, Susan was able to start putting her life together...” End of story.

I have no doubt that initially the treatment was effective, even highly effective. But I’m left to wonder about things like side effects, how long efficacy lasted, and if there were any consequences from long term use. The only place I’ve been able to find some sort of answer to these questions is on this forum.

Importantly, these forums are not biased against the use of stimulant medications. They’re openly discussed. This is not, for example, a forum where you’ll find strident anti psych-med advocates grinding their axe. (At least I haven’t run across this so far.) The postings on this website are first person accounts from the frontlines of treatment. They are, in short, the word on the street. As such, they are both believable and highly informative.

Remarkably, I’ve found way more red flags regarding stimulant meds on this website than anywhere else. This posting, by an addforum member named oracle, is an example of what I call a ‘red flag’ posting. http://www.addforums.com/forums/showthread.php?t=25496

Who could possibly read a post like oracle’s and not conclude that some kind of cellular damage has taken place (since her symptoms have increased when she doesn’t take the drug), and that, by remaining on the drug, damage continues to accrue?

It would be one thing if posts like her’s were rare or unusual - but this is not the case. I’ve read a number of other posts on this forum and elsewhere that describe similar experiences with stimulant medications. Here are a couple from this website:
http://www.addforums.com/forums/showthread.php?t=25490

http://www.addforums.com/forums/showthread.php?t=25152

Even when the experience with a stimulant medication (after a year or more of regular use) is more benign, you often see comments like “Overall, it’s been very helpful - but when I’m off the med, my symptoms are worse (less motivated, focused, etc.) than they were before I started treatment.”

Oracle’s experience (albeit considerably milder) has noticeable similarities to descriptions of meth abuse. This is hardly surprising if you spend a little time researching the amphetamines. Briefly: “Amphetamine, dextroamphetamine, methamphetamine, and their various salts are collectively referred to as amphetamines. In fact, their chemical properties and actions are so similar that even experienced users have difficulty knowing which drug they have taken.”

Meth abuse and its consequences have been extensively studied, of course. In an effort to learn more about the amphetamines, I've done a bit of research on meth. A standard description of meth abuse reads something like this: “...users experience a sense of euphoria, as well as increased energy, focus, (and) confidence... users require more and more of the drug to reproduce and maintain those feelings. ... With repeated use, methamphetamine robs users of their physical health, cognitive abilities, and their ability to experience pleasure.” Compare these statements regarding meth to posts like oracle’s, and you’d have to be blind not to see the similarities.

Amphetamines are like a high-octane fuel for the brain’s 'dopamine engines'. To produce their positive (or theraputic) effects, these drugs substantially rev these cellular 'engines', greatly increasing dopamine release. Repeated over-stimulation through chronic amphetamine use, however, causes the cellular structure involved in dopamine tranfer to degenerate.

“...research (has shown) that methamphetamine damages the nerve endings of brain cells containing dopamine, a chemical messenger that plays a role in movement and pleasure. ... The damage, which affects dopamine nerve endings located in the brain structures that make up the striatum, is similar to but less extensive than that caused by Parkinson's disease.”

Among the results (surprise, surprise):“...chronic doses of methamphetamine in drug abusers have been associated with increased impulsivity, and impairments in learning and attention.”

Because the actions of the various amphetamines on the dopamine transmission system are virtually identical, it’s not difficult to extrapolate from what is known about the consequences of chronic meth abuse, and apply it to long-term amphetamine use for the treatment of ADD. Though the symptoms of cellular degeneration are milder and slower to appear when dosage is regulated by a doctor, I find it difficult not to conclude that identical damage begins to occur. Posts like oracle’s - which describe the negative consequences of long term Adderal use - appear to corroborate this.

I don’t believe - not in the least - that doctors, psychiatrists, or even the drug companies are in on some kind of evil conspiracy to generate profits or get people to conform to regimented behavioral norms. (And I’ve read some eye-roll worthy theories along these lines.) I think that they really do have the best interests of their patients in mind and are using the best treatments currently available in an effort to alleviate symptoms.

However... what do you tell someone who is 24 - has been on Adderal for 5 or 6 years - is currently taking a far higher dose than originally prescribed in an effort to maintain any degree of efficacy - and yet the medication’s effectiveness continues to diminish? Continued drug therapy appears increasingly problematic, and likely to cease being effective altogether. And when the drug is stopped, the symptoms originally being treated have noticeably increased. At 24, the patient is worse off than they were prior to treatment, their treatment options have obviously decreased, and they’ve still got a lot of life yet to live. Do you tell them this?

“After 14 month of abstinence from the drug, users have regrown most of their damaged dopamine receptors; however, they showed no improvement in the cognitive abilities damaged by the drug. After more than a year's sobriety, former users still showed severe impairment in memory, judgment and motor coordination...”

Therapy - if it’s to be called that - should not involve damaging precisely those areas one is seeking to treat. It appears to me, however, that the use of stimulant medication runs the risk of doing just that.

I have a few comments:

1 Methamphetamine is not a drug for ADD. The very reason is the fear for addictiveness and maybe also the possibility of long term nerve damage.

2 It's too simple to say some medications are wrong. It really depends on what dosage you take. If you take a very overdose the risk of having bad side effects is high. But taking low doses should avoid this. Your research did not quote the med dosages that were used and caused damage to neurons. If you did that then we can compare these dosages to normal, therapeutic dosages.

3 AD(H)D is a very serious psychiatric disorder. I lived with it all my life. It has very profound effect on how I lived my life. You can't say meds are wonderfull, but someone with AD(H)D can profit very much from meds even if there are some side effects. Ofcourse you should stop medication if you experience severe tachycardia or any other bad side effect. Nobody asked you to risk your life to treat AD(H)D. Everybody is a different situation and what works well for one person may be a nightmare for another person. For one person adderall may be a "lifesaver", but for the other person it's a poison.

4 If you find a good, safe med then the benefits of it with treating AD(H)D are very good. But safety is more important ofcourse. That's why I don't use adderall, because I think it is much too potent. The combination of amphetamine and dextroamphetamine is too much for me I think.

5 Tolerance is something you are discribing (needing more meds to obtain the same result), but this does not always occur. For example with my usage of methylphenidate (not amphetamine/ dextroamphetamine) I don't get tolerance. But every person is different ofcourse. If somebody develops tolerance he should switch to another med or be off meds for a while.


Therapy - if it’s to be called that - should not involve damaging precisely those areas one is seeking to treat. It appears to me, however, that the use of stimulant medication runs the risk of doing just that.Then go to therapy! Hope it works better then meds...

None of your links work, all that you say is suspect.

Nice antipsych post there spoonbits. Be very careful what you read on the internet. Groups like Scientology have an axe to grind and have been proven wrong countless times. It can be done one more time if you wish.

For the record, therapeutic levels of stimulants have a long history of effective use for the treatment of ADHD. Stimulants are considered to one of the safest classes of drugs out there and also of the most effective. What more could you ask from a medication?

I fixed the link issue in "spoonbits" post.

I don't think this post is a slam on the use of medication. Actually, I am glad "spoonbits" is doing research before making a decision to try medication as a treatment plan.

He has some good points, as well as, specific situations of people experiencing issues with medication usage.

Therapy - if it’s to be called that - should not involve damaging precisely those areas one is seeking to treat. It appears to me, however, that the use of stimulant medication runs the risk of doing just that.
Based on the threads you posted your observation is very possible. But, also take into consideration these are only 2 or 3 instances out of thousands of posts and members of this forum. In no way am I down playing these individual's issues. They are real, very serious and I feel bad for them.

Any medication you take has a risk. Look at over-the-counter aspirin. In reality, it is a very dangerous medication that kills thousands of children and adults per year. It causes serious medical conditions that include bleading ulcers and strokes. Yet, we don't see anyone raising a fuss about getting it removed from the market.

The key is a combination of medication, therapy and self-improvement. While on the medication take steps to make positive changes and build processes. Make those processes into habits. Then when/if the time comes to reduce or stop the medication, those processes "may" stay.

I feel, many people view medication as the "magic pill" that can be used as a crutch. Medication should be use only as a tool.

A standard description of meth abuse reads something like this: “...users experience a sense of euphoria, as well as increased energy, focus, (and) confidence... users require more and more of the drug to reproduce and maintain those feelings. ... With repeated use, methamphetamine robs users of their physical health, cognitive abilities, and their ability to experience pleasure.”
This is true. Most people report that they do not experience the euphoric feeling when taking a prescribed dose. I know I can take my prescribed dose and take a nap within 30 min. I do not speed up, I slow down. I feel good because of my improved self-esteem. I get stuff done, stay on track and not struggle to get my thoughts and ideas out of my head. I don't stumble when I talk, my numbers don't get reversed, I don't make careless mistakes and I don't get that "flooded" feeling mid-thought.

My son is in 2nd grade now. He was diagnosed in kindergarten. All of the signs were there. This was observed by us, his teacher, school psychologist and the doctor. His grades were a couple A's, mostly B's and S's. We started medication and he has completely turned around. He is a straight "A" student now. He is also reading at a 5th/6th grade level. We are also very in-tune with his behaviors and dispense his medication.

You have made some very legitimate observations, "spoonbits". Unfortunately, this topic has been brought up so many times in the past that it is a sore spot among the veterans. The veterans also have to remember there are a lot of people just starting their ADHD journey. Sorry to sound so "reality TV". :)

Remarkably, I’ve found way more red flags regarding stimulant meds on this website than anywhere else. This posting, by an addforum member named oracle, is an example of what I call a ‘red flag’ posting. http://www.addforums.com/forums/showthread.php?t=25496
REMEMBER: it is not the med that is bad, but it's how the person taking it uses it (and his doctor). For example, if one takes a overdose of a med he will suffer the consequences and he may even find himself in hospital, but if one monitors himself well he will most likely benefit from it. Treatment with meds for AD(H)D involves constantly looking for the best and safest med and dosage.

Maybe for oracle, adderall is not "his" med. But fortunately, he can use other meds and they may prove to be much better.

Scientology just loves the personal story. "Man kills his pet after taking Ritalin", or something like that. They loath to use Science or any sort of statistical study, in fact they never do. This is why I'm highly suspicious of any post that draws general conclusions based on individual and personal observations. It is very dangerous to base any conclusion on your own personal observation or that of others. Yet, that is what TV has trained us do. We get sucked in and have an emotional reaction. "Isn't horrible that John lost a limb after taking prozac. How will he ever play football again"? Once we have an emotional response our thinking can easily become influenced and biased. Yet we as a society continue to draw unsupported conclusions. This is such a basic premise to avoid yet so few do it.

...Who could possibly read a post like oracle’s and not conclude that some kind of cellular damage has taken place (since her symptoms have increased when she doesn’t take the drug), and that, by remaining on the drug, damage continues to accrue? ....


I could.

....It would be one thing if posts like her’s were rare or unusual - but this is not the case. I’ve read a number of other posts on this forum and elsewhere that describe similar experiences with stimulant medications. Here are a couple from this website:
http://www.addforums.com/forums/showthread.php?t=25490

http://www.addforums.com/forums/showthread.php?t=25152

Even when the experience with a stimulant medication (after a year or more of regular use) is more benign, you often see comments like “Overall, it’s been very helpful - but when I’m off the med, my symptoms are worse (less motivated, focused, etc.) than they were before I started treatment.”....


Conclusions totally based on personal observation.

And then the kicker. From personal observation of ADHD meds to making a direct connection to factual knowledge of meth abuse.


...Meth abuse and its consequences have been extensively studied, of course. In an effort to learn more about the amphetamines, I've done a bit of research on meth. A standard description of meth abuse reads something like this: “...users experience a sense of euphoria, as well as increased energy, focus, (and) confidence... users require more and more of the drug to reproduce and maintain those feelings. ... With repeated use, methamphetamine robs users of their physical health, cognitive abilities, and their ability to experience pleasure.” Compare these statements regarding meth to posts like oracle’s, and you’d have to be blind not to see the similarities.


To factual and unfactual.
[QUOTE=spoonbits]
Amphetamines are like a high-octane fuel for the brain’s 'dopamine engines'. To produce their positive (or theraputic) effects, these drugs substantially rev these cellular 'engines', greatly increasing dopamine release. Repeated over-stimulation through chronic amphetamine use, however, causes the cellular structure involved in dopamine tranfer to degenerate.

“...research (has shown) that methamphetamine damages the nerve endings of brain cells containing dopamine, a chemical messenger that plays a role in movement and pleasure. ... The damage, which affects dopamine nerve endings located in the brain structures that make up the striatum, is similar to but less extensive than that caused by Parkinson's disease.”

Among the results (surprise, surprise):“...chronic doses of methamphetamine in drug abusers have been associated with increased impulsivity, and impairments in learning and attention.”


Because the actions of the various amphetamines on the dopamine transmission system are virtually identical, it’s not difficult to extrapolate from what is known about the consequences of chronic meth abuse, and apply it to long-term amphetamine use for the treatment of ADD.
Why would you even try to extrapolate? These are two different delivery systems and the dossages are not the same either. Try injecting 80% alcohol into your veins and see what happens.

......I don’t believe - not in the least - that doctors, psychiatrists, or even the drug companies are in on some kind of evil conspiracy to generate profits or get people to conform to regimented behavioral norms. (And I’ve read some eye-roll worthy theories along these lines.) I think that they really do have the best interests of their patients in mind and are using the best treatments currently available in an effort to alleviate symptoms.....

What is really being said here?

However... what do you tell someone who is 24 - has been on Adderal for 5 or 6 years - is currently taking a far higher dose than originally prescribed in an effort to maintain any degree of efficacy - and yet the medication’s effectiveness continues to diminish? Continued drug therapy appears increasingly problematic, and likely to cease being effective altogether. And when the drug is stopped, the symptoms originally being treated have noticeably increased. At 24, the patient is worse off than they were prior to treatment, their treatment options have obviously decreased, and they’ve still got a lot of life yet to live. Do you tell them this?

“After 14 month of abstinence from the drug, users have regrown most of their damaged dopamine receptors; however, they showed no improvement in the cognitive abilities damaged by the drug. After more than a year's sobriety, former users still showed severe impairment in memory, judgment and motor coordination...”

Therapy - if it’s to be called that - should not involve damaging precisely those areas one is seeking to treat. It appears to me, however, that the use of stimulant medication runs the risk of doing just that.
I reject all of the conclusions drawn in the final paragraphs.
http://www.addforums.com/forums/showthread.php?t=17742

I don’t believe - not in the least - that doctors, psychiatrists, or even the drug companies are in on some kind of evil conspiracy to generate profits or get people to conform to regimented behavioral norms. (And I’ve read some eye-roll worthy theories along these lines.) I think that they really do have the best interests of their patients in mind and are using the best treatments currently available in an effort to alleviate symptoms.evil conspiracy? generate profits? get people to conform? :soapbox: :soapbox: that's GOEDE TIJDEN, SLECHTE TIJDEN or AS THE WORLD TURNS :soapbox: :soapbox: :soapbox:

Don't know where you read those theories.

I think you got brainwashed.
Are you brainwashed by watching too much soap or are you brainwashed by scientology?

Here a few advices:

Don't look too many soaps.

Don't read too much scientology stuff, you see what happens.

Don't think about evil conspiracies too much.

instructions how to get the "scientology" stuff out of your head:

http://members.aol.com/opsgreen/

Right now I am more worried about you than I am worried about adderall spoonbits.

aaahhh I understand. I read some scientology. For a "scientologist" the world is "controlled" by psychiatrists who plan to control people throught psychiatric meds (brainwash) and then the only ones who can stop that from happening is them, the scientologists ofcourse.

And the CIA conducted experiments ultra secret "mind control". To control people's mind.

And eli lilly produces mind control meds together with CIA.

Get the point? (STATTERA)

Yeah it looks pretty stupid, but if you really believe in it and you read the stuff over and over you can become pretty much brainwashed.

So don't read it. Don't even look at it.

Steven,

I think you missed the important word "don't" in the OP.


Scuro,

Chill, baby! ;)


Spoonbits,

Interesting points, but my points have already been made by Tim & Scuro. However, let me just summarize it in a more direct way than Tim and a more *eHem!* tactful way than Scuro (no offense, friend).

Who could possibly read a post like oracle’s and not conclude that some kind of cellular damage has taken place (since her symptoms have increased when she doesn’t take the drug), and that, by remaining on the drug, damage continues to accrue?
I'm sure you realize that anecdotal evidence does not produce reliable conclusions. These stories certainly illustrate what could happen, but so does the package insert that comes with the meds. We all know the risks. Fortunately, however, the piles of research that led to FDA approval demonstrates that benefits FAR outweigh those risks for the majority of ADDers.

I would certainly never prescribe Adderall to a patient with a heart condition or epilepsy, but that in no way indicates that it should not be prescribed to others.


Meth abuse and its consequences have been extensively studied, of course. In an effort to learn more about the amphetamines, I've done a bit of research on meth. A standard description of meth abuse reads something like this: “...users experience a sense of euphoria, as well as increased energy, focus, (and) confidence... users require more and more of the drug to reproduce and maintain those feelings. ... With repeated use, methamphetamine robs users of their physical health, cognitive abilities, and their ability to experience pleasure.” Compare these statements regarding meth to posts like oracle’s, and you’d have to be blind not to see the similarities.
As both Tim & Scuro have pointed out, methamphetamine is not Adderall. Adderall clearly warns of the possibility of tolerance and, while tolerance is less likely for ADDers on a theraputic dose, it is possible. With respect to the possibility of addiction, these two amphetamines are similar in that they both carry a risk. With respect to nerve damage, however, they are NOT similar.

There is no evidence to my knowledge that Adderall causes nerve damage in even the highest theraputic doses. Just about any psychoactive med will in high enough doses, but of course that's not in question. If you have a credible source to support that your "extrapolation" is accurate, please post it. I'm sure we'd all benefit from this knowledge.

In the meantime, please know that your view is welcome by members such as myself. But, I will refute what the evidence disputes. If you can support your claim, I WILL look into those arguments and/or studies with an open mind. I don't want to harm myself any more than anyone else, but my current view, based on the literature, is that Adderall is safe when taken as prescribed.

(This reply was written prior to reading barbyma’s - which just went up - so I don’t refer to it.)

However, thanks for the replies, all.

And thanks for the vote of confidence, timh - I very much appreciate the even tone of your reply. (and your fixing of my links.) I have no doubt that this topic has been rehashed a zillion and 1 times on this forum - but (as you noted) it appears fresh when viewed from my computer screen. I’m new to this stuff.

And you are exactly right about my curiousity as to what’s up with the stimulant medications. Having read of some very good responses to stimulant treatment, my interest recently has been considerably piqued. Reading reports of relief from the symptoms of ADD is something I find incredibly tantalizing. Digging through info about the theraputic use of amphetamines has been interesting, and at least some kind of sketchy picture has emerged. My observations are not scientific, of course.


This post is an effort to explain, to some degree, where I’m coming from. And yep, it’s dreadfully long - so, my apologies in advance to those who venture further.

Re: The ‘red flag’ posts.
My first exposure to a negative description of experience with Adderall was in a reader review of an ADD book on the Amazon website. Written by a woman 9 years into Adderall treatment, it reads a lot like oracle’s post here on this website. She writes “I loved the drug when I was 1st put on it... it was the answer to all my problems. I could finally do all the things that I had been wanting to do. My room was clean, my homework was done a week in advance, I could watch a movie all the way through”.

However, the overall tone of her post is very negative. She reports, for example: “My teeth are all decaying rapidly due to 9 years of dry mouth and clenching my jaw. (Another lovely side affect no one failed to mention) I was underweight and undernourished because of my lack of appitite. The older I get, the quicker I am falling apart. Dr. have no idea what this drug does in the long run, b/c no one has taken it that long. We, I, am a guinea pig...” etc.

I read the whole post, but the only thing I noted - the thing that blared at me like ten trumpets blasting - was this: “I could finally do all the things that I had been wanting to do. My room was clean, my homework was done a week in advance...” Regarding the negative overall view the post presented, I thought: “Oh well, that’s her thing, and besides... a cost/benefit analysis of my situation says ‘You must look into this.’”

There is also another factor to my dismissal of the negative aspects of her post. I have had excellent experience with an MAOI anti-depressant called Nardil. I’ve been using it for 9 years, primarily to treat social anxiety and dysthymia. I’ve posted about my experience on this forum under the headline “MAOIs and ADD”, if you’re interested.

