Hacker News new | past | comments | ask | show | jobs | submit login

“more energy to do things” is directly correlated to the level of dopamine ADHD medication augments in our brains



I disagree with this. For me, the energy is because I have to use less energy doing basic day to day shit. Unmedicated, it takes far more effort and work, and leaves less energy for later tasks.


Yep this is common.

Imagine doing the dishes. Unmedicated, thats 2 or 3 tasks. Each with a high failure rate, and high cognitive cost.

1. Stop what you’re currently doing. 2. Decide you next task will be to wash the dishes. 3. Wash dishes.

The spoon theory [0] covers this concept well, and can be a useful tool.

> The spoon theory[a] is a metaphor describing the amount of physical and/or mental energy that a person has available for daily activities and tasks, and how it can become limited.

https://en.wikipedia.org/wiki/Spoon_theory


It’s amphetamine. The energy is from the amphetamine. The mechanism of action (norepinephrine and dopamine reputable inhibition) isn’t far from that of cocaine or methamphetamine. Let’s be real here. Amphetamine is known to skew one’s self assessment of their performance while on the drug.


> It’s amphetamine. The energy is from the amphetamine.

Energy still comes from food, and if you forget to eat on stimulants your body will eventually catch up with you.

Like coffee, stimulants let you better tap into that energy.

> The mechanism of action (norepinephrine and dopamine reputable inhibition) isn’t far from that of cocaine or methamphetamine.

Yep, they’re all stimulants. ADHD meds however, are manufactured in very controlled conditions, and taken in specific doses. Street drugs are more variable in quality, ratios, ingredients and strengths, and so not relevant to the treatment of ADHD.

Methamphetamine is a legitimate treatment for the most severe ADHD cases, it’s often a last resort. It’s sold as Desoxyn. It’s rarely used, but it _is used legally and successfully_.

> Let’s be real here. Amphetamine is known to skew one’s self assessment of their performance while on the drug.

If you don’t need it, stimulants are going to have a different effect.

People with ADHD are in my experience, going to be able to self-assess performance on their meds better than off them.

Don’t assume one experience is universal, especially when we’re talking about neurodiversity. Even among those with ADHD, experiences are not universal. We may rhyme, but we don’t always repeat.


But it's not only perception. If at the end of the day you have done things as opposed to not done things, then the performance improvement is real.


The self-assessment is less to do with how efficient I was, and more based on the fact I get things done sooner, because I don't fuck around and get distracted every few minutes. Completing a task significantly sooner/earlier, because I managed to stay on task has a real impact on the energy and time I have to spend on other tasks.

If I only get 80% of the stuff I need to get done before bedtime, there's no chance for me to do other. If I get the stuff I need to get done well before bedtime, there's time left for other things. Skewed self-assessment isn't really a factor in that.


not everyone on ADHD medication is on amphetamine. methylphenidate and clonidine are other treatment options.


This is the truth.

And by the way, the effect on dopamine is secondary. ADHD meds work because they affect glutamate leveles. You all do not have low Dopamine, you have low glutamate.

https://www.nature.com/articles/nn0301_275

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3966039/

https://www.brown.edu/news/2018-03-12/glutamate

And you all probably just need B6: https://pubmed.ncbi.nlm.nih.gov/24321736/


The active form of B6 is the enzyme cofactor used by AADC:

https://en.wikipedia.org/wiki/Aromatic_L-amino_acid_decarbox...

AADC is an enzyme in the path that converts amino acids into dopamine and PEA/NMPEA (see "biosynthetic pathways" in above link), the latter of which is an endogenous structural isomer of amphetamine.

You're not really making a strong case that this isn't about dopamine or that amphetamine is the wrong thing for it.

Moreover, B6 will make more of these things up until the point that it's no longer the rate limiter in their production, if it ever was. (The rate limiting step for dopamine is ordinarily AAAH converting Tyrosine into L-DOPA). And if you hit a different rate limiter before you have enough dopamine or PEA/NMPEA, what then?

Important note: This is also a thing:

https://en.wikipedia.org/wiki/Megavitamin-B6_syndrome

> Megavitamin-B6 syndrome has been reported in doses as low as 24 mg/day.

Meanwhile people sell 500mg B6 tablets and it has a half life of like a month. Ask your doctor etc etc.


P5P is also the cofactor for GAD1 an GAD2:

https://www.uniprot.org/uniprotkb/Q99259/entry

https://www.researchgate.net/publication/340492849_The_Gluta...

I did not say it is not about dopamine, but it is, at a deeper level, about glutamate. Which is why coffee works so well for ADHD because the stimulant action from caffeine is produced by glutamate.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7700297/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4166758/

Regardless, here is so much evidence that B6 plays a large role in ADHD and what, you all just ignore it?


> Which is why coffee works so well for ADHD because the stimulant action from caffeine is produced by glutamate.

Caffeine also antagonizes adenosine receptors which modulate dopamine. (Caffeine is complicated. Nicotine too.)

> Regardless, here is so much evidence that B6 plays a large role in ADHD and what, you all just ignore it?

The problem is it's the same kind of thing as saying that eating more reduces nutrient deficiencies. It might be more effective than placebo. If you're deficient in one thing and you get more of everything, you get more of that. It might even be the right solution if your underlying problem is actually that you're not eating enough.

But you want the solution that solves the problem as effectively and as narrowly as possible. Unless your underlying problem is actually a B6 deficiency, it's completely plausible that B6 could be more effective than placebo and less effective than Adderall. At which point nobody wants to hear you telling them to give up their Adderall for B6.


zrm, FollowingTheDao, can I just say that I massively appreciate you for sharing your thoughts on this?

The fact that I can read up on this as a civilian compared to your expert level knowledge is something I am deeply grateful for. Truly!


Leading experts on ADHD do not say that coffee works well for ADHD




Guidelines | FAQ | Lists | API | Security | Legal | Apply to YC | Contact

Search: