But a lot of psychatric treatments are just that. Treatment for ADHD for example is giving ampethamines (which btw are chemically no different than a low dose of meth), which have a duration of 3-6 hours and its back to worse than baseline after the effect has worn off.

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Aurornis 2 days ago | parent | next [-]

There are multiple treatments for ADHD, including alpha-2 receptor agonists and norepinephrine reuptake inhibitors. Some of them show patterns of increasing efficacy out to a year (the length of the study).

The reason amphetamines are used for ADHD but not depression is that they've been studied to show that the ADHD improving effect can remain for many months, while the mood-improving effect will taper off quickly if you take them every day. Almost everyone who takes ADHD stimulant, feels a mood and motivation boost ("so happy I could cry" is the common phrase) and then is disappointed when that mood boost stops happening after a few weeks or months will learn this. Attention enhancement is less prone to tolerance, though it still accumulates tolerance too. There are some studies showing that the effects of stimulants in ADHD diminish substantially on a multi-year time frame, and it's probably not a coincidence that many people (though not all) who take stimulants discontinue after several years.

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sillywabbit 2 days ago | parent | prev | next [-]

Meth causes brain damage. Dex doesn't.

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landl0rd a day ago | parent | next [-]

Well, it's not that simple. It's reasonable to expect that you could see some increased level of oxidative and excitotoxicity. It's harder to draw a bright line around the dopaminergic system specifically because some level of neuronal death is expected over the course of a lifetime. We lose 5-10% starting with middle age yet don't tend to show parkinsonian symptoms until 60-80% are gone.

It's pretty reasonable to expect reversing DAT and inhibiting VMAT2 increases oxidative flux, the question is really how much not if. Methheads certainly get "brain damage", but is nudging the average loss from 5-10% to 7-12% "damage"? Is it meaningful? Over 30, 40 years that could very well add up.

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sillywabbit a day ago | parent [-]

Could you point me to your research?

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estimator7292 a day ago | parent [-]

You made the first unsubstantiated claim

	▲	a day ago \| parent [-]
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cyberax a day ago | parent | prev [-]

Meth is also used as an ADHD treatment. I think the reason is just the dosages that are used by addicts compared to people who just need the ADHD treatment.

A typical legitimate therapeutic methamphetamine dose is around ~20mg (up to maybe 60mg a day). A typical dose used by addicts is around 1 gram. And it's usually smoked, resulting in immediate bioavailability.

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andoando a day ago | parent [-]

Pretty sure a gram of pure meth or even adderall would kill you

	▲	cyberax a day ago \| parent [-]
		I should have clarified that it's a daily dose: https://www.medrxiv.org/content/10.1101/2025.05.09.25327334v... Not that it matters that much. It's no wonder that it fries your brain when you're using 25 _times_ the normal therapeutic dose.

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thesmtsolver2 a day ago | parent | prev | next [-]

Just like how Hydrogen peroxide is chemically no different than a low dose of dihydrogen monoxide?

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andoando a day ago | parent [-]

No not just like it, because the only difference with methampathemines is that the added meth group makes it able to cross the blood barrier much quicker, hence why I said its equivalent to a lose dose of meth. The chemical/biological response on the body and brain are very similar, the difference is in potency

	▲	briHass a day ago \| parent [-]
		But onset of action is a very important distinction in medicine/pharmacology, as is dose. Most abusers of methamphetamine are not taking it orally (slow route of administration) and are generally using much higher relative dosing than ADHD patients are using amphetamines. Potential for addiction and other physical harms are greatly affected by both of those things, so the comparison has some truth, but is obviously sensationalized.

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dns_snek a day ago | parent | prev [-]

That's a terrible oversimplification. Stimulant treatments for ADHD are not supposed to produce pronounced mood-enhancing effects. Stimulant treatment has been shown to be effective indefinitely in majority of people without increasing the dosage over time.

These days formulations like lisdexamfetamine and extended release methylphenidate are preferred because they have all-day efficacy with typical duration of action of around 8-12h which carries lower abuse potential.

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andoando a day ago | parent [-]

extended release are just two doses of the drug where half the beads are delayed by ~4 hours. How is that different from taking two edibles a day and claiming full day efficacy?

	▲	dns_snek a day ago \| parent \| next [-]
		That's not the case for lisdex nor Concerta methylphenidate. Some generics work that way and they're generally regarded as being worse than Concerta. The benefit is that the medication automatically produces a smooth effects profile allowing you to live your life without timing medication to perfection. A pronounced come-up and crash is a risk factor for abuse and addiction, so smoothing or removing the peaks and valleys is important.
	▲	yosame a day ago \| parent \| prev [-]
		I mean the difference is that you just take one in the morning? Which makes adherence easier, makes sure that the delay is constant rather than variable, and reduces abuse liability. (As an aside, there are more complex extended release mechanisms than just delayed bead release - like lisfexamfetamine is a inactive prodrug, so cleaving the lysine off the amphetamine is rate limited. This has the effect of extended the duration of effect, and reduces the potential to abuse by snorting/iv/etc).