[HN Gopher] Smart drugs reduce quality of effort, and slow decis...
       ___________________________________________________________________
        
       Smart drugs reduce quality of effort, and slow decision-making
        
       Author : wjb3
       Score  : 214 points
       Date   : 2023-11-16 09:12 UTC (13 hours ago)
        
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       | inciampati wrote:
       | Wow. Smart drugs just increase time spent working. N=40
        
       | cmcaleer wrote:
       | Anecdote regarding 'smart drugs': The most interesting thing I
       | observed in starting treatment of my ADHD as an adult is that it
       | I think that it stimulated my brain such that I was better able
       | to recognise my tiredness. I remember taking dexamphetamine while
       | I was titrating in the afternoon and pulling over an hour later
       | while driving because I felt I was too tired to safely drive.
       | This was after what I had considered a 'normal' amount of sleep
       | in the past.
       | 
       | When I spoke to people who took these drugs in university (almost
       | all w/o ADHD) sleepiness or calmness never reported by them as a
       | side effect. I avoided coffee and 'energy' drinks in the past
       | because I had this effect, and didn't really understand how
       | people took caffeine to keep themselves awake - I thought it was
       | kind of a meme and I wouldn't understand why my coworkers would
       | drink it during night shifts.
       | 
       | I don't think dehydration adequately explains these to me, as I
       | do take care to try to stay hydrated.
        
         | jhfdbkofdchk wrote:
         | yeah that's how you know you legit have ADHD, when a cup or two
         | of coffee makes you calm instead of wired. I do have a
         | threshold where if I drink too much coffee I can't sleep, get
         | jittery etc.
        
           | petesergeant wrote:
           | That is also how you know you have a caffeine dependence,
           | though
        
             | kaashif wrote:
             | Yeah, back when I drank a lot of coffee, one cup would make
             | me feel calmer, while going too far and drinking like 3-4
             | cups (which I did do once to see what it was like) makes me
             | feel like shit, have a headache, be unable to sleep well,
             | etc.
             | 
             | After stopping, even one cup makes me jittery and I no
             | longer feel like I need to drink coffee to feel awake.
             | 
             | Caffeine dependence is terrible and widespread.
        
               | matwood wrote:
               | > Caffeine dependence is terrible and widespread.
               | 
               | There are plenty of reasons to not want to be dependent
               | on caffeine, but I wouldn't put its dependence in the
               | terrible category.
        
             | qwertox wrote:
             | Agree. If I don't drink coffee for a couple of weeks, which
             | I rarely do due to the extreme migraine from withdrawal
             | (3-4 days), and then drink one with half a spoon of coffee,
             | I'm extremely alert and focused for house. Now I'm drinking
             | like at least 10 cups a day with zero benefit.
        
               | robocat wrote:
               | It is easy to quit without headaches - _slowly_ reduce
               | your caffeine intake over a few weeks. Quitting cold
               | turkey (abruptly stopping) will give most people nasty
               | withdrawal symptoms.
               | 
               | I regularly give up either (a) using caffeine only pills
               | and breaking them to linearly decrease caffeine dose, or
               | (b) measured reduction of instant coffee over time.
               | 
               | Start at your current caffeine intake, every morning take
               | one dose (might start high) and reduce slowly over say 3
               | weeks. It requires significant patience and self-control,
               | but it has worked for me. My main problem is ensuring I
               | don't have social coffees: it is easy to fall back into
               | the habit of drinking coffee if I don't follow the
               | titration regime.
               | 
               | https://hn.algolia.com/?query=robocat%20caffeine%20quit&t
               | ype...
        
               | ishjoh wrote:
               | One easy thing you can do to reduce your caffeine intake
               | is to drink 1/2 caff or have every X coffee be decaf. I
               | switched to 1/2 caff and tapered down, that was a lot
               | easier for me.
        
           | culi wrote:
           | I think this is a vast simplification. People vary. Sometimes
           | drastically. Sometimes even from day to day.
           | 
           | I have certain foods that seems to dramatically change the
           | way stimulants like caffeine affect me. For whatever reason
           | if I eat bananas and nut butter (maybe I have an allergy or
           | food intolerance?) I find that caffeine makes me feel like I
           | crash. When taken on an empty stomach I can get very "wired"
           | but it also depends heavily on my sleep schedule and the time
           | of day I take it.
           | 
           | I've noticed I can get an incredibly productive boost from
           | caffeine when I take it at a time that disrupts my current
           | circadian rhythm. I (used to) usually drink coffee in the
           | morning and it rarely felt like it helped at all. I knew if I
           | was desperate I could drink it around noon and see a big
           | boost but then I wouldn't be able to go sleep on time and
           | would pay for it the next day
           | 
           | Genetics, diet, microbiome, epigenetics, sleep habits, study
           | habits, social health, seasonality, etc all likely play
           | _some_ role in the way people metabolize caffeine.
           | 
           | There is no published evidence that stimulants universally
           | make people ADHD more tired or calm.
           | 
           | And personally I believe given the right conditions anyone
           | might get to experience the effect of caffeine actually
           | making them sleepy.
        
             | anonymouskimmer wrote:
             | > Genetics, diet, microbiome, epigenetics, sleep habits,
             | study habits, social health, seasonality, etc all likely
             | play some role in the way people metabolize caffeine.
             | 
             | > And personally I believe given the right conditions
             | anyone might get to experience the effect of caffeine
             | actually making them sleepy.
             | 
             | There was a 6 month time in my late 20s when I was
             | averaging 3.5 hours of sleep during the week while working
             | two jobs and going to school. The third energy drink of the
             | day seemed to signal my body to be tired.
             | 
             | Years later with a much better life balance and fully off
             | of caffeine for months at a time a single 12 ounce can of
             | Coca-Cola at lunchtime was enough to keep me wired until
             | late into the evening. Some time after that, while fully
             | off of caffeine for about a year, 80 mg accidentally
             | ingested from caffeinated protein bars disrupted my sleep
             | deep into the night and took a couple of days to recover
             | from.
             | 
             | I could definitely do better with procrastination, and
             | sometimes have trouble focusing, but am pretty sure I don't
             | have ADD/ADHD.
        
           | LoganDark wrote:
           | It sucks that meds used to work this way for me, but now they
           | just don't. They stopped working after a couple months, and
           | never started working again, even after taking absolutely
           | nothing for weeks. It's been almost a year since they've
           | worked and I'm convinced my brain just patched a backdoor or
           | something and just _wants_ me to be useless and dysfunctional
           | all the time.
        
             | cvdub wrote:
             | They are probably still working, but you'll never get the
             | same rush of excitement/euphoria that you felt in the first
             | few months.
             | 
             | The euphoria is a negative side effect in my opinion.
             | That's what leads to abuse and addiction. Don't chase it!
             | 
             | I'm sure you've heard all this before, but make sure you're
             | getting enough sleep and exercise. Also, avoid acidic
             | drinks in the morning like coffee and OJ when taking your
             | medication. The acid can break down some of the medication
             | before your body has a chance to absorb it.
        
               | LoganDark wrote:
               | > They are probably still working, but you'll never get
               | the same rush of excitement/euphoria that you felt in the
               | first few months.
               | 
               | > The euphoria is a negative side effect in my opinion.
               | That's what leads to abuse and addiction. Don't chase it!
               | 
               | Yeah that's so not what I'm talking about.
               | 
               | When they worked, I was able to practice art, take
               | regular showers, get chores done and stay focused without
               | getting bored and compulsive. It doesn't help with any of
               | those anymore. I can't use it to draw, can't take regular
               | showers, can't get chores done even if they're staring me
               | in the face, and boy do I get extremely, painfully bored
               | _all the time_. And this happens whether I am on or off
               | stimulants.
               | 
               | Again, they used to _work_. That is, actually _treat the
               | ADHD_. And now they don 't.
               | 
               | This has _nothing_ to do with euphoria.
        
         | gtirloni wrote:
         | I can relate. Various friends took them and I never bothered.
         | They looked like crackheads and it scared me.
         | 
         | I was recently diagnosed with severe ADHD by several doctors
         | (something I've been treating as anxiety/depression for my
         | whole life), and was prescribed lisdexamfetamine.
         | 
         | It makes me super calm and my thoughts organized. When I'm
         | tired, I feel tired. If I'm sleepy, I'm sleepy. My productivity
         | isn't insane, it's just more stable and predictable now.
         | 
         | I wish I had been diagnosed many decades ago.
        
           | cmcaleer wrote:
           | This is almost exactly my experience. I sat on my diagnosis
           | for a number of years thinking it was wrong and 'this is just
           | me', not really fully understanding the benefits I was giving
           | up by foregoing meds.
           | 
           | After starting I really just didn't need my anxiety meds
           | anymore. Turns out being able to keep your shit together
           | makes you less anxious. Who knew!
           | 
           | Paranoia about the cardiac side effects have led me in to
           | caring a lot about my overall cardiac health, which has meant
           | that I've largely countered side negative effects with the
           | obsession over HIIT and less medication overall. Giving up
           | alcohol has been kind of sad but I'm getting to the age where
           | hangovers are starting to get brutal so maybe it's for the
           | best.
           | 
           | It's also been nice to keep certain aspects of ADHD that I
           | like, like my hyperfocus on certain subjects.
           | 
           | I wish I could tell teenage me to investigate this sooner.
        
             | gtirloni wrote:
             | _> After starting I really just didn 't need my anxiety
             | meds anymore_
             | 
             | Exactly. I'm currently slowly going off antidepressants.
        
           | paulocal wrote:
           | Same story here, just with modafinil. All the signs were
           | there since as far back as I was 7 years old.
           | 
           | I've been able to control my focus so much better which seems
           | to make me less tired. When I sit to get work done and
           | inevitably get distracted, I can recover instead of go down a
           | spiral of unproductiveness. I'm also better at prioritizing
           | my focus on the things that are important, such as a must-
           | have feature for launch, rather than a nice-to-have that I
           | just enjoy working on more.
           | 
           | And surprisingly, I've been getting some of the best sleep of
           | my life so far on a pill designed to keep you awake. Who
           | knew?
        
             | gtirloni wrote:
             | _> And surprisingly, I 've been getting some of the best
             | sleep of my life so far on a pill designed to keep you
             | awake. Who knew_
             | 
             | It's my experience as well. I used to wake up really tired.
             | I still get the same hours of sleep but I wake up
             | feeling... normal? which is an improvement. Very
             | unintuitive.
        
             | JohnBooty wrote:
             | Yeah I feel like I sleep great at night w/ modafinil.
             | 
             | To be clear: I can't sleep well at all for about 8-12 hours
             | following a dose. It has killed my ability to take a
             | lunchtime nap.
             | 
             | But as long as I don't take it after noon, I get great
             | sleep at night. I fall right to sleep in minutes. Plenty of
             | dreams as well, which suggests to me I'm getting in some
             | good REM sleep.
        
           | JohnBooty wrote:
           | First: congrats on the progress! That sounds great!
           | 
           | I've been thinking about moving in the opposite direction,
           | actually. ADHD meds like lisdexamfetamine/adderall have been
           | moderately helpful.
           | 
           | But I am starting to think that I might do better treating
           | this from an anxiety/depression angle. ADHD is so comingled
           | with anxiety for me that I can't tell them apart. When I'm
           | falling behind on tasks I get anxiety, which is _the literal
           | worst thing for my ADHD_ , so that exacerbates the ADHD,
           | which increases the anxiety.
           | 
           | I'm curious (if you're open to sharing) if you're still
           | treating the anxiety/depression side of things?
        
         | jm4 wrote:
         | I had the same experience with amphetamine. I think it's an
         | ADHD thing. My doctor started me off on a low dose and I was
         | falling asleep when I took it. We bumped it up and I'm working
         | harder to stick to a good sleep schedule. It's mostly subsided,
         | but I do still need the occasional afternoon nap.
         | 
         | I didn't have that same experience with methylphenidate. That
         | one was a much more pronounced effect. I felt pretty locked in
         | and it was easy to focus. The downside was I was getting
         | headaches, stomach cramps, I would sweat more and my heart was
         | always racing like I had too much coffee.
         | 
         | The amphetamine feels much different. It's more of a chilled
         | out effect where all the noise seems to go away. It doesn't
         | make me feel any smarter, but I do feel less distracted and I'm
         | able to complete boring routine tasks. I wonder if that's why I
         | sometimes get sleepy with it. It's like a relaxation spa for my
         | brain.
        
       | baryphonic wrote:
       | > While on a drug, participants made a poorer, more random first
       | attempt at filling a knapsack than they did after taking the
       | placebo, and this had an especially negative impact on the
       | subsequent performance of those who'd been above average in the
       | placebo condition, explaining why they dropped below the mean.
       | Overall, the results suggest that the participants' approach to
       | solving the knapsack task became less systematic while they were
       | on each of the three drugs, the researchers write.
       | 
       | I can't help but think that since the knapsack problem is NP-
       | complete, any attempt to fill the sack could subjectively appear
       | "more random." Certainly the participants could use certain
       | heuristics, but since in general there is no known way to
       | systematically solve the problem, this study seems to enable some
       | confirmation bias on the part of the experimenters.
        
         | bglazer wrote:
         | NP-complete just means that it's very difficult to verify that
         | any solution is the best possible solution. It's very easy to
         | compare any two attempts at a solution. That's what the
         | researchers did, they saw that the knapsacks from the drugged
         | attempts were worse than placebo
        
           | nyssos wrote:
           | > NP-complete just means that it's very difficult to verify
           | that any solution is the best possible solution.
           | 
           | It means that it's hard to _find_ the best solution, but easy
           | to verify.
        
         | Hnrobert42 wrote:
         | That's an interesting observation. However, maybe that makes it
         | the perfect type of problem. That is, it's a problem you can
         | spend a lot more time on without better results, on average.
        
       | mdorazio wrote:
       | The authors of the paper seem to have misinterpreted why many
       | cognitively healthy students take ritalin/adderall. It's not to
       | make you smarter or more able to solve complex problems, it's to
       | let you focus and cram on large workloads for far longer than you
       | otherwise would be able to. Basically, quantity over quality.
       | 
       | A much better test would have been to give all the study
       | participants some new material requiring multiple hours of study
       | to memorize & learn, then give them a test. The knapsack problem
       | is fine to test some measure of "intelligence", but a bad choice
       | to simulate academics.
        
         | poultron wrote:
         | Agree - as someone who took Adderall in highschool and college,
         | and has started taking it again as an executive in my career, I
         | always took it to be able to handle multitasking more
         | efficiently with less distraction, and to motivate an action to
         | be performed vs procrastinating. A test in which you HAVE to
         | get a job done and you're being monitored and timed - I
         | wouldn't expect a large improvement in results with 'smart
         | drugs'. I think it would be much more interesting to watch
         | study or work habits while under the influence of these smart
         | drugs, measured in pages reviewed/written or emails sent or
         | slides created or phone calls made, etc. True measures of
         | productivity without knowing someone is looking over your
         | shoulder.
         | 
         | Also notice as I take my "smart drugs" my ability to focus in
         | meetings is increased, and therefore allows me to better recall
         | information in subsequent days... vs when not on meds I'm
         | constantly distracted and my memory is much more foggy,
         | especially specifics or details.
        
           | FFP999 wrote:
           | > I think it would be much more interesting to watch study or
           | work habits while under the influence of these smart drugs,
           | measured in pages reviewed/written or emails sent or slides
           | created or phone calls made, etc. True measures of
           | productivity...
           | 
           | I think you've confused "productivity" with "bulk". Do you
           | evaluate engineers by how many lines of source code they
           | write in a day?
        
             | Slava_Propanei wrote:
             | Ask yourself what is actually required to succeed in
             | academia
        
               | FFP999 wrote:
               | The ability to kowtow to corporate foundations to get
               | funding?
        
               | bumby wrote:
               | Depends on level, no? Certainly it seems higher up (PhD
               | or other research-oriented role), rote busy work may be
               | necessary from time to time, but it also requires more
               | creative work trying to synthesize new ideas.
        
               | Jensson wrote:
               | ADHD has too much creativity and barely any capacity for
               | bulk, so trading a bit of that creativity to do the bulk
               | work is worth it.
               | 
               | Imagine if your brain refuses to do worthless uncreative
               | work, that is ADHD, it is great for coming up with ideas
               | but sucks for doing the work you often have to do.
        
             | breakfastduck wrote:
             | I think you're missing the point. If you struggle with ADHD
             | / executive dysfunction, there is a material benefit to
             | measuring by those in that kind of job. Ultimately it is
             | not that you're at a normal baseline and these things just
             | make you do more busy work, it's that you struggle to keep
             | up with so many competing priorities and demands that you
             | end up dealing with none of it. So yes, for this purpose,
             | that measure is worthwhile in this case.
        
               | poultron wrote:
               | This is well said. People who dont have ADHD or a similar
               | cognitive dysfunction look at smart drugs as a boost
               | above average to gain high performance - because they
               | havent experienced ADHD or dismiss it. Unfortunately the
               | reality is that folks with ADHD typically feel very below
               | average regardless of their IQ, missing out on meeting
               | details, falling behind in work, procrastinating severely
               | vs their peers. Adderall makes me think "so this is what
               | everyone else feels like" when I take it, and I can just
               | get things done at the most simple levels.
        
             | n8cpdx wrote:
             | Lots of jobs do actually involve bulk reading and writing
             | with relatively low quality targets. Lawyers and assistants
             | being the prime examples. Also, almost all of undergrad for
             | many, many degrees.
        
           | pookha wrote:
           | I get distracted easier if my diet is awful (which it has
           | been in the past)... Refined carbs, sugar, tap water
           | (fluoride in tap water is
           | insane:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5285601/)
           | and highly processed foods. Switch to a diet high in nitric
           | oxide and run and I'm a much better problem solver. And I
           | have no desire to work "for fourteen straight hours" and I'll
           | find another job if I'm being asked too.
        
             | satellite2 wrote:
             | The study on fluoride level is basically garbage. It's pure
             | randomness and the IQ level is probably only correlated to
             | the affluence of the region.
             | 
             | Just look at the results
             | 
             | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5285601/table/
             | T...
             | 
             | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5285601/figure
             | /...
        
               | pookha wrote:
               | What about these?
               | 
               | https://ntp.niehs.nih.gov/sites/default/files/ntp/about_n
               | tp/...
               | 
               | "This review finds, with moderate confidence, that higher
               | fluoride exposure (e.g., represented by populations whose
               | total fluoride exposure approximates or exceeds the World
               | Health Organization Guidelines for Drinking-water Quality
               | of 1.5 mg/L of fluoride) is consistently associated with
               | lower IQ in children."
               | 
               | https://www.hsph.harvard.edu/news/features/fluoride-
               | children...
               | 
               | https://pubmed.ncbi.nlm.nih.gov/25446012/
               | 
               | You don't seriously think that drinking fluoride is OK?
               | It's been studied to death and it's obvious at this point
               | that long term fluoride exposure causes developmental
               | neurotoxicity. Multiple countries have sponsored these
               | studies and they show negative correlations to IQ and an
               | increase in fluoride. They've demonstrated this in rats
               | with sodium fluoride as well.
        
               | satellite2 wrote:
               | Why stop here? Just take the 10 first results in Scholar,
               | you have as much low correlations as no correlation
               | results. You can also easily find structural issues in
               | many papers. And finally fluoride supplement from the
               | family can easily tip the scale dramatically in total
               | consumption which make the comparison pointless.
               | 
               | Finally, there is probably a level at which it actually
               | does become toxic. Like with many other minerals, too
               | little is actually harmful, there is a right dosage and
               | too much is again showing toxicity.
               | 
               | Why do the papers against do not mention this, do not
               | mention any theorical model to explain their findings, do
               | not correct for socio-demographics factors when we know
               | that intelligence is generally very poorly related to any
               | other variables except those ones which
               | disproportionately explain it?
        
               | pookha wrote:
               | "And finally fluoride supplement from the family can
               | easily tip the scale dramatically in total consumption
               | which make the comparison pointless."
               | 
               | In groups of 100? What's the percentage of people that
               | routinely consume toxic levels of fluoride from dental
               | supplements (that study ran four months)? People don't
               | generally eat toothpaste or drink mouthwash but I'm sure
               | it happens. I just wouldn't assume that it would happen
               | often enough to give you poison data.
               | 
               | " Like with many other minerals, too little is actually
               | harmful, there is a right dosage and too much is again
               | showing toxicity."
               | 
               | This is where I'm at on tap water...I assert that LOW-
               | DOSAGE exposure over extended periods of time is bad and
               | I assert that in the US there are area's that have
               | incredibly high-doses of fluoride in tap water (at least
               | 6 parts per million). Which is bad all around. Water is
               | controlled at the jurisdiction level and there's NO
               | guarantee that you're getting below the recommended dose
               | of fluoride. I'm of the opinion that it's completely nuts
               | to put this stuff in the drinking water and the Indian,
               | Harvard, and recent NIH papers appear to back this up.
               | 
               | "Why do the papers against do not mention this, do not
               | mention any theorical model to explain their findings, do
               | not correct for socio-demographics factors when we know
               | that intelligence is generally very poorly related to any
               | other variables except those ones which
               | disproportionately explain it?"
               | 
               | I agree with this...In the first study I could not tell
               | if they controlled for socio-economic status. They
               | identified villages with varying levels of fluoride and
               | called it a day. The Harvard study did though. And the
               | American study I linked to seemed to control for this as
               | well...And they all came back with results that were
               | similar...Repeated low-doses of fluoride have detrimental
               | effects to development health.
               | 
               | Form the harvard study: "We carried out a pilot study of
               | 51 first-grade children in southern Sichuan, China, using
               | the fluoride concentration in morning urine after an
               | exposure-free night; fluoride in well-water source; and
               | dental fluorosis status as indices of past fluoride
               | exposure. We administered a battery of age-appropriate,
               | relatively culture-independent tests that reflect
               | different functional domains: the Wide Range Assessment
               | of Memory and Learning (WRAML), Wechsler Intelligence
               | Scale for Children-Revised (WISC-IV) digit span and block
               | design; finger tapping and grooved pegboard. Confounder-
               | adjusted associations between exposure indicators and
               | test scores were assessed using multiple regression
               | models. "
        
               | Wojtkie wrote:
               | From your first link, they literally state that the
               | "moderate effect" is at concentrations exceeding what
               | flourinated water supplies in the US have. Here's the
               | comment.
               | 
               | >Reviewer comment (DocB1_Monograph, page 2): It would be
               | helpful if the Abstract was clear in the Discussion that
               | the conclusion about effects on IQ in children was
               | derived from high human exposures (higher than US
               | exposures) without getting into more hazard conclusions
               | or assessments.
               | 
               | They repeatedly say that the current research is no where
               | near comprehensive and results are weak.
        
             | poultron wrote:
             | Agreed - when I dont take Adderall, the closest I feel to
             | it is when I do intermittent carb-free fasting paired with
             | high water intake. If I eat shitty, I have what feels like
             | a severe mental hangover every single day with significant
             | impacts to motivation and productivity.
        
           | Aurornis wrote:
           | > and to motivate an action to be performed vs
           | procrastinating
           | 
           | I've watched several peers go down the path of trying to use
           | stimulants for motivation starting in college and again later
           | in my career. There's no denying that it works at first. They
           | are stimulants, after all, and they stimulate people
           | especially well when they first start taking them.
           | 
           | The problem is that the motivation from stimulants is
           | famously prone to tolerance and rebound effects. It's also
           | very prone to habit-forming associations. I've noticed
           | several people try to use prescription stimulants in an "as
           | needed" fashion when they need to get a lot of work done
           | quickly and they don't really want to do it. It doesn't take
           | long before it's obvious to their friends and coworkers when
           | they're having an off day or an on day, even though they
           | might deny any rebound effect. It gets scary when they do
           | this so long that they forget how to self-motivate without
           | taking stimulants because they've built such a strong mental
           | association between "I have a lot of work to do" being a
           | trigger for "I should take another pill today" or even "I'll
           | save this work until tomorrow when I can take a pill". It
           | gets even scarier when tolerance sets in (to the
           | motivating/stimulating effect, not so much the intended
           | attention-enhancing effect) and they're now flirting with
           | escalating doses, double doses, combinations with
           | 'nootropics' to boost effects or 'reduce tolerance' and other
           | slippery slopes.
           | 
           | The short-term productivity boost shouldn't be denied, but I
           | think it's also short-sighted to hold these drugs up as a
           | free lunch productivity boost. Let's be honest: A little
           | experimenting here and there isn't going to show tolerance,
           | extensive rebound, psychological associations, or other
           | effects, but that's also what gets people in trouble when
           | they start to think it's a free lunch. There's a reason the
           | traditional ADHD treatment approach involves taking the same
           | dose every day rather than encouraging the patient to build
           | psychological associations between taking the drug to alter
           | their mood state.
           | 
           | The strange part about this conversation is that if I wrote
           | all of the above text about drinking 2 energy drinks at the
           | start of a work day, few people would argue with it. The
           | tolerance, rebound, and dependence effects of caffeine seem
           | to be well known in pop culture. For some reason people with
           | a little exposure to prescription stimulants seem to think
           | that the normal rules don't apply to them, at least at first.
           | 
           | A lot of people who have minimal or sporadic experience with
           | stimulants seem to think they're no-strings-attached
           | productivity boosts, but there's no free lunch. The brain
           | will adapt over time.
        
             | WalterBright wrote:
             | I would get a short term productivity boost with caffeine,
             | and then a remarkably unproductive time when it wore off. I
             | deduced that the "up" part of the curve was cancelled out
             | by the "down" part.
             | 
             | So I switched to decaf. I'll still enjoy regular coffee now
             | and then as a special treat.
        
             | saiya-jin wrote:
             | Very good summary of long term situation, I hope OP and
             | similar folks would realize the drawbacks. Indeed, concept
             | of 'free lunch' simply doesn't exist in reality, especially
             | when it comes to drugs. Our bodies and minds constantly
             | adapt and what caused a certain reaction before will
             | gradually cause less of it the more its used. Some folks
             | fare better, some worse, some have very low threshold for
             | addictions.
             | 
             | A very US-centric view I think, i never knew a single
             | person in my University who took these 'enhancing' drugs,
             | we just got wasted from alcohol and smoked weed. And I went
             | through rather stressful University where 2/3 of people who
             | started were thrown out of school in first 2 years in one
             | or the other filtering hardcore courses with slightly
             | psychotic professors (still not getting why by far the
             | hardest course from 5 years for studying freakin' Software
             | engineering had to be 'Theoretical electrotechnics' with
             | some hardcore math way beyond our actual math courses, of
             | course never used any of that, not even on rest of
             | studies).
             | 
             | Anyway, any substance you abuse will eventually kick back
             | quite hard, if it didn't yet give it some time (or take a
             | bit harder look in the mirror next time). Same for bad
             | habits.
        
             | nikkwong wrote:
             | I could see someone making the exact same arguments that
             | you're making about caffeine: you need to increase the dose
             | over time, it's habit forming, people are not the same when
             | they're not on it, etc; but many would argue that they
             | drink coffee successfully for entire lifespans and are
             | better off for it. You're demonstrating a 'spiraling out of
             | control' reaction that happens when people habituate to
             | stimulants but--well, I'm not sure how many cases this
             | actually occurs in.
             | 
             | Stimulants may be used by individuals with true
             | deficiencies in an effort to get to baseline. Many people
             | who start using stimulants in their 20's and 30's report
             | being able to express healthy, practical behaviors that
             | they couldn't summon themselves to express before: cleaning
             | the house, making it to meetings on time, paying attention
             | in conversations. The caution that you're expressing is
             | warranted with any substance, but I'm sensing a bit of
             | fearmongering which I think could possibly stop individuals
             | from trying a substance through which they could possibly
             | receive benefit.
        
         | nicoburns wrote:
         | Yes, which makes sense because we rarely reward people for
         | making high quality decisions. And this is _especially_ the
         | case within academic contexts.
        
         | The_Colonel wrote:
         | Yeah, exactly. I take modafinil, and it doesn't make me smarter
         | in the sense of "fluid" intelligence, it just gives me the
         | ability to last longer on mental tasks.
         | 
         | I used to be completely mentally exhausted after a single
         | meeting, modafinil fixes that for me. It makes me smarter in
         | the sense of "crystallized" intelligence as a consequence of
         | accumulating more knowledge, experience, mental models etc.
         | 
         | There's also the problem of getting used to the drug. When I
         | first started taking it, there were various side effects
         | (including perceived worsened short term memory), which
         | subsided with time.
        
           | thelittleone wrote:
           | I used to get great results from modafinil. But it slowed to
           | the point of having no effect at all. Was concerned I was
           | getting fake ones. So went to India where its made, bought
           | from source and same thing. This was years after I had
           | stopped already. But I'm grateful for the focus it gave me
           | for 3 or 4 years.
        
             | lynx23 wrote:
             | Long term tolerance... When I found Ibometin as a remedy
             | for occasional headaches, I could only take half a pill and
             | had to actually ly down because it felt rather strong.
             | These days, I can eat two and dont even notice the ffects.
             | And no, I dont take it regularily, more like every 2 or 3
             | months.
        
               | anonymouskimmer wrote:
               | I wonder if for some of these drugs it may not be a
               | tolerance effect, but perhaps the drugs are just doing
               | what they are going to do (a long-term physiological
               | change) and after that point no longer have an effect.
               | Like growth hormones after bone plates have fused.
        
             | corndoge wrote:
             | I had exactly the same experience over the same time
             | period. Even waited a year and tried it again, same thing.
             | Also started getting nasty side effects (dyspnea). Wasn't
             | aware of any other drug that acts this way so i'm glad you
             | made this comment because i've always wondered if it was
             | the drug quality changing over time or if it was my
             | reaction to the same drug.
        
             | itchyouch wrote:
             | As someone with a real Rx for ADHD/Narcolepsy, I noticed
             | the same thing after several years.
             | 
             | After being on it for ~5 years it lost its magic and
             | efficacy, so I ended up introducing lifestyle changes in
             | the form of a 5-color-a-day smoothie, exercise & sleep.
             | Lifestyle changes were helpful, but not quite enough.
             | 
             | When I recently started back up, I noticed that Provigil
             | was a bit too stimulating for me. And I've found a good
             | balance in doing a 1/4 to 1/2 a pill. About 50-100mg dose +
             | caffiene (coffee/tea/energy drink) instead of the typical
             | 200mg.
             | 
             | And that's been quite a nice boost.
             | 
             | Adderall on the other hand is a massive dump of dopamine
             | and focus, so the focus is there, but it's easy to become a
             | stimulated zombie.
        
               | xkcd-sucks wrote:
               | Someone, um, very close to me, who has an d-amphetamine
               | RX, in grad school that found modafinil to be excellent
               | in staving off psychosis caused by staying awake for
               | several days in a row. However they also found developing
               | better working habits and leaving academia to much more
               | significantly improve quality of life.
        
               | Aurornis wrote:
               | Modafinil is a DAT inhibitor. Taking it will reduce the
               | amount of amphetamine getting into neurons, effectively
               | reducing or blocking the effects of the amphetamine
               | because it can't access the parts of your brain that it
               | uses to operate.
               | 
               | Your 'friend' was probably into overdose territory and
               | the Modafinil antagonized the d-amphetamine while also
               | inducing a wakefulness effect.
               | 
               | I really hope your friend realizes how bad this was.
        
             | AuryGlenz wrote:
             | I had a similar experience. I was taking it for idiopathic
             | hypersomnia. At first it was a miracle drug, and then after
             | only a few months it made me feel like absolute shit. Just
             | - my whole body feeling bad, in a bad mood, etc. Hard to
             | describe.
             | 
             | I've asked my doctor for a prescription so that I could use
             | it to go on stimulant breaks, but since I already have a
             | prescription for Vyvanse and Adderall he was concerned I'd
             | get drug audited. The last time I tried to find a good
             | online Indian source it seems it's very hard to find
             | anything legit.
        
               | Aurornis wrote:
               | You may already know this, but Pitolisant is a new non-
               | stimulant medication that could be helpful.
               | 
               | People either love it or find that it does nothing for
               | them, so don't get your hopes up too high. However, for
               | patients who respond it seems to be a great improvement.
               | Be warned that it can take a long time for the positive
               | effects to appear. Unlike stimulants that work well on
               | the first day and decline over the subsequent
               | months/years, it seems to do very little or have
               | uncomfortable side effects on the first few days and then
               | reveal the positives after a month.
               | 
               | And FYI, there's a weird copayment reimbursement program
               | from the manufacturer that makes it affordable for many.
               | Dumb game to have to play, but it's there.
        
             | Aurornis wrote:
             | I remember someone showed me the subreddits for Modafinil
             | and other stimulants (before they were banned, I believe).
             | It felt like every 3rd post was from someone complaining
             | that their Modafinil "didn't work any more" and they didn't
             | realize that tolerance was going to set in.
             | 
             | They thought they had discovered a free source of
             | motivation in a pill.
             | 
             | Of course, most people's initial assumption was that they
             | received fake pills. Not a bad assumption after ordering
             | online with crypto from an overseas website, but most of
             | the stories went the same way: It didn't matter the source,
             | it just wasn't "working" for them any more.
             | 
             | I'm always surprised that people understand how tolerance
             | works for energy drinks, coffee, and other caffeine
             | sources. But then they get exposed to prescription drugs
             | and assume it's going to feel like that forever.
             | 
             | The second part of this problem is the misunderstanding
             | about dosing. The prescription pill doses are set for
             | continuous dosing of patients who need to take it every
             | single day.
             | 
             | A Narcolepsy patient taking 400mg of Modafinil every day
             | forever is going to get into a steady-state tolerance that,
             | ideally, brings their function back to a normal adult. A
             | non-Narcoleptic person who takes 200mg or 400mg of
             | Modafinil without having a baseline tolerance is going to
             | be zipping around with extra stimulation. However,
             | tolerance will set in eventually as well, leaving them with
             | some stimulation, but nothing like those early doses when
             | they had no tolerance. Again, this is a well known effect
             | for other drugs like opioids or caffeine or benzos, but for
             | some reason people forget the laws of tolerance apply to
             | prescription stimulants too.
        
               | The_Colonel wrote:
               | > It felt like every 3rd post was from someone
               | complaining that their Modafinil "didn't work any more"
               | and they didn't realize that tolerance was going to set
               | in.
               | 
               | I believe it's at least partially caused by incorrect
               | expectations. When people start taking modafinil, the
               | effects are quite strong and stimulant-like, sometimes
               | even with mild euphoria. But then these effects disappear
               | and people are like - what's happening, I can't feel it
               | anymore? Tolerance or fake pills?
               | 
               | I fell into this trap originally as well and was
               | comparing production batches etc. But the actual reason
               | is that with a pro-longed use, Modafinil doesn't "feel"
               | like anything. There's no altered state of mind, there
               | isn't even a mild kick you get from a coffee. Modafinil
               | isn't a stimulant which would kind of push you to do
               | things. It doesn't "give" you anything, it only "takes
               | away" the fatigue, and this is far more difficult to
               | notice. On a relaxing day off, it doesn't feel any
               | different if I take modafinil or not.
        