If you’re unfamiliar with the MAOIs, they’re considered a “last line” treatment - often referred to as “old” or “dangerous” - and they’re very seldom prescribed. There is a reason for this - they are notorious for potentially deadly food and drug interactions. Finding a doctor willing to prescribe them requires effort, determination, and a bended knee. At the time, however, my experience with social anxiety had become so painful that I wouldn’t have cared if it was pharmaceutical PCP - for after reading that the MAOIs were considered the “Gold Standard” of treatment for social anxiety, I did whatever it took to get a prescription. It proved, indeed, to be extremely effective. For all practical purposes, it saved my life.

In the years prior to this discovery, I had seen two different “talk therapists”, and both were adamantly opposed to any kind of drug treatment. According to them, there were, apparently, hidden conflicts or something or whatever that I needed to discover and resolve - and I bought this approach in its entirety.


In time, however, with no improvement in sight, and having endured far too much discomfort - I struck out on my own and discovered treatment by digging through whatever relevant literature I could find. In the event, the degree to which the medication worked was both mind boggling and utterly fascinating. I also found myself resentful of my “anti drug” therapists for having told me that drug therapy was illegitimate. Quite a few years had gone down the toilet while effective treatment was already available. I mention all this because my experience with the MAOIs reflects where I am coming from in regards to pharmacotherapy.

I still use the MAOIs, and they remain effective. Overall, if you ask me, they are an excellent medication for the treatment of certain kinds of depression and social anxiety. They do not, however, seem to have any impact on the symptoms of ADD.

As I am now looking into treatment for ADD, I’ve been reading about the use of amphetamines. While they are often described as highly effective, there is also an impression of them as “scary” drugs. They are strictly regulated, frequently demonized, and doctors can be quite wary of them. This impression of the amphetamines sounds a bit similar to what I’d heard about the MAOIs prior to my experience with them. As a result, the “scary” perception of them has not dissuaded me in the least. A “dangerous” drug can, indeed, prove enormously beneficial. And it’s for this reason also, that I largely disregard the negative aspects of the above mentioned post I had read on Amazon.

Wanting to find more first person accounts of Adderall treatment, I discovered a couple of websites. This forum is one of them. Reading posts on both websites I noticed myself occassionally coming across descriptions that mirrored the one I had read on Amazon. “that's kind of a... red flag... hmmmm. And look - boink! - another! This is curious. I wonder what’s up with the amphetamines?”

So I began looking deeper into the amphetamines. In doing this, I soon became aware of the tremendous amount of research and information available on the web regarding methamphetamine. I also noticed that there is a pharmaceutical grade of methamphetamine available for AD/HD treatment sold under the brand name Desoxyn. Curious, I examined the difference between methamphetamine and the more standard amphetamines, and the information I was reading had me wondering if any of what’s known about meth could be applied to longterm amphetamine use for theraputical purposes. Would it explain, for example, some of the negative posts I’d been reading? For myself - I have had to conclude that, since the drugs are so similar in both chemical makeup and action - the answer could only be yes.

Personally, I’ve found all this rather deflating - because I’m very serious about seeking treatment for my ADD. And frankly ... god, I just don’t want to hear it. I haven’t really wanted to come to the conclusions I seem to be arriving at. What I’m reading, however, definately has me spooked - and not without reason.

One post I read on another website involves an individual’s experience of longterm, unregulated Adderall abuse. In it, he describes the mysterious onset of the symptoms of social anxiety after a number of years. This person professed to never having experienced anything like social anxiety before and found it very uncomfortable. Keep in mind, low dopamine levels are implicated in social anxiety - consequently diminished dopamine function is implied by his story. Upon reading this, I found myself thinking - oh my god, that’s absolutely the last thing I need. (Not to mention any kind of increase in my ADD symptoms.)

So, indeed - the information I’ve been reading and the dots I’ve been connecting create a picture that resides decidedly in the bummer zone. I’ve posted my thoughts on this wondering if anyone out there might look at some of these dots I’ve connected and tell me if I’m just making it up - or if I’m zipping way off target - or perhaps reading the wrong info - or, who knows, maybe it does all rather reasonably fit together.

Anyway, thanks for the responses so far.

Ciao.

Spoon,

you write well..."but where's the beef"?

As far as clenching teeth go -- I do that. I also did that and had to get a prescription mouth guard before I started meds. I didn't know I did it until my dentist informed me I was wearing my teeth down.

You know my first reaction when I read that she could get all this stuff done now was -- wow, I've never had that. I listen better, remember better, follow through better, think before I act better, but I'm not suddenly some dynamo. Her description sounds more like what I've read stimulents do for non ADD folks. I'm not saying she's not ADD, but maybe her dose was too high -- that will take a pretty tough toll on anyone. Also if I look at a picture of myself 10 years ago (I've only been on meds one year), last year when I started meds I looked about 20 years older because of the stress I was under from uncontrolled ADD and the fact that after 40 things head downhill a bit faster. I actually look younger now than a year ago. We don't have all the facts in this woman's case and one case study by itself does not a prove anything. There is a ADD forums member that posted last year that he had been on stimulent medication (Ritalin I believe) for 20 years and was doing great! More research is needed on long term outcomes, but let's wait for the actual research with control groups and double blind studies before reaching conclusions.

Scattered

I'd just like to say that I'm guessing that most of the time when people are motivated to post about their meds it is when something is going wrong rather than when everything is hunky dory. So, I wouldn't take it that since all the posts are negative that meds are a negative experience for everyone. Also, there is some amount of withdrawal from a lot of pyschiatric drugs and what someone experiences in the short term after they stop meds isn't a good indication of how they will feel in the long term.

My first exposure to a negative description of experience with Adderall was in a reader review of an ADD book on the Amazon website. Written by a woman 9 years into Adderall treatment, it reads a lot like oracle’s post here on this website. She writes “I loved the drug when I was 1st put on it... it was the answer to all my problems. I could finally do all the things that I had been wanting to do. My room was clean, my homework was done a week in advance, I could watch a movie all the way through”.

However, the overall tone of her post is very negative. She reports, for example: “My teeth are all decaying rapidly due to 9 years of dry mouth and clenching my jaw. (Another lovely side affect no one failed to mention) I was underweight and undernourished because of my lack of appitite. The older I get, the quicker I am falling apart. Dr. have no idea what this drug does in the long run, b/c no one has taken it that long. We, I, am a guinea pig...” etc.I think you could be right. But the very reason this happens has to do with the fact that some doctors prescribe too high dosages and too potent meds. Here, in the netherlands we don't have adderall. And the highest safe dosage is 60 mg of ritalin for someone weighting 60 kg. Stay low, be safe. Remember that there are also safe meds and safe dosages. It really is your choice, do you want to be safe or do you want a high dosage and a potent med. YOU decide!

Also you want to be very safe??? Then go to your dentist every week. You enjoy being safe huh? And check your heart rate every day. Point is: if you check your health well the meds should not do you any harm.

