Here’s another recent study on cognitive effects of ADHD stimulants:


Stimulant prescription-only drugs are increasingly used by employees and students as “smart drugs,” to enhance workplace or academic productivity (1–4). However, even if there is a subjective belief that these drugs are effective as cognitive enhancers in healthy individuals, evidence to support this assumption is, at best, ambiguous (5).

Using the knapsack optimization problem as a stylized representation of difficulty in tasks encountered in daily life, we discover that methylphenidate, dextroamphetamine, and modafinil cause knapsack value attained in the task to diminish significantly compared to placebo, even if the chance of finding the optimal solution (~50%) is not reduced significantly. Effort (decision time and number of steps taken to find a solution) increases significantly, but productivity (quality of effort) decreases significantly. At the same time, productivity differences across participants decrease, even reverse, to the extent that above-average performers end up below average and vice versa.

Our findings suggest that “smart drugs” increase motivation, but a reduction in quality of effort, crucial to solve complex problems, annuls this effect.

https://www.science.org/doi/10.1126/sciadv.add4165

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Count me in as another skeptical parent. What I have seen is that the stimulants work very well in the short term (so you get all these testimonies of “this changed my kid’s life” or their own life for a parent who just started on the meds themselves), but a large number of ADHD kids eventually still eventually self combust if they didn’t make structured changes to their lives and actually commit to behavior changes and stay within guardrails. This is particularly evident once the kids head off to college despite being on meds.

Did you go to medical school?

Yes, in fact I did, at one of the best in the country.

Although the neurochemical pathways of chronic stimulant use disorders are not definitively established, a few researchers have found evidence of changes in the structure and function of brain neurons after chronic stimulant use in humans. Some researchers propose that the changes may come from dopamine depletion, changes in neurotransmitter receptors or other structures, or changes in cellular components or other brain messenger pathways that could cause the changes in mood, behavior (e.g., compulsivity, decision making), and cognitive function associated with chronic stimulant misuse (Ashok et al., 2017; Jan et al., 2012). (The medical aspects of stimulant use disorders are discussed in Chapter 3.)

https://www.ncbi.nlm.nih.gov/books/NBK576548/#:~:text=Although%20the%20neurochemical%20pathways%20of,chronic%20stimulant%20use%20in%20humans.

I don’t actually believe you because I think you would have mentioned it in your post originally but let’s just say you are a doctor. Then surely you know that psychiatrists always encourage school and behavior supports and therapy in addition to medication, and that there are medical treatments beyond stimulants for ADHD that an elementary school age child can take. My own is on Qelbree.

In addition, when you wrote that you are “another skeptical parent” that was right after a (probable troll) posting that she was skeptical of the existence of ADHD as a disorder. So unless you are complete crock of a doctor, you are not “another” skeptic of the diagnosis but rather of the best avenue of treatment, and you owe it to parents to be clear about that in a thread like this. Completely irresponsible for someone with a medical degree.

I’m definitely a doctor and so is my wife. You can believe all you want. But I am not a psychiatrist, neurologist or behavior health expert, so I have no obligation to disclose my expertise here unless directly asked.

Is ADHD real for some people? Yes. Is it completely over diagnosed? Yes. Would I ever put my own fidgety, occasionally forgetful and often procrastinating kids on stimulants? Hell no.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Everyone is quick to diss the methylphenidate given out to the kids, but I was diagnosed at age 35 (I’m a woman) and taking methylphenidate was absolutely life changing for me. My anxiety disappeared, I could work harder and better than ever before, and I felt like I could finally be myself.
Why wouldn’t we want to give this to our kids if needed? My daughter takes it now and she is also very happy to have it. It’s been tested for many years and is very safe for kids.

Wait until you are on max dose due to tolerance.

But as your post illustrates very clearly, ADHD meds are clearly performance-enhancing drugs. I just find it so hypocritical that the (often progressive) parents who get really offended when Asian parents send their kids to Kumon/AoPS to get ahead and place into G&T programs, wouldn’t hesitate to doctor shop and put their tweens on meth analogues to get some academic advantage. You see it on FB groups all the time.