               | FireBeyond wrote:
               | > I'm always surprised that people understand how
               | tolerance works for energy drinks, coffee, and other
               | caffeine sources. But then they get exposed to
               | prescription drugs and assume it's going to feel like
               | that forever.
               | 
               | In fairness, tolerance management and mitigation is a
               | component of prescription drug design and composition,
               | unlike the others. It of course can't overcome
               | pharmacology, but there are mechanisms with varying
               | efficacies.
        
             | trashface wrote:
             | Had a similar effect with bupropion, which is an
             | antidepressant not a stimulant, but known for its
             | activating effects, unlike the SSRIs which make some people
             | (including me) super sleepy. Unfortunately I wasted the
             | period where bupropion was giving me energy by pumping it
             | into a dead end job, which eventually went away. I should
             | have 100% used it to find a new job.
        
         | michaelt wrote:
         | _> it 's to let you focus and cram on large workloads for far
         | longer than you otherwise would be able to_
         | 
         | Isn't the point of doing that _to get better results_?
         | 
         | I mean, imagine if without drugs I can do a hard slog through
         | the books for 6 hours before giving up; and with drugs I can
         | spend 12 hours anxiously bouncing between tasks and _feeling_
         | very busy; but I actually learn more by doing the former than
         | the latter - nobody taking study drugs is hoping to spend twice
         | as long for worse results.
        
           | criddell wrote:
           | Think of it this way.
           | 
           | Say unaided, you can get to 85% proficiency in 6 hours and
           | that's about all you can sustain.
           | 
           | With smart drugs, you only get to 75% proficiency in 6 hours
           | but can keep going and will hit 95% in 9 hours.
           | 
           | Think of it like a pick up truck with two gas tanks. It is
           | less efficient than a small car but because of the larger
           | tank it has more range.
        
           | The_Colonel wrote:
           | > I mean, imagine if without drugs I can do a hard slog
           | through the books for 6 hours before giving up;
           | 
           | Many people using this kind of drugs normally lasted maybe 1
           | hour or so before giving up (without the drugs). And it often
           | took a long ramp-up to even get to that 1 hour of focus.
           | 
           | > and with drugs I can spend 12 hours anxiously bouncing
           | between tasks and feeling very busy
           | 
           | I guess this is maybe the case when your body isn't yet
           | accustomed to the drug. I don't have any such issue after I
           | got used to the drug (in my case modafinil).
        
           | shortrounddev2 wrote:
           | I would replace the word "learn" with memorize here. You
           | aren't rewarded in school for learning, you are rewarded for
           | information regurgitation. The point of taking Ritalin is to
           | improve this capacity. Learning is secondary to passing in
           | school
        
           | TrackerFF wrote:
           | Anecdotally: I never met failing or bottom-barrel students
           | taking ADHD meds to boost their performance.
           | 
           | Obviously, I can't know if students from the bottom
           | percentile also engaged in that, but all the students I knew
           | that took drugs to perform better, were motivated students
           | that wanted to maximize their grades. And they studied things
           | that required lots of reading and memorization (law,
           | medicine, and similar).
           | 
           | My take was that the kids that used those drugs, were the
           | ones that wanted an extra push on the last 10% - to put it
           | that way.
        
         | tiahura wrote:
         | Read the paper, or at least the abstract before you criticize
         | researchers for misunderstanding. They were testing performance
         | on the knapsack problem.
        
           | HDThoreaun wrote:
           | No one is taking these drugs to improve their performance on
           | the knapsack problem. They're taking them so they can work
           | for 15 hours straight without being distracted. It doesn't
           | make any sense to say they don't work when the test is
           | completely irrelevant.
        
             | thruway516 wrote:
             | They didn't say it doesn't work. They said it seems to make
             | you dumber, at least on certain tasks - not the same thing
             | as 'it doesn't work for studying or distraction'. Their
             | findings are pretty interesting and relevant, at least for
             | correcting a mis-perception that not a few people have
             | about those drugs and what they're supposed to do (many
             | people call them 'smart' drugs).
        
         | sheepscreek wrote:
         | "Smart drugs" is a poor choice of words to describe them. They
         | are really "executive function support drugs".
         | 
         | Even on them, a person will need to consciously make healthy
         | choices. These drugs do not magically help you think smart.
         | That still has to come from you.
         | 
         | If anything, I feel ever so slightly "dumber" on them. They
         | dull my creative thinking and in return, I gain a bit of
         | motivation. It does nothing to my willpower. So I still need to
         | want xyz thing bad, but it makes the act of doing that more
         | fulfilling. Even if it's a waste of my time but something I
         | _must_ do. The experience is more fulfilling. I reckon it's the
         | extra dopamine at play.
         | 
         | Regardless, xyz is still my decision and I can very much pick
         | an unhealthy thing. Drugs don't aid your prioritization skills.
         | They don't improve your communication. Those are skills that
         | have to be learned. Maybe not, if you won an organized parent
         | lottery. Then at least you will know what good looks like, and
         | can learn to emulate that.
        
           | cvdub wrote:
           | Super accurate description!
           | 
           | I never considered motivation and willpower to be separate,
           | but I think your breakdown makes a lot of sense.
        
           | somestag wrote:
           | Agree. Amusingly, the authors found evidence that the drugs
           | work: students spent more time focusing on even the easy
           | version of the task. The impulse to "be done" with something
           | and stop focusing on it is one of the things stimulants
           | counteract.
           | 
           | I'm also not a big fan on emphasizing the "cognitively
           | healthy" part of the equation. My understanding is that
           | stimulants do exactly the same thing in a person whether
           | they're "cognitively healthy" or not; they're not the sort of
           | drugs that target a deficiency or clear up some specific
           | problem. The only difference is that some people have more of
           | a need in this area than others.
           | 
           | This reminds me of an old article I read about how
           | psychedelics don't actually "increase connectivity in the
           | brain" like users thought, as though that had anything to do
           | with why people use psychedelics.
        
             | garciasn wrote:
             | > This reminds me of an old article I read about how
             | psychedelics don't actually "increase connectivity in the
             | brain" like users thought, as though that had anything to
             | do with why people use psychedelics.
             | 
             | That's why some folks say they take psychedelics; they want
             | to justify their drug use for 'fun' as something more
             | beneficial. I wish people were more honest with themselves
             | and others.
        
               | ethanbond wrote:
               | "The drug increases connectivity in the brain" is a
               | completely orthogonal claim to "the drug does something
               | beneficial for me."
               | 
               | In fact a lot of people who have taken (and really
               | cherish) psychedelics would _not_ describe them as fun,
               | and sometimes they 're very actively un-
               | fun/terrifying/unenjoyable, and yet can _still_ be
               | beneficial.
               | 
               | What exactly is going on at the level of "brain
               | connectivity" is pretty much unrelated to all of that^
        
               | somestag wrote:
               | Some people take psychedelics for the _feeling_ of
               | connectivity, and there is some talk out there about
               | psychedelics being healthy for the brain and  "helping
               | the brain form new connections" (all of that is based on
               | very limited evidence and a lot of woo), but even that
               | isn't what the article was about.
               | 
               | The article just scanned people's brains while they were
               | on drugs and saw that the electrical activity was more
               | erratic and scattered than normal, not more active and
               | connected, and concluded that people were using
               | psychedelics based on a myth.
        
               | renewiltord wrote:
               | Legality in the US depends on suffering being alleviated.
               | Honesty won't get you legality. I'm pro legalization so
               | I'll lie about the benefits if necessary. You'll then
               | have to pay the costs necessary to detect lies.
        
               | jimz wrote:
               | Wait, what? US as in the United States? That's simply not
               | true. Even if we disregard that "legality in the US" is
               | at best a moving target considering that federalism
               | creates jurisdictional differences as a feature and
               | therefore there are few things that are entirely outlawed
               | in the US across the board everywhere, but considering
               | that the most efficacious painkillers are also the most
               | controlled, while deliriants that, prior to processing,
               | extraction of active ingredients, and pairing with other
               | psychoactive substances at minute doses, have little
               | health benefits but great potential to create harm
               | (thinking of belladonna and datura as a start), are legal
               | to grow and aren't even subject to scheduling.
               | Criminalization's link to health is effectively ret-
               | conned and a poor ret-con at that. What turned Laudanum
               | from something acceptable to give to babies to something
               | of a moral hazard far worse than a health hazard was the
               | same rationale that turned a nation of with no provision
               | for immigration controls for the first hundred years of
               | its existence into one where entire ethnicities,
               | nationalities, and places of origin served as the basis
               | for exclusion and continues to do so under the thinnest
               | of guises: moral panics based in racism and perpetuated
               | by those empowered and enriched via the propagation of
               | such policies.
               | 
               | Lying about efficacy will do nothing but only bolster
               | what was never a legitimate rationale to begin with. This
               | is a country that failed to learn lessons from
               | prohibition, that managed to kept the Mann Act on the
               | books even though the legislative intent - that of the
               | fear over 'miscegenation' was hardly a secret, a country
               | where congress never bothered to even get rid of the
               | chapter in the US Code that contained the Chinese
               | Exclusion Act and therefore leaving the ugly legacy plain
               | to see for all. Why lie about your cause when the truth
               | that undergirds the reality is far uglier and far more
               | disconcerting to begin with? And of course, for once,
               | Oscar Wilde was wrong and the truth may not be pure but
               | certainly simple: prohibitionist policies began in racism
               | and are sustained by moral panics while protected by the
               | state agencies that now benefit financially from its
               | existence. All this has a paper trail, both online and in
               | print, in the federal register, in the US Code, in
               | congressional records and archives. If that's not enough
               | to justify resistance, your real reasoning will still be
               | more persuasive than having to make up something to
               | justify a position against a line of thinking that has
               | goalposts with wheels built in from the start.
        
               | renewiltord wrote:
               | Dude, there is no way I'm going to get shrooms legalized
               | by saying I want it for fun. It's too hard to get support
               | for. It's much easier to place this fig leaf in front:
               | look at these suffering people with mental illness;
               | here's some evidence that it heals them; look at this
               | grandma who has less pain; look at this grandpa who
               | doesn't have seizures.
               | 
               | Marijuana legalization used the same strategy: medical
               | first, then complete. The technique works. The other
               | technique of "Oh yeah, I want it for fun so you should
               | let me do it" has been tried for eons and got nowhere.
               | You can come up with all the theory, but one technique
               | worked and the other didn't, so I'm not interested in the
               | theory.
               | 
               | Fake science it's going to be. The people who hate it
               | don't have the ability to tell that it's fake.
        
               | somestag wrote:
               | I don't agree with them, but I don't agree with you
               | either. Spreading fake science and medicine is
               | fundamentally harmful to society, and doing it just
               | because you want to trip legally is not a good enough
               | excuse. This is like a textbook example of the ends not
               | justifying the means, and it's from the same playbook
               | that big pharma uses.
        
               | somestag wrote:
               | I don't agree with the parent that it's okay to lie about
               | the health effects of a drug just because you want it
               | legalized, but I feel like you missed the forest for the
               | trees here.
               | 
               | When a drug is stigmatized in the United States, it is
               | essentially impossible to get it legalized without
               | showing there is a medical use for it. That's just how it
               | is. If your goal is to get a drug legalized, it does not
               | matter whether that's how it _should_ be, or whether this
               | is all rooted in systemic discrimination, or whether
               | pharmaceutical companies push stuff that 's just as bad
               | under their veil of legitimacy. Citizens who are anti-
               | drug are under the impression _right now_ that ~100% of
               | illicit drugs are extremely dangerous and a major threat
               | to their community, and they are not going to sit around
               | and listen to a history lesson philosophizing about how
               | all their fears are a propagandized illusion.
               | 
               | Even if you got them to listen, they would just say "Why
               | risk it?" The only way to start changing minds is to
               | point out there are upsides to drug legalization beyond
               | just "freedom is good." That's why all of the arguments
               | for legalization focus on health/therapeautic benefits,
               | either directly from the drugs themselves or in the
               | ability to treat those who need help with addiction.
        