....
So I began looking deeper into the amphetamines. In doing this, I soon became aware of the tremendous amount of research and information available on the web regarding methamphetamine. I also noticed that there is a pharmaceutical grade of methamphetamine available for AD/HD treatment sold under the brand name Desoxyn. Curious, I examined the difference between methamphetamine and the more standard amphetamines, and the information I was reading had me wondering if any of what’s known about meth could be applied to longterm amphetamine use for theraputical purposes. Would it explain, for example, some of the negative posts I’d been reading? For myself - I have had to conclude that, since the drugs are so similar in both chemical makeup and action - the answer could only be yes.


The answer could only be yes? This is simplistic thinking. When in Science is the answer only yes? Never. You don't have to reinvent the wheel here because this topic has already been researched. I'll say it again, it's the delivery system. Snorting and injecting a drug completly changes the bodies reaction to that drug. Do add some substance to the debate with references and links. Finding snippets of stray anecdotal posts proves nothing, it just shows a bias on the subject. Given enough time, I could build a strong argument that all Americans are child eating devil worshipers based on snippets of conversation posted on the internet.


Here is some beef...



From the National Institute of Drug Abuse
Brain scan shows Ritalin's effects.
American Journal of Psychiatry
http://www.bnl.gov/bnlweb/pubaf/pr/1998/bnlpr092998.html

"It is extremely important to clarify that different methods of taking a medication can alter its medicinal effects and can make it more or less dangerous in ways totally unrelated to its clinical indications," said Dr. Alan I. Leshner, director of the National Institute on Drug Abuse, which jointly funded the research along with the Department of Energy. "This research helps explain why Ritalin rarely leads to abuse and addiction when taken properly as a treatment for ADHD."

and...

"Said Volkow, "The slow-acting effect we've seen with PET gives us confidence that the low oral doses given to children with ADHD cannot cause the quick and intense feeling of reward that is necessary to reinforce the behavior of taking the drug." This may also explain why medications such as the typically very addicting narcotic analgesics, when given orally, do not cause a high when used therapeutically."

and...

"This finding points out why Ritalin eases the symptoms of ADHD, without putting children at risk," said psychiatrist Nora Volkow, head of the research team and of Brookhaven's Medical Department.

"We saw a dramatic difference between Ritalin taken orally by ADHD children and Ritalin injected by teenagers and adults to get high, as well as the difference from cocaine," she continued. "And when the pathway to the brain is less direct, as with a pill, the effects aren't sudden enough to cause a high and to develop a reinforcing effect that leads to addiction. But they are enough to focus the attention of the child and calm the hyperactivity."

http://www.pbs.org/wgbh/pages/frontline/shows/medicating/drugs/diller.html
From PBS -Dr. Diller

"Experiencing euphoria is, of course, one of the features of a drug that makes it a candidate for abuse. The most serious drugs of abuse are those that readily cause users to develop tolerance (the need for a higher and higher dose to obtain the same effect) or addiction (a physical and emotional craving for the drug). In the typical dose range of 5 mg to 20 mg, up to perhaps 60 mg total per day, Ritalin does not produce either tolerance or addiction. Ritalin does not accumulate in the bloodstream or elsewhere in the body, and no withdrawal symptoms occur when someone abruptly stops taking the drug, even after years of use. However, with teenagers and adults who abuse Ritalin--by taking high doses, sometimes via snorting or shooting the drug--the phenomena of tolerance, addiction, and withdrawal can occur".

My psychologist also explained along the same lines as Scuro posted that when the body is able to utilize the medication without having an excess amount circulating in the system that is above the body's ability to utilize (which is when euphoria is experienced) there isn't euphoria or addiction. ADD stimulent medication appears to correct the dopamine shortage in the synaptic gap, so the drug is utilized by the body at the correct dose without promoting euphoria or addiction. In England, he told me heroin is frequently given to patients in severe pain -- it does not produce euphoria or addiction, because the medication is utilized by their bodies. There is also a very large difference when the medication hits the body all at once (grinding up and snorting medication) and when it is released according to the pill's design. Small changes in the chemistry between different drugs makes a huge difference.

Scattered

Given enough time, I could build a strong argument that all Americans are child eating devil worshipers based on snippets of conversation posted on the internet.

Just for fun, I thought that I would try this experiment. The "proof" took 5 minutes.

http://www.addforums.com/forums/showthread.php?t=25674

Hahahahaha...the above link has been removed and the thread has been "disappeared". Post any blathering which states that ADHD is FRAUD and you are given the benefit of the doubt. Feel free to wax on poetically for pages. Post on how Ritalin users are turning into speed freaks and no one will lift a finger about your unsubstantiated opinion that pollutes the waters.

Post a totally fabricated tongue and check thread about how all Americans are child eating devil worshippers and it's zapped within the hour. One is threatening the other isn’t, both used anecdotal evidence and links to make their point. One topic is banned, the other isn’t. One thread is educational about how internet sources can't be trusted, the other....

To bad, there was the opportunity for some real lurn' to happen here.

Hahahahaha...the above link has been removed and the thread has been "disappeared".
I guess people just don't recognize humor when they see it.

I'm so very disturbed by the turn toward abusing truth and encouraging propoganda this forum has taken in recent days. I'm guessing from your posts I'm not alone, Scuro?

On topic: There is absolutely nothing wrong with posting questions about the efficacy and risk of these medications.

We take them. We give them to our children. We all benefit from knowledge.

But, asserting unsupported claims in the face of counterevidence is not helpful to anyone. If we are to make any progress in treating this disorder either world-wide, country-wide, forum-wide, or in our own lives, reliable information is a must. Fear-evoking strategies, lies, and the warping of facts should never be tolerated.

I have no reason to believe any of the members of this forum would employ such tatics, but I'm pointing it out because the internet is FULL of such propoganda and many forum members are getting their information from such sources.

Consider the source before drawing conclusions.....

Quite a number of new posts on this thread. I just logged on having written another post - which I'm now posting.

Here’s an article describing amphetamine neurotoxicity. http://www.acnp.org/g4/GN401000166/CH162.htm
I found this on the website of the American College of Neuropsychopharmacology. I invite those interested to read it.

The article discusses “the amphetamines” as a class of drugs. At a cellular level, the action of the amphetamines is virtually identical. Methamphetamine is distinguished by degree of potency.

Quoting:
"Sustained high-dose administration of amphetamines (especially methamphetamine) to experimental animals produces a persistent depletion of dopamine which is associated with terminal degeneration, as well as neuronal chromatolysis in the brain stem, cortex and striatum. In contrast, continuous dosing with extremely high doses of cocaine (100–250 mg/kg/dopaminey i.v.) did not induce terminal degeneration in frontal cortex and striatum. Recently, Cubellis et al. presented evidence that amphetamine, in contrast to cocaine, induces redistribution of dopamine from the vesicles into the cytosol; thus, the loss of the protection of the vesicles' relatively reducing environment results in cytosolic oxidopaminetive stress that may initiate amphetamine neurotoxicity. The dopamine depletion is reported to be permanent in the caudopaminete of monkeys. The main hypotheses for underlying mechanisms have included 1) the conversion of dopamine into a hydroxy oxidopaminetive metabolite; and 2) glutaminergic stimulation of toxicity, which can be inhibited by N-methyl-D-aspartate antagonist MK-801."

