Yeah, antidepressants are way more complicated, they have more side effects, and have to be monitored carefully to not make the underlying issues that caused the patient to take them worse. Suicidal thoughts plus antidepressants that give you energy can give you the motivation to go through it. And despite not being categorized as addictive you can't stop taking them without wrecking your mental health until your body readjusts. If you don't refill your Rx of antidepressants your doctor will be notified and reach out to you because stopping has such pronounced effects.
While at the same time despite being a controlled substance because they're supposedly so addictive people with ADHD forget to take adderall and with normal use you don't take it every day.
We got this this shit so unbelievably backwards because we haven't shook the puritanical bullshit of "oh no someone might experience euphoria if they go out of their way to abuse it." Like bro, people with real medical issues shouldn't suffer because of this crap. If everyone who is buying cocaine from their dealer switched to medically supervised stimulants we would be unquestionably better off.
> While at the same time despite being a controlled substance because they're supposedly so addictive people with ADHD forget to take adderall and with normal use you don't take it every day.
This is incorrect: Normal use of stimulant medication is to take it regularly every day.
We also have evidence from studies showing that the brain adapts to consistent dosing in order to counter some of the damaging oxidative effects of amphetamine. Inconsistent dosing could undermine this adaptation and does not mirror the dosing protocol used in studies to determine long term safety. Sporadic dosing is also known to cause sensitization effects in studies, which can sensitize people to the negative side effects of a drug or exaggerate cravings.
Some people do take medication holidays as recommended by doctors, but even those should be done on a pre-determined schedule.
People get themselves into trouble when they start treating Adderall like an ad-hoc drug that they can take more or less of depending on how they feel that day or how much work they need to get done. This not only leaves the brain in a constant and unpredictable state of flux, it creates an association between “I need to do work” and “I need more Adderall”. Patients who go down this path often end up escalating doses, playing games with saving up pills to take more, or trying to talk their prescribers into extra dosages beyond what they need. It ultimately ends with higher tolerance and reduce effectiveness.
> If you don't refill your Rx of antidepressants your doctor will be notified and reach out to you because stopping has such pronounced effects.
This also isn’t true. There are many medications with withdrawal symptoms far worse than antidepressants. Some drugs can be potentially fatal if discontinued abruptly. Pharmacies don’t generally hunt down doctors when a patient doesn’t get a refill.
Antidepressant withdrawal (without taper) can be difficult for some, but so can withdrawing from Adderall. There are entire subreddits acting as support groups for people tapering down Adderall and trying to get back to feeling normal after taking Adderall for years.
Stimulants are definitely habit-forming and have a high abuse potential. Let’s not downplay it.
> Normal use of stimulant medication is to take it regularly every day.
Yeah, that doesn't really track with the fact that non-extended release lasts about 6 hours and extended release lasts about 8. Every single doctor I have ever been to has told me to take it as needed and try to not take it if possible so I don't form a habit and build a tolerance. Doing this I've managed to stay on the same exact dose for years. I would be willing to chalk it up to doctor doing it wrong but I see people whose job is specifically to oversee ADHD patients' medication and they say the same thing.
It's technically possible to be under it's effects for your entire waking hours and overlap to smooth the comedown in the middle but it's never prescribed this way so you'll always be in a state of flux.
> and does not mirror the dosing protocol used in studies to determine long term safety [...] it creates an association between “I need to do work” and “I need more Adderall”
Both of these are absolutely true which is why the studies are silly since nobody takes stimulants this way. And I absolutely have that association but it leads me to take less not more. If I want to spend the day hyperfixating on a new video game I can and just skip it. I can wait until understimulation and executive dysfunction actually impacts me.
I know it's not what you mean but I still think "this medication is incredibly habit forming so make sure to take it habitually" is really funny.
> Pharmacies don’t generally hunt down doctors when a patient doesn’t get a refill.
It was my insurance company actually. They called my doctor to see if I was supposed to still be taking it, told him to reach out, and then called me and sent a whole informational pamphlet about why it's important to take it regularly.
My doctor suggests that I don't take my adhd meds when I don't need it (school/work), and has had no objection for me to only take them on weekdays. That would absolutely not be the case for antideps.
I don't disagree, but stats are hard to come by for other types of psychiatric drug. I'd be interested to know if international studies have done on the subject, because it might very well not be an ideal "proxy" for general drug usage!
But I also personally think that adderall has less side effects and better/smoother withdrawals. SSRIs and other antidepressants usually have a heavier impact on the brain too.
Now I don't doubt that Adderall is probably over prescribed, but I think that it is better to look at entire families of drugs to compensate for differences between markets.