               | Levitz wrote:
               | I've had fun with psychedelics, I also honestly consider
               | they have improved my life.
               | 
               | Yes the trip can be lots of fun, but really, "fun" is
               | widely available once you cross the line and take drugs.
               | MDMA is fun. Amphetamines can be fun. There is no
               | scarcity of "fun" here and I have no issue admitting I've
               | taken those to the possible detriment of my health and
               | for fun.
               | 
               | The difference is that if I had to skip the "trip" part
               | of psychedelics and retain the rest, I'd still do it.
        
               | samtho wrote:
               | Let's say for the sake of argument (because it's not
               | true) that the _only_ possible benefit of psychedelics is
               | "fun". Assuming sensible doses do not cause harm, what is
               | the problem with it only being fun?
        
               | jimz wrote:
               | Or hell, even if it's not "fun" (since what is fun is
               | ultimately subjective as well), as long as it is not
               | harming anyone else, what is really the problem?
               | 
               | I did a lot of psychedelics, I don't know if fun was ever
               | the word I'd use to describe most of it, but I don't
               | regret any of it. It opened up a lot of the back of my
               | brain in a way I never could conceive and really allowed
               | me to think and analyze things in ways that I wouldn't
               | have access to without. That in itself is well worth the
               | experience, in my subjective reckoning. When I no longer
               | felt that psychedelics were able to provide me with what
               | it once did, I stopped. That was that. That surely is
               | enough, right?
        
             | jdietrich wrote:
             | _> This reminds me of an old article I read about how
             | psychedelics don't actually "increase connectivity in the
             | brain" like users thought, as though that had anything to
             | do with why people use psychedelics._
             | 
             | I don't recall seeing anyone make that argument, but I do
             | tend to avoid woo and pop sci. What is reasonably clear is
             | that psychedelics increase neuroplasticity even in vitro,
             | which is hypothesised as being one of the plausible
             | mechanisms of action for psychedelics as a treatment for
             | mental disorder - they potentially create a window of
             | opportunity for habitual patterns of maladaptive cognition
             | and behaviour to be unlearned.
             | 
             | Some people are very attached to the idea that the
             | qualitative experience of the "trip" is integral to the
             | therapeutic effects of psychedelics, but that is by no
             | means a universal belief; many groups are working on non-
             | psychedelic drugs that exploit this mechanism.
             | 
             | I think it's entirely reasonable to be wary of people
             | justifying their recreational drug use with outsized claims
             | of therapeutic benefits, but in the case of psychedelics
             | there is definitely something of clinical interest
             | happening. I'm quite circumspect about the clinical use of
             | psychedelics, but I think it's highly likely that we are
             | going to see a generation of novel and useful psychiatric
             | drugs emerge based on what we have learned from
             | psychedelics research.
             | 
             | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082376/
        
           | ericmcer wrote:
           | I find they make me "smarter" at coding because of how
           | important the ability to hold multiple contexts in your head
           | is. Being able to focus unwaveringly while drilling through a
           | bunch of nested function calls does make you a better
           | programmer.
           | 
           | At some point during debugging you might throw your hands up
           | and wonder who created this tangled web of complexity but
           | adderall delays that moment for awhile.
        
             | projectazorian wrote:
             | > At some point during debugging you might throw your hands
             | up and wonder who created this tangled web of complexity
             | 
             | There's a nonzero chance that it was your predecessor on a
             | 2am Adderall binge ;)
        
           | raducu wrote:
           | > If anything, I feel ever so slightly "dumber" on them. They
           | dull my creative thinking and in return, I gain a bit of
           | motivation. It does nothing to my willpower. So I still need
           | to want xyz thing bad, but it makes the act of doing that
           | more fulfilling. Even if it's a waste of my time
           | 
           | I also feel "dumber" while on ritalin, but at the end of the
           | day the job gets done. Also a lot of frustrating stuff, the
           | kind of stuff that would easily derail me, just becomes easy
           | to overcome.
           | 
           | Progress is just happens, but you can also be motivated to do
           | dumb/useless work, for stimulants dosage is key.
        
             | ImaCake wrote:
             | Similar for me, I take the smallest possible dose of
             | vyvanse that works to balance off the positives and
             | negatives. Honestly, its a similar trade-off with Coffee or
             | sugary foods.
        
         | throw1234651234 wrote:
         | Reading all this, it feels like these basically do the same
         | thing as drinking an energy drink, minus the 20point blood
         | pressure spike and tooth destruction. I am theoretically very
         | much against all of this except in absolutely extreme cases.
         | 
         | https://www.reynoldsclinic.com/why-french-kids-dont-have-
         | adh....
        
           | anonymouskimmer wrote:
           | Change the person for the social environment, or change the
           | social environment for the person. Very odd that in the US
           | "land of the free" we chose to former.
           | 
           | > Numbers in America show that at least 9% of the children
           | that are school-age are diagnosed with the disorder
           | 
           | That percentage seriously makes me think that we might be
           | overdiagnosing based on personality type instead of just
           | diagnosing based on underlying disorders. Either that or US
           | schools are very different than French schools.
        
           | cvdub wrote:
           | The article you linked is ridiculous...
           | 
           | > There's also the differences in how children are brought up
           | in America and in France. For example, French parents have
           | set strict limits from the time they are born. The children
           | are raised with limits such as not being allowed to snack
           | whenever they want. They have four strict meal times and they
           | know those are the times they are allowed to eat, not before.
           | While they love their children just as much as others do,
           | they do believe in forced strict limitations to help the
           | children grow up in guidelines and feel safe and secure.
           | 
           | Really?
        
             | throw1234651234 wrote:
             | In terms of whether these things actually make a difference
             | in how likely a child is to seem "ADHD" - yes, really.
             | Controlling inhibitions and not being on a constant insulin
             | spike ride from snacking helps stay focused.
             | 
             | I have also had a number of friends with "ADHD" for whom
             | the solution was "cut sugar, sleep enough, go into a room
             | with no electronics (or a user account with nothing else
             | installed), do some cardio".
             | 
             | I am not denying the existence of ADHD, but as a society,
             | we look for shortcuts to problems that have real solutions
             | and are therefore more likely to just pop a pill. See the
             | sister comment, it addresses this too.
             | 
             | And furthermore - yes, cutting screen time in children
             | dramatically increases their ability to focus later in
             | life.
        
             | hotnfresh wrote:
             | What's your objection? I can't tell if you believe
             | (possibly with evidence/experience!) that French parents
             | don't do this, or that the approach is (for some reason)
             | misguided.
        
               | cvdub wrote:
               | Sorry, I should have explained more.
               | 
               | I think it's ridiculous to make a blanket statement about
               | how kids are raised in America vs France with zero
               | evidence to back it up. There are plenty of strict
               | parents in the US, and I'm sure there are plenty of lax
               | parents in France. Plus, as the article states:
               | 
               | > The American psychiatrists believe that ADHD is a
               | disorder based on biological issues.
               | 
               | So the way a kid is raised has nothing to do with whether
               | or not they have ADHD.
               | 
               | According to the article, the real reason "Why French
               | Kids Don't Have ADHD" is because the doctors avoid that
               | diagnosis:
               | 
               | > Basically the French community has decided to focus
               | more on fixing the underlying causes of the problem
               | behavior instead of giving it a wide range diagnosis.
               | 
               | Looking for underlying causes and fixing problem behavior
               | sounds great, I just feel like the article is confuses
               | having ADHD and being diagnosed with ADHD.
               | 
               | Despite my problems with the article, I actually do think
               | that ADHD in children is over diagnosed in the US. And
               | even if the disorder itself isn't over diagnosed, I think
               | ADHD medication are over prescribed to children. Those
               | medications have can have negative side effects, like
               | reducing appetite and therefore growth, but that's not
               | even my main problem with it. As other posters have
               | described really well, ADHD medication can reduce
               | creativity and problem solving skills. If a kid is
               | medicated too young they might obey the rules a little
               | too much and develop into a less creative, interesting,
               | and dynamic person as a result.
        
             | bitwize wrote:
             | "All so-called ADHD kids need is a little good old-
             | fashioned discipline."
             | 
             | https://news.ycombinator.com/item?id=38278555
        
               | mmatants wrote:
               | Yeah this kind of stuff makes my blood boil. One can
               | shame and belt their kid into compliance, and it might
               | even get them (barely, only if they're lucky) all the way
               | through university but holy shit the lifelong damage of
               | self loathing and burnout and broken relationships it
               | creates is im-fucking-measurable.
               | 
               | Taking a neurological imbalance and turning it into a
               | morality thing is abuse. Even if unintentional. This is
               | real. Parents look for simple answers like "give em the
               | strap" but how is that less reductive than "give em the
               | pill"?
        
               | throw1234651234 wrote:
               | Or, you know, set a good example. No one said anything
               | about beating anyone, that's all you.
        
               | bitwize wrote:
               | I brought up "the strap" in the comment I linked to. The
               | sort of person who thinks ADHD is just a lack of
               | discipline also tends to be nostalgic for a time when
               | corporal punishment, including the use of straps and even
               | paddles, was considered routine and even admirable.
               | "Spare the rod and spoil the child" and that.
        
         | insanitybit wrote:
         | The problem with these tests is that the students participating
         | are likely already very motivated. School is something we do
         | for the first ~20 years of our life, it's hard to replicate how
         | fucking boring and unmotivating it is in a lab.
        
         | hn8305823 wrote:
         | Makes sense since the entire point of school is to give you
         | enough executive function to perform well in society. Learning
         | can happen too, but school is obviously not optimized for that.
        
         | mtlmtlmtlmtl wrote:
         | It's my feeling that stimulant use in healthy people is rarely
         | functional at all. I've seen a fair amount of friends try this,
         | and generally very little is gained. Often they end up focused
         | on something completely different than they intended. E.g they
         | wanted to start some music before studying, then they ended up
         | spending 5 hours making The Perfect Playlist. Stimulants make
         | you very distractable that way. It can be very hard to control
         | what you end up focusing on.
         | 
         | In addition, when able to focus, the quality of work still
         | suffers from several factors such as sleep deprivation and the
         | fact that you forgot to eat or even drink for the last several
         | hours.
         | 
         | I've never seen code written in one of these stimulant fueled
         | all-nighters that didn't create more work than it took to
         | write.
         | 
         | The only exception I've found is for doing housework and other
         | mindless, repetitive tasks.
        
         | HDThoreaun wrote:
         | Right, no one calls these "smart drugs". They're called study
         | drugs, because they help you focus for long periods of time.
        
           | bigtunacan wrote:
           | That's maybe a location thing. I've never heard them referred
           | to as "study drugs", but often heard then referred to as
           | "smart drugs".
        
         | mattmaroon wrote:
         | And to stay awake longer.
        
         | Der_Einzige wrote:
         | Fun fact about the knapsack problem - it's what you're solving
         | in a lot of video games when you do inventory management.
        
         | setgree wrote:
         | You're right about the average user's mentality, but there's
         | value in publishing this kind of research for anyone who didn't
         | get the memo, e.g. Caroline Ellison, who once wrote: "Nothing
         | like regular amphetamine use to make you appreciate how dumb a
         | lot of normal, non-medicated human experience is" [0]. The
         | implicit contrast to 'dumb' here is smart.
         | 
         | [0]
         | https://twitter.com/carolinecapital/status/13790363463003054...
        