[An attempt at translating part of what I’ve highlighted in red: “Cytosolic oxidopaminetive stress” = “stress of the cytosol caused by the oxidation of dopamine” may initiate amphetamine cell damage.]

The mention of cocaine is interesting. Since it’s action is quite different, it does not appear to induce a similar degeneration. (According to the above, it does not, for example, “redistribute dopamine from the vesicles into the cytosol”.) Cocaine, remarkably, has less neurotoxicity than the amphetamines.

"These marked neurotoxic effects on the dopamine systems may underlie the mild Parkinson-like symptoms or "burned out" clinical picture in chronic, high-dose amphetamine abusers. These same individuals have a readily activated stimulant psychosis response. Similar re-activation of psychosis by L-dopa and direct agonists in Parkinson patients raises the question of whether the more severe psychosis resulting from amphetamine vs. cocaine abuse may have a partial basis in the greater toxicity induced by amphetamine."

The article further mentions this in regards to the clinical use of amphetamines:

"Since amphetamine-like stimulants have high abuse potential and other adverse toxic consequences, why do we continue to use them? In the US, there are only two Food and Drug Administration (FDA) approved indications for dextroamphetamine and methylphenidate: 1) narcolepsy and 2) attention deficit hyperactivity disorder (ADHD). In Europe, some countries have prohibited any use of stimulants. However, most experts agree that in ADHD and narcolepsy, stimulants have an definitive and uncontroversial therapeutic role when used judiciously."

Considering that the article has, at length, just described the neurotoxic effects of the amphetamines, one is invited to draw their own conclusions - there is a degree of contradiction in what is stated. (Nor is the occassional questioning of 'authority' unhealthy.) The first question coming to my mind is: Does the neurotoxicity of amphetamines entirely disappear when the drug is prescribed for clinical purposes? Logically, it would seem, the answer is no.

An analogy, perhaps, might be made to a chemical that oxidizes metal. Applied in large quantity, it will significantly rust the metal, causing rapid deterioration. Applied in small amounts, only a mild tarnishing of the metal occurs. Repeated application over a long period of time, however, will cause the effects of that tarnishing to accrue.

My conclusion as to the underlying cause of the ‘red flag’ posts re: Adderall use - the experience described is most likely explained by the accrued neurotoxic effects of long term amphetamine use.

Further observations: Any mention of prolonged mild euphoria during the initial stages of treatment appears to be something of a warning sign (mention of this is common in the posts I have labelled "red flags".) Also, (based on postings I’ve read) people who do well over the long term frequently report taking breaks from the drug - on weekends, or during more extended vacation time. In considering Adderall use for myself, I have concluded that - we’re I to use it - drug breaks would be manditory.

An analogy, perhaps, might be made to a chemical that oxidizes metal. Applied in large quantity, it will significantly rust the metal, causing rapid deterioration. Applied in small amounts, only a mild tarnishing of the metal occurs. Repeated application over a long period of time, however, will cause the effects of that tarnishing to accrue.
I don't see it that way at all.

There is no reason to believe that lower doses have the same effect on a smaller scale. Especially with all of the evidence to the contrary.

There is no substance I can conjure that I will believe is safe when consumed in excess.


My conclusion as to the underlying cause of the ‘red flag’ posts re: Adderall use - the experience described is most likely explained by the accrued neurotoxic effects of long term amphetamine use.
The thing is, amphetamines are not toxic in theraputic doses. They don't accumulate. In higher doses, yes.

I would say the most likely explanation of the most recent thread starter is tolerance due to the long-term use of a dose that was probably just a little too high. Unfortunately, though, that's pretty easy to do.


Further observations: Any mention of prolonged mild euphoria during the initial stages of treatment appears to be something of a warning sign (mention of this is common in the posts I have labelled "red flags".)

Agree with you there. For the majority of forum members, any initial euphoria was extremely brief. Those that have reported anything more than that often report problems as well.

I would like to see some do a study on this specifically.


In considering Adderall use for myself, I have concluded that - we’re I to use it - drug breaks would be manditory.
Oh, not me! I don't like inconsistency in my cognitive functioning and breaks would require that I adjust, then readjust, then adjust, then readjust..... I get enough of that each morning and evening as the med's direct effects fluctuate.

I also don't have my son taking breaks. He has no a behavior problems at all, but I don't want him to have to experience the wide ups and downs, nor do I want to cheat him out of his brain for the weekend. He's a lot like me in that all of his leisure pursuits involve some intellectual activity.

What I said in terms of experiencing prolonged mild euphoria - or just a bit too much "feeling great" - or becoming a bit of a dynamo in terms of focus and getting things done - is something that others have noted throughout this thread. (Scattered, for example.) I just want to mention that I'm aware of this in their posts. I think, if I've figured out anything in terms of stimulant medication use, it's to pay careful attention to that.

Also, what timh said is worth repeating:
The key is a combination of medication, therapy and self-improvement. While on the medication take steps to make positive changes and build processes. Make those processes into habits. Then when/if the time comes to reduce or stop the medication, those processes "may" stay. I realize that he puts “may” in quotes because the meds don’t alter the underlying physical arrangement of brain cells.

:) I ain't weighing in on this one!

Is that because you're a euphoric dynamo?
joke, joke.

Spoon, you have side stepped the whole drug delivery issue. Until you address that, there is no point in comparing anything. That is the key to this debate.

...Fear-evoking strategies, lies, and the warping of facts should never be tolerated.
Yes, yes, and yes....is anyone listening?

We go around in circles. The issue has been clearly defined now by someone besides myself.

Spoon, you have side stepped the whole drug delivery issue. Until you address that, there is no point in comparing anything. That is the key to this debate. I'm not sure precisely what you are referring to when you say "drug delivery". I am going to assume, however, that you are referring to the drug's administration - oral consumption, smoking, or injection.

I can't say anything in regards to the differing effects of each beyond the obvious - oral consumption provides the slowest and smoothest uptake into the body.

However, drug delivery is not the issue. I'm not concerned about whether or not massive, chronic doses of amphetamine administered intravenously or by smoking cause cellular damage. That issue has been studied extensively and the answer is a resounding 'yes'. Further argument is unnecessary.

The key to the debate, from my standpoint, is this: What is the neurotoxicity of the amphetamines? And can long term exposure at doctor prescribed levels initiate cell degeneration?

These questions occurred to me only after reading a number of first person experiences describing diminished functioning in individuals who've had relatively long term exposure. An example from this very forum: "My beloved Dexedrine (dextroamphetamine) had stopped working properly after slightly over 8 years as it had started negatively affecting my ability is speak. I was stuttering and slurring my words so badly no one could understand me. So it had to go." Stuttering and slurring are symptoms commonly found in Parkinson's disease, and Parkinson's disease is related to dopamine cell degeneration. Parkinson's disease is frequently referenced in studies of amphetamine toxicity.