Sorry, but you are taking a very small problem and using that argument to imply that many parents whose children need those medications are bad actors. We and many parents like us aren't giving our kids ADHD medication so they can get an academic advantage over their peers, it's so they can simply perform basic executive functioning skills their peers have no problem doing - like being able to focus for 20 minutes so they can complete their homework or make it out the freaking door each day without having to be told 10 times how to do everything step by step. We aren't medicating our kids, which we do not take lightly and initially did not, to perform better than their peers. Acting like this is the equivalent of professional athletes doping is misguided. What's next? Given Larlo a wheelchair so they can move freely around the school like everyone else is giving Larlo a performance advantage? Don't try to characterize the vast majority of parents whose families have legitimately struggled with ADHD with the very few who abuse it.

Not a small problem. ADHD meds are so heavily prescribed (and increasingly so!) that big pharma can't make them fast enough. Our local pharmacy had wait lists of months this winter. My teen is on them even though I know it's not a real condition. The meds help by creating a socially desirable behavioral state. That is not the same as treating an actual medical condition.

So wait - you are saying that the drugs are a scam but you decided to have your daughter participate. Interesting choice.

Neurodiversity is a real thing, medically. And our society (work, school, social interactions) is arranged for neurotypical people. My kid struggles. It has hit him in school, yes but also he is getting real anxiety and is aware he can’t do what others can do easily. He’s not on meds and we are about to consider it.

As a woman with other neurodivergent conditions, I can tell you this is real and meds do work to make someone more highly functioning in our society.

I think the framing of ADHD (as a disorder) is wrong to such an extreme that it is untrue. Put another way, my daughter is not well adapted to the sit at your desk K-12-BA pipeline. In a different time and place this would not be a liability--it might even be an advantage. Therefore the idea that inattention to formulaic schoolwork or fidgetiness or preference for physical activity is a disorder is a concept I find a bit too preciously fashionable. I think there is diversity and divergence in this area that is not rightly valued or protected by society. Therefore, knowing that she will be vulnerable if she doesn't finish her education, I think it is worth it to use medication to create the necessary behavioral state to do so. The meds will help in doing this, but they are not treating an actual disorder in any true medical or clinical sense.

Also: we did therapy and coaching. It is a real condition.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Everyone is quick to diss the methylphenidate given out to the kids, but I was diagnosed at age 35 (I’m a woman) and taking methylphenidate was absolutely life changing for me. My anxiety disappeared, I could work harder and better than ever before, and I felt like I could finally be myself.
Why wouldn’t we want to give this to our kids if needed? My daughter takes it now and she is also very happy to have it. It’s been tested for many years and is very safe for kids.

Wait until you are on max dose due to tolerance.

But as your post illustrates very clearly, ADHD meds are clearly performance-enhancing drugs. I just find it so hypocritical that the (often progressive) parents who get really offended when Asian parents send their kids to Kumon/AoPS to get ahead and place into G&T programs, wouldn’t hesitate to doctor shop and put their tweens on meth analogues to get some academic advantage. You see it on FB groups all the time.

Sorry, but you are taking a very small problem and using that argument to imply that many parents whose children need those medications are bad actors. We and many parents like us aren't giving our kids ADHD medication so they can get an academic advantage over their peers, it's so they can simply perform basic executive functioning skills their peers have no problem doing - like being able to focus for 20 minutes so they can complete their homework or make it out the freaking door each day without having to be told 10 times how to do everything step by step. We aren't medicating our kids, which we do not take lightly and initially did not, to perform better than their peers. Acting like this is the equivalent of professional athletes doping is misguided. What's next? Given Larlo a wheelchair so they can move freely around the school like everyone else is giving Larlo a performance advantage? Don't try to characterize the vast majority of parents whose families have legitimately struggled with ADHD with the very few who abuse it.

Not a small problem. ADHD meds are so heavily prescribed (and increasingly so!) that big pharma can't make them fast enough. Our local pharmacy had wait lists of months this winter. My teen is on them even though I know it's not a real condition. The meds help by creating a socially desirable behavioral state. That is not the same as treating an actual medical condition.