           | thruway516 wrote:
           | Someone should also do a study to see if using 'smart' drugs
           | over time lowers the criminal inhibitions of chronic abusers.
           | SBF, Caroline Ellison and that whole gang, that Razzlekhan
           | lady. It's funny how they all seemed smart but were
           | ultimately just building a house of cards. I wonder if that
           | is also an effect of long-term use.
        
         | oooyay wrote:
         | > It's not to make you smarter or more able to solve complex
         | problems, it's to let you focus and cram on large workloads for
         | far longer than you otherwise would be able to. Basically,
         | quantity over quality.
         | 
         | imo, that's kind of a dangerous assertion. I'm an adult in his
         | thirties. I take Adderall because I have a genuine loss in
         | executive function at times. A small dose of Adderall (read:
         | less than 2mg) puts me back on track where I can deeply focus,
         | understand, and interpret things. There's certainly people I've
         | seen abuse the drug, but I don't think it's safe to say that
         | the results of Adderall are quantity over quality and frankly
         | the abuse of the drug often doesn't occur in a vacuum. It
         | happens in people that aren't very substance aware in the first
         | place.
        
         | thruway516 wrote:
         | They did not misinterprete anything. They said it reduced the
         | 'quality' of effort and increased the time to find a correct
         | solution. It is you who misread the title as "Ritalin does not
         | work for students".
        
       | instagraham wrote:
       | Wow. Worth noting that there doesn't seem to have been much
       | research or coverage of modafinil since the 2016 boom in "it's
       | safe and makes you smart!" media hype.
       | 
       | By far the easiest to obtain and abuse, though it's as yet
       | unclear what abusing it looks like
        
         | The_Colonel wrote:
         | Abuse typically means taking higher than prescribed doses which
         | then "unlocks" some kind of euphoria - e.g. Adderall,
         | benzodiazepines etc.
         | 
         | Modafinil can't really be abused in this way, it doesn't get
         | you high and increasing the dose is usually counter-productive.
         | 
         | Another element of abuse is addiction and Modafinil has no
         | physical addiction and IMHO minimal to non-existent
         | psychological addiction.
        
         | Inviz wrote:
         | Would you mind sharing where's your antagonism towards
         | modafinil coming from? Is it your personal experience or is it
         | everybody's enthusiasm rubs you the wrong way?
        
       | gtroja wrote:
       | I take adhd drugs to resist the urge to do something else that
       | the voices of my head tell me to. Maybe I think less, but I think
       | enough to get the task done
        
       | TrackerFF wrote:
       | I have ADHD (inattentive), and wasn't diagnosed until I was in my
       | mid 20s - I somehow managed to graduate from university. I
       | attribute the countless all-nighters for that. I never tried ADHD
       | meds before I was officially diagnosed, but I good chunk of my
       | classmates would regularly use meds in the days / weeks leading
       | to exams, so that they could cram for 12 hours.
       | 
       | From experience, the different drugs available can feel wildly
       | different on me - so I'm going to assume that would also be valid
       | for the non-ADHD users?
       | 
       | But, anyway, looking back - the playing field def seemed uneven.
       | How on earth are unmedicated neurodivergent going to compete
       | against "enhanced" healthy people - it's like playing football
       | with crutches, while your opponent is not only healthy, but also
       | using steroids.
       | 
       | EDIT: And, yes, I'm sure some % of the students that perform
       | better when using meds may have some underlying/undiagnosed
       | condition.
        
         | culi wrote:
         | I think you have a very simplified view of how ADHD and
         | stimulants work. There's no actual research to back up the oft-
         | repeated claim that stimulants affect people with an ADHD
         | diagnosis differently from those without one. Actually the one
         | bit of research I found suggests the exact opposite--that
         | stimulants negatively impact the productivity and concentration
         | of people without ADHD
         | 
         | https://www.healthline.com/health-news/if-you-dont-have-adhd...
        
           | TrackerFF wrote:
           | So the implication is that there must be millions of students
           | out there that are experiencing placebo effects from taking
           | stimulants? Because there is practically an endless supply of
           | feedback out there, from "normal" students, that report their
           | ability to study/focus/cram going up, when using ADHD meds.
        
           | anonymoushn wrote:
           | If they negatively impact productivity and concentration for
           | people without ADHD, and they affect people with and without
           | ADHD diagnoses the same way, do they negatively impact
           | productivity and concentration for people with ADHD?
        
           | culi wrote:
           | People seem to be focused on the study I cited rather than
           | what my comment was saying overall. It's just one study with
           | a sample size of 40.
           | 
           | My point in including it was to show how variable (and
           | generally lacking) research results are about the effects
           | people feel from these substances.
        
       | jugg1es wrote:
       | I'd like to see if they still get these results if they use
       | people who are acclimated to these drugs before-hand. The first
       | time taking any drug always hits the hardest and it's possible
       | these people were just too high.
        
       | photochemsyn wrote:
       | They missed an opportunity to compare microdosing psychedelics
       | like LSD with the amphetamine class stimulants. Many users report
       | that psychedelics do have interesting cognitive effects related
       | to enhanced creativity and making long-range connections between
       | disparate subjects, though I'm not sure it would help with
       | knapsack optimization.
       | 
       | As others note, the ADHD-type drugs just let you work longer
       | without needing sleep, although the bill must eventually be paid
       | with interest, which is why people who take a lot of stimulants
       | tend to go through boom-bust cycles over time. Such drugs also
       | have a kind of jangly nervous side effect which inhibits the
       | creation of complex mental architectures of the kind that
       | mathematicians rely on, so I'm not surprised by the study's
       | results. They're more suited to rote learning (unfortunately
       | common in today's academia) and repetitive tasks (factory work
       | etc.).
        
         | cmcaleer wrote:
         | > why people who take a lot of stimulants tend to go through
         | boom-bust cycles over time
         | 
         | SBF (and all those in Alameda+FTX who got scripts from their
         | in-house psych) in particular having the biggest boom-bust
         | cycle in stimulant history. Though that doesn't count world
         | leaders alleged to have stimulant use history.
        
       | mtizim wrote:
       | > single dose trial
       | 
       | Humans make better decisions when in a state they've been pretty
       | much their entire lives than in an altered one, more news at 11.
       | 
       | The study seems useless - it's like giving the participants their
       | own, long used car, asking them to set a time, and then comparing
       | that to the time they would set in the same car, but with a
       | slightly different clutch. I'd very gladly read a similar
       | comparison for long term regular users.
        
       | jfrbfbreudh wrote:
       | I take ADHD meds and find that it definitely dulls my thinking
       | and creative problem solving, but it at least gives me the
       | motivation to actually write code vs. do nothing.
       | 
       | Ideally, I'd have unmedicated days where I just sit and think
       | through problems, and then medicated days where I'd work on the
       | actual implementation. Unfortunately, I just spend all of my time
       | on HN and youtube on my unmedicated days.
        
         | r3d0c wrote:
         | the opposite for me, makes it easier for me to solve problem
         | because i can cohesively hold multiple thoughts in my head for
         | long enough for me to see the patterns to be able to understand
         | them, along with the emotional regulation an increase in
         | executive functioning ability that meds help with (which is
         | what adhd really is, not just problems with motivation or bad
         | at concentrating)
         | 
         | but i also work out 5-6 days a week and that + meds have been a
         | huge boon than just meds because it keeps the depression down
         | too, which is what you might be afflicted with because on my
         | rare off days i still can do some work & be motivated
        
         | unshavedyak wrote:
         | > Unfortunately, I just spend all of my time on HN and youtube
         | on my unmedicated days.
         | 
         | I often wonder about this with me. I've got various hallmarks
         | of ADHD (especially after my SO was diagnosed), but generally
         | i'm productive.
         | 
         | In this specific case, i can't figure out if it's something
         | like ADHD that drives this behavior _or_ just normal human
         | avoidance of work i dislike.
         | 
         | Ie i of course don't have this problem when it's an interesting
         | problem. I also tend not to have this problem after i get
         | started, since most larger domains have interesting subdomains.
         | Difficulty (read: vagueness, scope issues, etc) definitely lead
         | to more of this for me though.
         | 
         | Human brains are weird.
        
           | ActorNightly wrote:
           | ADHD isn't so much as you are all over the place, its more
           | along the lines of erradic attention. Hyperfocusing on a
           | problem (especially one that is interesting) and being super
           | productive is a common symptom.
           | 
           | Stimulants basically help regulate the dopamine levels so you
           | can context switch easier and spread your attention to more
           | things.
        
             | JohnBooty wrote:
             | Yeah. I describe it like this:
             | 
             | Imagine a top of the line TV. Fantastic image quality. The
             | only catch is... you can't choose what content it's
             | playing.
             | 
             | That's ADHD. At least for some people. Like me.
        
         | ActorNightly wrote:
         | Im the same way. Days are not enough. You basically need to
         | have like an umedicated week to gain your creativity back. I
         | also (2xmicro)dose shrooms (i.e enough where I feel a very very
         | slight trip but can still function).
        
         | raducu wrote:
         | > I just spend all of my time on HN and youtube on my
         | unmedicated days.
         | 
         | The first times I tried stimulants, after 2-3 hours of euphoric
         | productivity, the effects would wear off but the residual
         | stimulation would be enough to make me continue working and I
         | would always think "hey, I can do this no problem without the
         | stimulants, I just need to push over the hump", but never
         | seemed to work.
         | 
         | A few years in, and yes, I can do without stimulants on easy
         | tasks, but not really on complex stuff.
         | 
         | I also can drive wile not on stimulants and not be a complete
         | nervous mess afterwards, which is a big permanent gain for me.
         | 
         | Also the "OMG, OMG, I'm so screwed by this messup at work,
         | they're going to find me, things are going to crash because of
         | it" changed to "it's going to be ok, things always work out in
         | the end"
        
       | willtemperley wrote:
       | It's not unusual for students to crush and snort ritalin before
       | exams in the UK.
       | 
       | We have an interesting system - final year exams are essentially
       | a one-shot thing in the UK. If you are lucky enough to able to
       | retake a final exam, your mark is capped at 40% - a third class
       | mark. An upper second class degree is required for PhD entry.
       | 
       | Little wonder people will do _anything_ to pass those exams.
        
         | anonymouskimmer wrote:
         | What's the justification for capping scores on retakes? I can't
         | believe that any empirical data supports it.
        
           | TrackerFF wrote:
           | My guess would be that it gives students the unfair advantage
           | of more study time?
           | 
           | Where I studied (Norway), university students would regularly
           | fail on purpose on the first exam, so that they could get
           | two-ish months more time to read on the subject, as the re-
           | take/postponed exam would be around August/September, or
           | January/February - depending on semester.
           | 
           | It was/is called "strategic re-take", and unsurprisingly,
           | you'd always see a bunch or A grades on the re-take.
           | 
           | Same thing happens in the high-school level. People that want
           | to study wildly popular majors, like medicine, will spend
           | YEARS re-taking HS classes/exams to polish their grades.
           | Those studies are so competitive that you could get almost
           | straight A's, but still not be good enough.
        
           | willtemperley wrote:
           | Good question. I suppose it's to penalise those who can't
           | work under pressure to a very tight schedule and reward those
           | who are prepared to risk brain-damage with performance
           | enhancing drugs for the sake of recognition.
        
         | etothepii wrote:
         | This is university specific.
        
         | onemoresoop wrote:
         | IS there an advantage to snorting it? Does it not damage the
         | nasal passages?
        
       | ryukoposting wrote:
       | Shocker, your brain function is impaired while on a drug you've
       | never taken before and you weren't prescribed.
       | 
       | In my experience, it doesn't matter if you have multiple
       | psychological evaluations and 10+ years of success with a
       | consistent dosage of an ADHD medication. Most doctors just won't
       | write the prescription because of this sort of bunk.
        