As diminished function in the area of dopamine transfer is indicated, one has to ask: Are the amphetamines neurotoxic in areas of dopamine transfer? Yes, as a matter of fact, they are. More toxic even, than cocaine. And since this is so, my next question is - can we reasonably put two and two together? That is: Given the dopamine related neurotoxicity of amphetamines, along with first person accounts relating symptoms of increased dopamine hypofunction, it does not seem entirely far-fetched to conclude that long term exposure to amphetamines, even at theraputic levels, appears to run a risk of damaging the very areas one is seeking to treat.

Is the logic I'm following unreasonable? Or am I just being an overly sensitive nanny in regards to my brain cells?

For you see, I'm seeking to resolve these questions for a reason - and it's not for the sake of your brain cells. It's for the sake of mine. If it relieves any of your concern, I can assure you that I am not going to start a nationwide campaign to remove amphetamines from pharmacy shelves.

More toxic even, than cocaine. And since this is so, my next question is - can we reasonably put two and two together?The answer to this is pretty obviously no, in my opinion. Without a valid study, using solid methods, it is no more trustworthy than tarot cards, horoscopes, or phrenology. Anecdotal evidence may provide the impetus to conduct a valid study (in fact AFAIK many have been conducted and others are under way), but in and of itself it is just that, anecdote.

By the way, it appears that coca in small doses is also not especially harmful; it is only when it is refined into high-purity cocaine that it becomes dangerous. If I recall, it takes on the order of 1,000 kg of coca leaf to produce 1 kg of cocaine.

Is the logic I'm following unreasonable? Or am I just being an overly sensitive nanny in regards to my brain cells?


It's a bit unreasonable. I can see where you might think some things are related, but you've built some pretty massive bridges to get from point A to point B.

However, drug delivery is not the issue.

When euphoria is brought up, of course drug delivery systems must be considered. As others have pointed out, the dosage is not the same either, nor is their build up as pointed out in that study I posted for you. Of course the drug delivery system is an issue.


What is the neurotoxicity of the amphetamines? And can long term exposure at doctor prescribed levels initiate cell degeneration?
Neurotoxicity with regards to therapeutic levels of stimulants is a term that only Scientologists and Dr. Breggin et al use. Both groups are incredibly biased and have an axe to grind. There have been few long term studies with regards to stimulants, so it is difficult to answer your second question.
http://www.addforums.com/forums/showthread.php?t=20721&highlight=breggin
http://www.addforums.com/forums/showthread.php?t=18118&highlight=scientology




These questions occurred to me only after reading a number of first person experiences describing diminished functioning in individuals who've had relatively long term exposure. An example from this very forum: "My beloved Dexedrine (dextroamphetamine) had stopped working properly after slightly over 8 years as it had started negatively affecting my ability is speak. I was stuttering and slurring my words so badly no one could understand me. So it had to go. Stuttering and slurring are symptoms commonly found in Parkinson's disease, and Parkinson's disease is related to dopamine cell degeneration. Parkinson's disease is frequently referenced in studies of amphetamine toxicity.
You make some incredible jumps of logic here, none of which is sound. As a good rule of thumb, check out what Scientists are researching. If no Scientist is making a similar connection in this highly studied field..odds are there isn't much there.


As diminished function in the area of dopamine transfer is indicated one has to ask: Are the amphetamines neurotoxic in areas of dopamine transfer? Yes, as a matter of fact, they are. More toxic even, than cocaine.
Wow...it appears that you made a statement of fact, which was the basis of your next question, and answered it with an absolute statement. None of which from my perspective are accurate.


It be best if you back up your thinking and look for support from Science in what you state. Do post some Scientific links or make reference to Scientific journals or books. The first hand accounts are getting tiresome. ie Tom's head blew off after taking Ritalin for 20 years.

The key to the debate, from my standpoint, is this: What is the neurotoxicity of the amphetamines? And can long term exposure at doctor prescribed levels initiate cell degeneration?If you think stimulants could do just that then you should not take them. However, your claim that you are just "doing some research" is wrong. You are now stating or suggesting that amphetamines are (neuro)toxic, something which is insane, just like watching television causes blindness and excessive gaming makes you psychotic and excessive internet makes you dull and drinking beer gives you dementia earier.

You are not in a position to do that. I really think you are smart, but you need to do more research to conclude this. For example just how many people who used stimulants got parkinsons? You have statistics???

Why would your doctor prescribe something that is toxic? Do you think doctors are so stupid as to do just that, prescribe a unsafe med? Don't you know meds get tested well before they are used?

The key to the debate, from my standpointSpoonbits, there is no debate. You are just spreading rumours. You are not responding to our posts and are stating things like neurotoxicity.

Unfortunately, most of the people here are well educated and they aren't respondent to your post regarding your rumours.

Don't you think we figured it out? You are posting some "juicy stuff" with some pickles on it. Where juicy stuff is amphetamines and pickles is neurotoxicity. Editied by Administration, please review Forum Etiquette Guidelines.

If you think stimulants could do just that then you should not take them. However, your claim that you are just "doing some research" is wrong. You are now stating or suggesting that amphetamines are (neuro)toxic, something which is insane, just like watching television causes blindness and excessive gaming makes you psychotic and excessive internet makes you dull and drinking beer gives you dementia earier.
Steve,

It's not insane. Amphetamines ARE toxic. They are toxic when taken in meth form, snorted, injected, or taken in high doses. People die from ONE HIT of methamphetamine.

There's no debate in the scientific community that amphetamines can be toxic. The debate is whether or not the points that spoonbits are making can be generalized to theraputic doses of prescription stimulants.

In my educated opinion, they cannot. However, they are VALID points that it is appropriate to address.

Some of the forum members who have posted here (like Scuro -- hope you don't mind me speaking for you...) just get a little tired of beating this particular dead horse. When someone new comes in, it's easier to point them to the search feature and let them know there's a consensus that disagrees with them and leave it at that. It shouldn't be taken as a consensus that it's a stupid question....

Anyway, My good question: Why don't you use methylphenidate instead of amphetamine? Isn't that safer? Maybe good for a discussion?

To barbyma: I find it an interesting discussion, but I don't really like how spoonbits describes cases and then suggests amphetamines are neurotoxic. And then he links amphetamine usage to parkinsons. Those cases are just anonymous cases. But then what I find really bugging is that he is spreading rumours on the internet.

I don't use amphetamines myself, so I don't choose a party. I am really open to spoonbits opinion too.

Steven,

Just a friendly bit of advice from someone who's attacked from all sides pretty constantly (but almost never outside the guidelines).

It's quite fine to disagree and to attack the message and the method, but we've got rules about attacking the person.

Besides, it just doesn't make your point. It's especially damaging to your own credibility when you accuse the person of not doing their research, then post a blanket statement like amphetamines & toxicity = insanity.:rolleyes: ;)

Scuro...

I think i just fell in love!! Thank you!

Ummmm...spoon, well your post was long..

.......

Wow...it appears that you made a statement of fact, which was the basis of your next question, and answered it with an absolute statement. None of which from my perspective are accurate.