So wait - you are saying that the drugs are a scam but you decided to have your daughter participate. Interesting choice.

Neurodiversity is a real thing, medically. And our society (work, school, social interactions) is arranged for neurotypical people. My kid struggles. It has hit him in school, yes but also he is getting real anxiety and is aware he can’t do what others can do easily. He’s not on meds and we are about to consider it.

As a woman with other neurodivergent conditions, I can tell you this is real and meds do work to make someone more highly functioning in our society.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Everyone is quick to diss the methylphenidate given out to the kids, but I was diagnosed at age 35 (I’m a woman) and taking methylphenidate was absolutely life changing for me. My anxiety disappeared, I could work harder and better than ever before, and I felt like I could finally be myself.
Why wouldn’t we want to give this to our kids if needed? My daughter takes it now and she is also very happy to have it. It’s been tested for many years and is very safe for kids.

Wait until you are on max dose due to tolerance.

But as your post illustrates very clearly, ADHD meds are clearly performance-enhancing drugs. I just find it so hypocritical that the (often progressive) parents who get really offended when Asian parents send their kids to Kumon/AoPS to get ahead and place into G&T programs, wouldn’t hesitate to doctor shop and put their tweens on meth analogues to get some academic advantage. You see it on FB groups all the time.

Sorry, but you are taking a very small problem and using that argument to imply that many parents whose children need those medications are bad actors. We and many parents like us aren't giving our kids ADHD medication so they can get an academic advantage over their peers, it's so they can simply perform basic executive functioning skills their peers have no problem doing - like being able to focus for 20 minutes so they can complete their homework or make it out the freaking door each day without having to be told 10 times how to do everything step by step. We aren't medicating our kids, which we do not take lightly and initially did not, to perform better than their peers. Acting like this is the equivalent of professional athletes doping is misguided. What's next? Given Larlo a wheelchair so they can move freely around the school like everyone else is giving Larlo a performance advantage? Don't try to characterize the vast majority of parents whose families have legitimately struggled with ADHD with the very few who abuse it.

Not a small problem. ADHD meds are so heavily prescribed (and increasingly so!) that big pharma can't make them fast enough. Our local pharmacy had wait lists of months this winter. My teen is on them even though I know it's not a real condition. The meds help by creating a socially desirable behavioral state. That is not the same as treating an actual medical condition.

You don’t believe your teen has ADHD or you erroneously don’t believe ADHD is real despite her diagnosis?!

ADHD, at least if you look at the DSM diagnostic criteria, is a set of behaviors that don't mesh well with modern society. Like most mental health diagnoses, ADHD includes subjective diagnostic criteria like whether the behaviors cause distress to self and others, does it impair me from doing things I would otherwise like to do (like focusing on boring schoolwork or office busywork).

I think the ADHD diagnosis rate is more an indictment of our society than of those who have been diagnosed with it.

I am the skeptical PP and my teenager is an active, outdoorsy, tomboyish girl by her own description. I do not think she is suffering from a mental health problem, but I think it is necessary for her to conform to mainstream society to the extent that she can complete her high school and college education. Hence the meds.

This has to be a complete troll.

Nope, master's degree in clinical mental health.

In my experience, it is the people with actual academic/professional exposure to this stuff that are the most skeptical. Like the MD poster above.

Now I’m convinced there are two trolls here. BS.

PP. My experience in grad school was that all of the professors and most of the students did not have a very good background in math or statistics. They therefore did not recognize dubious results in research literature, did not notice when meta-analyses showed variance in results far beyond the effect size of their most cherished individual studies, were blind to the fact that systematic reviews showed radically divergent outcomes and lack of replicability of supposedly important trials, ad infinitum. Let alone the now well documented blatant research fraud in this discipline over the last 20 years.

Just because you and your doc are both reading the same articles about ADHD in The Atlantic doesn't make them true.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Everyone is quick to diss the methylphenidate given out to the kids, but I was diagnosed at age 35 (I’m a woman) and taking methylphenidate was absolutely life changing for me. My anxiety disappeared, I could work harder and better than ever before, and I felt like I could finally be myself.
Why wouldn’t we want to give this to our kids if needed? My daughter takes it now and she is also very happy to have it. It’s been tested for many years and is very safe for kids.