         | anonymouskimmer wrote:
         | I think this research is pointing out that using ADHD-like
         | medication as "smart drugs" for school work in people without
         | ADD/ADHD is problematic. I don't know exactly how they are used
         | by those without a medical need, but I thought it was as
         | temporary fixes, not taken habitually.
         | 
         | The article specifically says:
         | 
         | > More work will be needed to establish exactly why these drugs
         | have these effects in those _without a medical need for them_ ,
         | as well as to explore the potential impacts of other so-called
         | smart drugs.
        
           | jonahrd wrote:
           | That is the point of the study, but in my non-scientific
           | opinion it seems like a very poorly crafted study.
           | 
           | Nobody is going to have issues with attention/motivation
           | during the one, short task they were assigned at some study.
           | It's a very novel, motivating environment.
           | 
           | And then of course if you're feeling the effects of a new
           | drug, you'll be "off" a bit.
           | 
           | This doesn't really prove anything about kids who take it for
           | a few nights during exam week to study.
        
           | ryukoposting wrote:
           | > I think this research is pointing out that using ADHD-like
           | medication as "smart drugs" for school work in people without
           | ADD/ADHD is problematic.
           | 
           | Yes, but the conclusions drawn by this study and others are
           | frequently wielded against people who _do_ have ADHD. The
           | very term  "smart drugs" comes from this mindset - the belief
           | that these drugs don't paper over an ailment, rather they
           | make the user "smarter."
        
       | Hnrobert42 wrote:
       | This study makes me think my dose may be too high. When my
       | Adderall hits in the morning, EVERYTHING seems like a good idea.
       | Then, I end up spending two hours writing the perfect email.
        
         | mp05 wrote:
         | This is me to a tee when I was frankly abusing Adderall as a
         | young adult. My judgment of how best to use my time goes
         | straight down the toilet when I'm jacked on amphetamines. The
         | physical side effects are not very desirable either.
        
         | cvdub wrote:
         | Adderall reduces your task activation threshold, the amount of
         | effort required to start something.
         | 
         | It's definitely possible to reduce this threshold too far! If
         | you do you'll end up jumping into the first project you come
         | across and tackling it with gusto, whether or not it's high
         | value. Having too much caffeine with Adderall makes this effect
         | much worse for me.
         | 
         | A little bit of laziness is good! You need to be able to power
         | through the tedious stuff you have to do in life, but you never
         | want to stop thinking, "this is tedious and boring, do I really
         | have to do this? Is there a better way?"
         | 
         | It's easy to lose the forest for the trees.
        
       | tomohawk wrote:
       | I decided long ago to not take substances such as these, or even
       | caffeine. I also abstain from tobacco, alcohol, and the like.
       | 
       | This forced me to develop skills and discipline over the years to
       | achieve self control, and this has more than paid off. I find I
       | can work a 12 hour day, and then go in the next day and do the
       | same. It doesn't seem like a huge deal to me - especially when I
       | consider family members who are/were farmers where this is quite
       | a normal work day and used to be quite normal for everyone until
       | about WWII.
       | 
       | Am I an outlier? I don't know, but I know others who have taken
       | the same path with similar results.
       | 
       | I've worked with many people who cannot function without
       | caffeine, let alone other substances. They will often claim how
       | it enhances their abilities, but it doesn't come across that way
       | in my observations. They seem to be dependent on a substance for
       | normal, or even sub-normal performance.
        
         | dboreham wrote:
         | 12 hours farming is not really the same as 12 hours figuring
         | out k8s.
        
         | tanjtanjtanj wrote:
         | The average farmer works less hours than the average office
         | worker. This isn't even due to modern automation, it seems they
         | have generally always worked <40 hours even during harvests.
         | People began to work longer hours during industrialization and
         | even then I can't find any time when working 12 hours a day was
         | the norm.
        
       | matznerd wrote:
       | This study is about the amphetamine stimulants methylphenidate,
       | dextroamphetamine, and the eugeroic (wakefulness agent)
       | modafinil, and not about nootropics. Though the term smart drug
       | can be inclusive of all of them...
       | 
       | Real smart drugs = nootropics = piracetam and piracetam-like
       | molecules. Stimulants generally decrease performance, increase
       | false positives, and lead to worse performance as this study
       | showed (especially in a first time user).
       | 
       | Most nootropics take about 14 days to hit their stride and the
       | effect isn't discernible immediately (though can be detected in
       | an EEG)...
       | 
       | See study: "Increase in the power of human memory in normal man
       | through the use of drugs"
       | 
       | "Nootropyl (Piracetam) a drug reported to facilitate learning in
       | animals was tested for its effect on man by administering it to
       | normal volunteers. The subjects were given 3x4 capsules at 400 mg
       | per day, in a double blind study. Each subject learned series of
       | words presented as stimuli upon a memory drum. No effects were
       | observed after 7 days but after 14 days verbal learning had
       | significantly increased."
       | 
       | https://pubmed.ncbi.nlm.nih.gov/826948/
       | 
       | Study: "Single-dose piracetam effects on global complexity
       | measures of human spontaneous multichannel EEG"
       | 
       | "The results indicate that a single dose of piracetam dose-
       | dependently affects the spontaneous EEG in normal volunteers,
       | showing effects at the lowest treatment level. The decreased EEG
       | complexity is interpreted as increased cooperativity of brain
       | functional processes."
       | 
       | https://pubmed.ncbi.nlm.nih.gov/10555876/
       | 
       | Study: "Single doses of piracetam affect 42-channel event-related
       | potential microstate maps in a cognitive paradigm"
       | 
       | "U-shaped dose-dependent effects were found; they were strongest
       | after 4.8 g piracetam. Since these particular ERP segments are
       | recognized to be strongly correlated to cognitive functions, the
       | present findings suggest that single medium doses of piracetam
       | selectively activate differently located or oriented neurons
       | during cognitive steps of information processing."
       | 
       | https://pubmed.ncbi.nlm.nih.gov/8272204/
        
         | scythe wrote:
         | The authors are rather unfair to modafinil, also, lumping it in
         | with the other two even though the negative "effects" of
         | modafinil were not statistically significant (except in the
         | rather dubious case of the rank testing of "productivity
         | deviations") and the mean deviation was very small. Also, the
         | "value attained" is not available for modafinil specifically;
         | for this criterion -- which is the most believable, as it
         | measures what participants _actually tried to achieve_ -- the
         | drugs are all counted together, while on other measures they
         | are listed separately. This is particularly disconcerting since
         | the total value attained makes its way into the abstract and
         | the press release yet gets shorted on the analysis.
        
         | cvdub wrote:
         | Is piracetam still the goto for the nootropics community? I
         | thought people were moving away from that for some reason, but
         | I can't remember why or where I heard that.
        
         | Solortho wrote:
         | About nootropics, I really enjoy noopept, it allows me to
         | perform long and focused session of work without any side
         | effect.
        
       | narrator wrote:
       | Meanwhile, in Russia they're making all kinds of smart drugs that
       | work way better than the ones in the study:
       | https://slatestarcodex.com/2014/08/16/an-iron-curtain-has-de...
       | 
       | Piracetam was also developed in Romania in the 60s. I don't like
       | communism or anything, but the complete ignorance of the U.S
       | medical system about drugs developed outside the United States
       | that are now out of patent is just a tragedy. Luckily, in the 80s
       | and 90s AIDS patients lobbied to let foreign drugs be imported
       | because many of them worked better than the domestically
       | developed AIDS drugs.
       | 
       | What's weird is illegal drugs are vastly more popular and studied
       | in the U.S, with the recent hallucinogen microdosing trend, than
       | drugs that have been used safely for decades overseas.
        
       | Eumenes wrote:
       | Kinda strange how they forgot to include the big stimulants, like
       | Adderall and Vyvanse, in the study. My guess its impossible to
       | incorporate a placebo with amphetamines. College kids are taking
       | those, not Ritalin or Concerta, lol.
        
         | averageRoyalty wrote:
         | This is an Australian study, so they used Australian brands. We
         | don't have those.
         | 
         | Two of the three tested drugs were amphetamines though, very
         | similar to those you listed[0].
         | 
         | 0. https://bocarecoverycenter.com/treatment/understanding-
         | add-a...
        
       | FFP999 wrote:
       | I spent a good deal of my 20s in an informal study on the
       | cognitive effects of long-term self-prescribed amphetamine use.
       | (Translation: I used to hang out with a whole lot of tweakers.)
       | This article squares with my experience: amphetamines make your
       | brain faster, not better.
        
       | karmakaze wrote:
       | > All of the drugs also increased the number of times the
       | participants moved items in and out of the knapsack. "Thus, if
       | one measures motivation in terms of time spent or number of items
       | moved, drugs clearly enhanced motivation," the team writes.
       | However, on average, the drugs did not increase 'effort quality'
       | or productivity, measured as the average gain in knapsack value
       | per move. Productivity was lower in all three drug conditions,
       | compared with placebo.
       | 
       | This "measured as the average gain in knapsack value per move" is
       | an unusually chosen metric. Why would it not simply be the
       | best/total score in the allotted time. This preemptively punishes
       | sustained effort which is one of the increased behaviors. I'd
       | like to see this done again with a different problem, a different
       | metric, or simply their raw data.
       | 
       | Now that I think about it, all of these types of reports should
       | include the raw data or GTFO. This one seems to provide some on
       | the referenced https://www.science.org/doi/10.1126/sciadv.add4165
       | 
       | > MATLAB code that generates the statistics and figures, along
       | with underlying data, can be found in the notebook "figures.mlx"
       | and "SOM.mlx" of the GitHub repository bmmlab/PECO
       | (https://zenodo.org/badge/latestdoi/592775835).
        
         | anonymouskimmer wrote:
         | Why are you leaving out the rest of the performance criteria
         | that the article mentions are done more poorly while on any of
         | the drugs?
        
       | Jeff_Brown wrote:
       | Two observations:
       | 
       | (1) When studying, the extra time spent could outweigh the
       | reduced quality of thought.
       | 
       | (2) Not a new point but it's strange how you can take a drug and
       | think it has one effect when it has another.
        
       | michael1999 wrote:
       | How does a placebo for amphetamines work? I'd know the difference
       | in 30 minutes.
        
         | insanitybit wrote:
         | Good question. Adding a third control group that took caffeine
         | would have been interesting, since it's so well studied and
         | mimics some of the side effects of amphetamines.
        
         | GuB-42 wrote:
         | You can definitely get high with a placebo. I have seen people
         | in festivals getting high just by touching people, the
         | "explanation" being that the people were sweating the drugs and
         | by touching enough of them, you get enough for yourself to get
         | high. This is as convincing to me as homeopathy, so definitely
         | placebo, and it happened to people who took these drugs before
         | and are familiar with their effects.
         | 
         | And here, they are not giving you a big dose of MDMA so you can
         | dance until sunrise, they are giving you a moderate dose of
         | amphetamines to (tentatively) boost your ability to solve a
         | maths problem.
         | 
         | Unless you have already trained yourself, don't overestimate
         | your ability to discriminate, the placebo effect is really
         | strong here.
        
       | insanitybit wrote:
       | > The results showed that on average, the drugs didn't affect the
       | chance of a participant finding the solution to a knapsack
       | problem. Contrary to perhaps many students' expectations,
       | however, participants tended to perform worse after taking one of
       | the drugs, packing a lower total value of items.
       | 
       | I have to assume that everyone who has taken these drugs could
       | have predicted this, yeah? No one gets this drug and thinks "I
       | will literally be more intelligent", they get them so that they
       | can grind out 12 hours of work without being distracted by
       | anything. 12 hours of work at 90% efficiency is way better than
       | ~2 hours of work at 100% efficiency.
       | 
       | > Not only that, but they spent substantially more time working
       | on their solution while on the smart drugs than they did after
       | taking the placebo. In fact, participants spent almost as much
       | time on the easiest presentations of the knapsack task while on
       | methylphenidate (Ritalin) as they did on the hardest instances of
       | the task after taking the placebo, without any corresponding
       | improvement in performance.
       | 
       | As expected! One of the "traps" you have to be aware of when
       | taking these medications is to be sure to not overfocus on things
       | that don't matter.
       | 
       | > The results have clear implications: healthy people who take
       | these drugs hoping for cognitive gains may work harder and longer
       | at a problem, but without any benefit.
       | 
       | No way lol that is a ridiculous conclusion to draw. Without any
       | benefit? Seriously? The benefits are _massive_.
        