It be best if you back up your thinking and look for support from Science in what you state. you are now stating or suggesting that amphetamines are (neuro)toxic, something which is insane. You have not been reading my posts very carefully. Please go back and read my earlier post re: amphetamine neurotoxicity on page two of this thread. In it I cite an article found on the website of the American College of Neuropsychopharmacology. (about as far from Breggin et. al. as you are likely to get.) I invite those interested to read it. Here it is again. http://www.acnp.org/g4/GN401000166/CH162.htm (http://www.acnp.org/g4/GN401000166/CH162.htm)

Please make note, while you read the article, that it is a discussion of the use of amphetaminesas a distinct class of drug. That is, the action of all the amphetamines on the brain is nearly identical. Methamphetamine is differentiated by degree of potency. (Cocaine, on the other hand, works by a different mechanism.) If you are unaware, the added methyl group attached to the amphetamine molecule serves to increase fat solubility. As the brain is composed of roughly two thirds fat, this allows for better absorption into the brain, thus increasing potency. I invite you to compare their molecules if you have any doubts as to their similarity.(1)


Posting again, from the acnp website:
"These marked neurotoxic effects on the dopamine systems may underlie the mild Parkinson-like symptoms or "burned out" clinical picture in chronic, high-dose amphetamine abusers. These same individuals have a readily activated stimulant psychosis response. Similar re-activation of psychosis by L-dopa and direct agonists in Parkinson patients raises the question of whether the more severe psychosis resulting from amphetamine vs. cocaine abuse may have a partial basis in the greater toxicity induced by amphetamine."

Why would your doctor prescribe something that is toxic? Do you think doctors are so stupid as to do just that, prescribe a unsafe med? Why would doctors prescribe something that is toxic? Good question. A little some research on the history of meth might lead you to tidbits like this, suggesting that sometimes they don't know any better: “Methamphetamine (MA) is a derivative of amphetamine, which was widely prescribed in the 1950s and 1960s as a medication for depression and obesity, reaching a peak of 31 million prescriptions in the United States in 1967.”(2) Doctors are not omniscient all-seeing beings. They do what they think is best at the time, based upon given information.

Also, investigate the uses of Desoxyn®, a.k.a. pharmatceutical methamphetamine. There’s a good discussion of it found on this website under the title “ever heard of Desoxyn?”. (3)

I would like to point out to scuro et. al., that you and I are probably far more alike in our thinking than you may realize. For example, I’ll bet that reading bits of “Dr.” Peter Breggin makes you blood boil. Well, mine too. Reading that b.s. is absolutely infuriating - so I avoid it.

Becoming aware of the neurotoxicity of amphetamines in regards to dopamine transfer - and reading first person posts that appear to reflect this - has caused some degree of concern. I’m concerned because I’ve been seriously contemplating it’s use. If long term amphetamine use appears to run the risk of increasing dopamine hypofunction - is that a risk I can afford to take? (or - if it is a risk - how best to avoid it?) For me, it’s not just a matter of lowered motivation or focus - it’s the possibility of increasing the symptoms of social anxiety. And, as the prospect of that is truly ugly - I am proceeding with extreme caution. Proceeding with extreme caution and raising questions should not be a frowned upon activity.

(1) http://www.erowid.org/cgi-bin/chem_compare/chem_compare.cgi?LM=_ch_amphetamines_ia_amphetamin e_2d.gif&RM=_ch_meth_ia_methamphetamine_2d.jpg

See also: http://www.erowid.org/ask/ask.cgi?ID=2846

(2) http://amphetamines.com/methamphetamine/index.html

(3) http://www.addforums.com/forums/showthread.php?t=22230

Ok I read that article and I take my previous post(s) back. Sorry for the trouble.

QUOTE:
Sustained high-dose administration of amphetamines (especially methamphetamine) to experimental animals produces a persistent depletion of DA which is associated with terminal degeneration (62, 182, 195), as well as neuronal chromatolysis in the brain stem, cortex and striatum (42, 182). In contrast, continuous dosing with extremely high doses of cocaine (100–250 mg/kg/day i.v.) did not induce terminal degeneration in frontal cortex and striatum (62, 183). Recently, Cubellis et al. (36) presented evidence that amphetamine, in contrast to cocaine, induces redistribution of DA from the vesicles into the cytosol; thus, the loss of the protection of the vesicles' relatively reducing environment results in cytosolic oxidative stress that may initiate amphetamine neurotoxicity. The DA depletion is reported to be permanent in the caudate of monkeys (196). The main hypotheses for underlying mechanisms have included 1) the conversion of DA into a hydroxy oxidative metabolite (195, 196); and 2) glutaminergic stimulation of toxicity, which can be inhibited by N-methyl-D-aspartate antagonist MK-801 (200).

Remember we still have methylphenidate.

For me, it’s not just a matter of lowered motivation or focus - it’s the possibility of increasing the symptoms of social anxiety. And, as the prospect of that is truly ugly - I am proceeding with extreme caution. Proceeding with extreme caution and raising questions should not be a frowned upon activity.
It's not, spoonbits. Not at all.

Your approach of using largely unreliable internet info & trying to generalize across a wide variety of substances, however, has been seen on the forum many-a time and members become a little wary. I've seen this on other forums, too.

So, you've come for input and I think there's been plenty. If it hasn't convinced you, I'm not sure what else to do for you. I listed a few articles on the safety of Adderall on another thread, and given as much input as I can.

Remember we still have methylphenidate.
Steven,

Don't throw the baby out with the bathwater.

Please read the rest of the responses in this thread. This article is NOT a reason to fear Adderall.

Well I'm with Spoony on this one. He provided the references, he has sound premises and has contructed a valid hypothesis. His logic isn't completely 'fuzzy'.

Having said that, I think what is important and is worth noting is that it is up to the patient at the end of the day to decide: Whether the risks outweight the <possible> consquences?

I am aware I could have a cardiac event, I am aware that I could very well develop complications/other disorders, skin problems etc. I am aware of these issues and I still think the medication is justified given the consequences of not treating my problem. I would rather have these problems down the track than attempt nothing and watch my life go down the toilet simply from untreated ADHD. I would rather have a shot at reaching my potential than be scared off from some medication. The meds are afterall highly effective and the first line treatment for ADHD.

Spoon,

From the article.
"Since amphetamine-like stimulants have high abuse potential and other adverse toxic consequences, why do we continue to use them? In the US, there are only two Food and Drug Administration (FDA) approved indications for dextroamphetamine and methylphenidate: 1) narcolepsy and 2) attention deficit hyperactivity disorder (ADHD). In Europe, some countries have prohibited any use of stimulants. However, most experts agree that in ADHD and narcolepsy, stimulants have an definitive and uncontroversial therapeutic role when used judiciously. Because of this agreement on specific therapeutic applications for these drugs, their use will not be reviewed here. Rather, we will discuss the use of stimulants for other problems, those for which stimulant administration may be somewhat more controversial".

Editied by Administration. Your information jives with what we have been saying all along. Abused meth (snorted or injected - different dilvery system) is very dangerous and creates long term problems. This is not so with theraputic levels of stimulants.