Wait until you are on max dose due to tolerance.

But as your post illustrates very clearly, ADHD meds are clearly performance-enhancing drugs. I just find it so hypocritical that the (often progressive) parents who get really offended when Asian parents send their kids to Kumon/AoPS to get ahead and place into G&T programs, wouldn’t hesitate to doctor shop and put their tweens on meth analogues to get some academic advantage. You see it on FB groups all the time.

Sorry, but you are taking a very small problem and using that argument to imply that many parents whose children need those medications are bad actors. We and many parents like us aren't giving our kids ADHD medication so they can get an academic advantage over their peers, it's so they can simply perform basic executive functioning skills their peers have no problem doing - like being able to focus for 20 minutes so they can complete their homework or make it out the freaking door each day without having to be told 10 times how to do everything step by step. We aren't medicating our kids, which we do not take lightly and initially did not, to perform better than their peers. Acting like this is the equivalent of professional athletes doping is misguided. What's next? Given Larlo a wheelchair so they can move freely around the school like everyone else is giving Larlo a performance advantage? Don't try to characterize the vast majority of parents whose families have legitimately struggled with ADHD with the very few who abuse it.

Not a small problem. ADHD meds are so heavily prescribed (and increasingly so!) that big pharma can't make them fast enough. Our local pharmacy had wait lists of months this winter. My teen is on them even though I know it's not a real condition. The meds help by creating a socially desirable behavioral state. That is not the same as treating an actual medical condition.

You don’t believe your teen has ADHD or you erroneously don’t believe ADHD is real despite her diagnosis?!

ADHD, at least if you look at the DSM diagnostic criteria, is a set of behaviors that don't mesh well with modern society. Like most mental health diagnoses, ADHD includes subjective diagnostic criteria like whether the behaviors cause distress to self and others, does it impair me from doing things I would otherwise like to do (like focusing on boring schoolwork or office busywork).

I think the ADHD diagnosis rate is more an indictment of our society than of those who have been diagnosed with it.

I am the skeptical PP and my teenager is an active, outdoorsy, tomboyish girl by her own description. I do not think she is suffering from a mental health problem, but I think it is necessary for her to conform to mainstream society to the extent that she can complete her high school and college education. Hence the meds.

This has to be a complete troll.

Nope, master's degree in clinical mental health.

In my experience, it is the people with actual academic/professional exposure to this stuff that are the most skeptical. Like the MD poster above.

Now I’m convinced there are two trolls here. BS.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Count me in as another skeptical parent. What I have seen is that the stimulants work very well in the short term (so you get all these testimonies of “this changed my kid’s life” or their own life for a parent who just started on the meds themselves), but a large number of ADHD kids eventually still eventually self combust if they didn’t make structured changes to their lives and actually commit to behavior changes and stay within guardrails. This is particularly evident once the kids head off to college despite being on meds.

Did you go to medical school?

Yes, in fact I did, at one of the best in the country.

Although the neurochemical pathways of chronic stimulant use disorders are not definitively established, a few researchers have found evidence of changes in the structure and function of brain neurons after chronic stimulant use in humans. Some researchers propose that the changes may come from dopamine depletion, changes in neurotransmitter receptors or other structures, or changes in cellular components or other brain messenger pathways that could cause the changes in mood, behavior (e.g., compulsivity, decision making), and cognitive function associated with chronic stimulant misuse (Ashok et al., 2017; Jan et al., 2012). (The medical aspects of stimulant use disorders are discussed in Chapter 3.)

https://www.ncbi.nlm.nih.gov/books/NBK576548/#:~:text=Although%20the%20neurochemical%20pathways%20of,chronic%20stimulant%20use%20in%20humans.

I don’t actually believe you because I think you would have mentioned it in your post originally but let’s just say you are a doctor. Then surely you know that psychiatrists always encourage school and behavior supports and therapy in addition to medication, and that there are medical treatments beyond stimulants for ADHD that an elementary school age child can take. My own is on Qelbree.