       | Clubber wrote:
       | This phenomenon reminds me of athletes taking steroids to improve
       | their performance, or slave dock workers being given cocaine to
       | improve their output. The problem with both is it requires other
       | people to also take those drugs to be competitive.
        
         | dragonwriter wrote:
         | I'm going to disagree with you that _the_ problem, or even the
         | main problem among a wide array of problems, with _slave dock
         | workers_ being given cocaine to improve output is "it requires
         | other people to also take those drugs to be competitive".
        
           | Clubber wrote:
           | If you read my comment with a little more discern rather than
           | jumping to virtue signal, you'll see "the problem," I was
           | referring to is taking performance enhancing drugs. There is
           | no need for you to remind everyone that slavery was bad
           | unless you just can't help yourself.
           | 
           | >The problem with both is it requires other people to also
           | take those drugs to be competitive.
        
             | dragonwriter wrote:
             | Hey, I'm not the one who chose the analogy or the "with
             | both"; if you would read what you wrote with more discern
             | _ment_ before posting it, maybe we would have avoided this
             | whole discussion.
        
               | Clubber wrote:
               | >The problem with both [examples of taking performance
               | enhancing drugs, _implied_ ] is it requires other people
               | to also take those drugs to be competitive.
               | 
               | Writers..
        
       | ulizzle wrote:
       | I don't think amphetamines do that on their own, but rather over
       | time the fatigue builds up and the drugs can't mask it anymore.
       | 
       | The issue with smart drugs is that high tolerance leads to
       | psychosis much easier than you'd think.
        
       | sarasasa28 wrote:
       | why are americans so addicted to adderall
        
         | jobs_throwaway wrote:
         | we love money, and adderall helps you focus on shit you don't
         | care about in order to make money
        
       | gehwartzen wrote:
       | Having been on Adderall I agree with most here that it increases
       | my executive function but doesn't really make me smarter.
       | 
       | I have a long history of experimenting with both legal and
       | illicit drugs and the only one I found to actually significantly
       | increase my cognitive ability to solve complex problems is low
       | dose Ketamine. Low dose lsd/shrooms as well but to a much lesser
       | degree.
        
         | Extropy_ wrote:
         | I've found that small amounts of psilocybin mushrooms appear to
         | calm me and allow me to "get in the zone" a lot better, as well
         | as radically increase my creativity. I also found that low-dose
         | MDMA, taken after eating, dramatically increased my focus and
         | productivity while somewhat dulling my creativity. I've never
         | tried LSD or Ketamine though.
        
         | ActorNightly wrote:
         | Generally, there is no drug that can make you smarter.
         | Psychedelics can help you explore different perspective, but
         | thats just being equivalent to a Monte Carlo approach to
         | problem solving.
         | 
         | That being said, if you are ADHD, stimulants can essentially
         | make you more efficient, which will make you appear smarter.
        
       | languagehacker wrote:
       | A few important things to consider:
       | 
       | Lumping all of the medications in question into a single study is
       | disingenuous, and seems biased towards concluding their
       | ineffectiveness.
       | 
       | All three of the drugs in question have different mechanisms of
       | action, which means that they will have a different effect on
       | people with different brain chemistry. My read here is that if
       | everyone takes all three and a placebo, performance may be
       | enhanced in one case, but the remaining three cases can make the
       | study come across as conclusive that on the whole, this course of
       | treatment is ineffective.
       | 
       | Not a lot of detail on the placebo and why it performs so much
       | better, but I'm curious about the "nocebo" effect and subjects'
       | prior exposure to the non-placebo dosage. In other words, is the
       | feeling of being on a new "smart" drug too distracting to
       | successfully take the test in question for the first time?
       | 
       | The sample size is incredibly small at only 40 people, and skewed
       | in terms of population. These were self-selecting individuals who
       | responded to campus advertisements. This has been the modern
       | critique of psychological experimentation in academia for
       | decades, and I find it a little disparaging that we still have to
       | suffer through it. I wish the HRB would ban things like campus
       | advertisements as a means of recruiting test subjects -- we all
       | really ought to know better by now.
       | 
       | While the sequencing of studies on each individual helps to avoid
       | some amount of sequence-based confounding variables, and the
       | spacing of seven days between studies allows for a pretty decent
       | return to homeostasis, the number of study participants is still
       | too low to be conclusive. I'd need to see this study get repeated
       | numerous times, at a larger scale, over individuals with a more
       | consistent neurological history to be considered conclusive.
       | 
       | I don't entirely buy the efficacy of working on individuals
       | without any history of psychotropic medication or illicit drug
       | use -- remember that this will rule out participants who have
       | taken things like fluoxetine -- ruling out nearly 20% of adults
       | in many countries -- or slightly skirted Australia's drug laws.
       | These are people answering an ad on a college campus, likely for
       | compensation. I don't think it's likely that all the subjects
       | truthfully self-reported.
       | 
       | If anything I'd expect the neurological variability of a fully
       | unscreened or undiagnosed population to make it really truly hard
       | to measure these drugs effectiveness. Given the mechanisms of
       | action, I'd expect that the likely 20% of subjects with
       | undiagnosed depression and additional likely 5% of individuals
       | with undiagnosed ADHD would really throw a wrench in any
       | conclusive numbers.
       | 
       | I'm not trying to say that smart drugs are the answer to
       | performing better at work. In fact, I'd expect a good night of
       | sleep to make a bigger bump in these kinds of test scores. But I
       | found the BPS is really jumping to conclusions based on what
       | looks to me like very flimsy evidence.
       | 
       | Testing on people is hard, but publishing summaries of articles
       | that don't entirely stand on their own and drawing authoritative
       | conclusions is incredibly easy.
        
       | Inviz wrote:
       | Modafinil is a great tool to have in one's toolbelt.
       | 
       | There're days and situations when having uninterrupted focus for
       | 10-14 hours does make a big impact. Condensing certain workloads
       | into one day can save a lot of time in a longer run. For example
       | going through huge refactoring with a lot of moving parts can be
       | very draining to work through if you need to load in the context
       | every day. Striking the iron while it's hot can help a great
       | deal.
        
         | Volrath89 wrote:
         | True. I remember I used this back in the day when I was a pro
         | online poker player. I would like to try again in Software,
         | maybe to kickstart an indie project ... food for thought.
         | 
         | How often do you use it and have you found any side effects?
         | (or long term effects for that matter)
        
           | Inviz wrote:
           | I use about 100mg (average amount) 2-4 days a week for the
           | last 1.5 years, going through a very challenging project. I
           | had a small stretch of time when my skin started drying up on
           | the forehead and was peeling off in minor quantities, so i
           | took a break for a month and it fixed it.
           | 
           | Some of the days I may not take it and not notice it, there's
           | definitely no cravings. But during a break I felt slightly
           | hazy when getting off it. I do notice an increase in typical
           | stimulator tell-tale symptoms (like some jaw clenching), but
           | i do have that from coffee as well (which i drink too). There
           | can be days when i'm too wired up to fall asleep fast, so i
           | may drop a 5-htp pill.
           | 
           | The upside is that there's a lot of times when I manage to
           | really concentrate on some activities. Doing 8 hours shifts
           | is trivial. People note that I am pretty responsive at the
           | end of the working days. Quite often I manage to do some
           | personal hobby work after a full working day too.
           | 
           | Modafinil doesn't have the ecstatic effects of Adderall and
           | its friends, so working a lot can make me feel overly
           | emotionally invested into some things that are not important
           | in a grand picture. The stress can add up if not managed
           | well. So I do not recommend working a lot for working's sake,
           | there has to be a cause to pull heroic stunts like this. My
           | excuse is to save up the money to enable myself to do other
           | activites not related to programming later.
        
             | bartwr wrote:
             | How's your sleep and emotional state when using it like
             | this? With an elimination half-life of 15h, 2-4 days a week
             | it won't leave your body. I personally hated it for this
             | reason - poor sleep, tossing and turning even with a sleep
             | aid -> feeling emotionally unstable and even less
             | productive the following day. Plus unable to recover from
             | any moderate sports activity.
        
       | cosmojg wrote:
       | Everything's a trade-off. Most people who take stimulants
       | regularly would be far less likely to even make an effort or make
       | a decision without them. It seems obvious that the quality of an
       | effort or decision will decrease in proportion when you take away
       | all of the additional indecisive overthinking an individual would
       | normally be doing instead of, y'know, actually doing the thing.
       | Again, that's the trade-off, and I think most people are behaving
       | rationally when they accept that deal. Until clinical psychology
       | cracks how to simply teach the skills of "not overthinking,"
       | "staying singularly focused," and "maintaining a bias towards
       | action," it would seem that we're stuck with stimulants for the
       | foreseeable future.
        
       | ActorNightly wrote:
       | Mandatory reading about Adderall
       | 
       | https://slatestarcodex.com/2017/12/28/adderall-risks-much-mo...
        
       | epgui wrote:
       | All other things being equal, I think slower thinking or
       | decision-making is probably a very good thing.
       | 
       | I mean it depends on what the goal and situation is, but I
       | strongly believe that _in general_ , fast thinking prioritizes
       | heuristics over analysis and comes at an enormous (often
       | unrecognized) cost.
        
       | nurettin wrote:
       | So if you suspect that you took a "smart drug" and it is a
       | placebo, you get smarter. Got it.
        
       | beefman wrote:
       | I've long wished for more studies like this. So it's good to see.
       | 
       | This one does miss some important variables:
       | 
       | 1. Dose-dependent effects
       | 
       | 2. Naive vs experienced users of a drug
       | 
       | 3. Novel vs familiar task
       | 
       | Though the authors spend a lot of time showing these stimulants
       | reduce work efficiency, their central finding seems to be: "There
       | was no significant effect of drug on performance"
       | 
       | https://www.science.org/doi/10.1126/sciadv.add4165
        
       | zeroCalories wrote:
       | My personal experience as someone diagnosed with ADHD is that
       | they definitely make me more effective. My attention gets grabbed
       | and redirected in inefficient ways, and being on the meds allows
       | me to keep my focus fully on a task. But when I'm working on
       | something I find exciting or fun, like a production failure, or a
       | video game, I don't think my meds help me. Sometimes I wonder if
       | my ADHD is even real.
        
       | fredgrott wrote:
       | Seems suspicious as these are narco class drugs and the study
       | gave them to those who did not have the condition for the
       | medicine. Did they give the study participants ample warning that
       | they could be addicted after one dose?
       | 
       | Ah ah! ADHD'ers including me have double the amount of DATs and
       | NATs you guys and gals do not! Its why I will not get addicted
       | taking Ritalin, Adderall, etc and yet you in fact will!
        
       | tflinton wrote:
       | I've been taking Adderall for a very long time. Prior to it I had
       | a very difficult time motivating myself and simply being able to
       | block out a thousand other thoughts and stimulus. I developed
       | techniques to cope prior to taking it but once I started it was
       | like night and day. It doesn't at all make me smarter but allows
       | me to decide what I want to do rather than some sub-cognitive
       | part of me. Should people take it to make them smarter? In my
       | experience it helps focus, not intelligence.
        
       | sneak wrote:
       | When I hear "smart drugs" in a headline, I don't think of
       | amphetamines.
        
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