In addition, when you wrote that you are “another skeptical parent” that was right after a (probable troll) posting that she was skeptical of the existence of ADHD as a disorder. So unless you are complete crock of a doctor, you are not “another” skeptic of the diagnosis but rather of the best avenue of treatment, and you owe it to parents to be clear about that in a thread like this. Completely irresponsible for someone with a medical degree.

There are also non stimulant ADHD medications.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Everyone is quick to diss the methylphenidate given out to the kids, but I was diagnosed at age 35 (I’m a woman) and taking methylphenidate was absolutely life changing for me. My anxiety disappeared, I could work harder and better than ever before, and I felt like I could finally be myself.
Why wouldn’t we want to give this to our kids if needed? My daughter takes it now and she is also very happy to have it. It’s been tested for many years and is very safe for kids.

Wait until you are on max dose due to tolerance.

But as your post illustrates very clearly, ADHD meds are clearly performance-enhancing drugs. I just find it so hypocritical that the (often progressive) parents who get really offended when Asian parents send their kids to Kumon/AoPS to get ahead and place into G&T programs, wouldn’t hesitate to doctor shop and put their tweens on meth analogues to get some academic advantage. You see it on FB groups all the time.

Sorry, but you are taking a very small problem and using that argument to imply that many parents whose children need those medications are bad actors. We and many parents like us aren't giving our kids ADHD medication so they can get an academic advantage over their peers, it's so they can simply perform basic executive functioning skills their peers have no problem doing - like being able to focus for 20 minutes so they can complete their homework or make it out the freaking door each day without having to be told 10 times how to do everything step by step. We aren't medicating our kids, which we do not take lightly and initially did not, to perform better than their peers. Acting like this is the equivalent of professional athletes doping is misguided. What's next? Given Larlo a wheelchair so they can move freely around the school like everyone else is giving Larlo a performance advantage? Don't try to characterize the vast majority of parents whose families have legitimately struggled with ADHD with the very few who abuse it.

Not a small problem. ADHD meds are so heavily prescribed (and increasingly so!) that big pharma can't make them fast enough. Our local pharmacy had wait lists of months this winter. My teen is on them even though I know it's not a real condition. The meds help by creating a socially desirable behavioral state. That is not the same as treating an actual medical condition.

You don’t believe your teen has ADHD or you erroneously don’t believe ADHD is real despite her diagnosis?!

ADHD, at least if you look at the DSM diagnostic criteria, is a set of behaviors that don't mesh well with modern society. Like most mental health diagnoses, ADHD includes subjective diagnostic criteria like whether the behaviors cause distress to self and others, does it impair me from doing things I would otherwise like to do (like focusing on boring schoolwork or office busywork).

I think the ADHD diagnosis rate is more an indictment of our society than of those who have been diagnosed with it.

I am the skeptical PP and my teenager is an active, outdoorsy, tomboyish girl by her own description. I do not think she is suffering from a mental health problem, but I think it is necessary for her to conform to mainstream society to the extent that she can complete her high school and college education. Hence the meds.

This has to be a complete troll.

Nope, master's degree in clinical mental health.

In my experience, it is the people with actual academic/professional exposure to this stuff that are the most skeptical. Like the MD poster above.

It's based mostly on parents and teachers filling out questionnaires. Look up the Vanderbilt questionnaire online, and you can get an idea based on your observations at home and what you've heard from school. Sometimes inattentive ADHD flies under the radar because daydreaming and forgetting to turn things in isn't as disruptive as hyperactivity.

If you find yourself wondering why there isn't an "all the d@nm time" column for the Vanderbilt, pursuing a diagnosis makes sense. Hang in there.

I read something that probably rings true. Does one parent think there’s an issue or two parents? Is it two parents plus teacher? Once both parents and outside observers start questioning it’s more likely there is an issue than one crazy gunner parent.

Anonymous wrote:

Anonymous wrote:Count me in as another skeptical parent. What I have seen is that the stimulants work very well in the short term (so you get all these testimonies of “this changed my kid’s life” or their own life for a parent who just started on the meds themselves), but a large number of ADHD kids eventually still eventually self combust if they didn’t make structured changes to their lives and actually commit to behavior changes and stay within guardrails. This is particularly evident once the kids head off to college despite being on meds.

Did you go to medical school?

Yes, in fact I did, at one of the best in the country.

Although the neurochemical pathways of chronic stimulant use disorders are not definitively established, a few researchers have found evidence of changes in the structure and function of brain neurons after chronic stimulant use in humans. Some researchers propose that the changes may come from dopamine depletion, changes in neurotransmitter receptors or other structures, or changes in cellular components or other brain messenger pathways that could cause the changes in mood, behavior (e.g., compulsivity, decision making), and cognitive function associated with chronic stimulant misuse (Ashok et al., 2017; Jan et al., 2012). (The medical aspects of stimulant use disorders are discussed in Chapter 3.)

https://www.ncbi.nlm.nih.gov/books/NBK576548/#:~:text=Although%20the%20neurochemical%20pathways%20of,chronic%20stimulant%20use%20in%20humans.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Everyone is quick to diss the methylphenidate given out to the kids, but I was diagnosed at age 35 (I’m a woman) and taking methylphenidate was absolutely life changing for me. My anxiety disappeared, I could work harder and better than ever before, and I felt like I could finally be myself.
Why wouldn’t we want to give this to our kids if needed? My daughter takes it now and she is also very happy to have it. It’s been tested for many years and is very safe for kids.

Wait until you are on max dose due to tolerance.

But as your post illustrates very clearly, ADHD meds are clearly performance-enhancing drugs. I just find it so hypocritical that the (often progressive) parents who get really offended when Asian parents send their kids to Kumon/AoPS to get ahead and place into G&T programs, wouldn’t hesitate to doctor shop and put their tweens on meth analogues to get some academic advantage. You see it on FB groups all the time.

Sorry, but you are taking a very small problem and using that argument to imply that many parents whose children need those medications are bad actors. We and many parents like us aren't giving our kids ADHD medication so they can get an academic advantage over their peers, it's so they can simply perform basic executive functioning skills their peers have no problem doing - like being able to focus for 20 minutes so they can complete their homework or make it out the freaking door each day without having to be told 10 times how to do everything step by step. We aren't medicating our kids, which we do not take lightly and initially did not, to perform better than their peers. Acting like this is the equivalent of professional athletes doping is misguided. What's next? Given Larlo a wheelchair so they can move freely around the school like everyone else is giving Larlo a performance advantage? Don't try to characterize the vast majority of parents whose families have legitimately struggled with ADHD with the very few who abuse it.

Not a small problem. ADHD meds are so heavily prescribed (and increasingly so!) that big pharma can't make them fast enough. Our local pharmacy had wait lists of months this winter. My teen is on them even though I know it's not a real condition. The meds help by creating a socially desirable behavioral state. That is not the same as treating an actual medical condition.

You don’t believe your teen has ADHD or you erroneously don’t believe ADHD is real despite her diagnosis?!

ADHD, at least if you look at the DSM diagnostic criteria, is a set of behaviors that don't mesh well with modern society. Like most mental health diagnoses, ADHD includes subjective diagnostic criteria like whether the behaviors cause distress to self and others, does it impair me from doing things I would otherwise like to do (like focusing on boring schoolwork or office busywork).

I think the ADHD diagnosis rate is more an indictment of our society than of those who have been diagnosed with it.

I am the skeptical PP and my teenager is an active, outdoorsy, tomboyish girl by her own description. I do not think she is suffering from a mental health problem, but I think it is necessary for her to conform to mainstream society to the extent that she can complete her high school and college education. Hence the meds.

This has to be a complete troll.

Anonymous wrote:Count me in as another skeptical parent. What I have seen is that the stimulants work very well in the short term (so you get all these testimonies of “this changed my kid’s life” or their own life for a parent who just started on the meds themselves), but a large number of ADHD kids eventually still eventually self combust if they didn’t make structured changes to their lives and actually commit to behavior changes and stay within guardrails. This is particularly evident once the kids head off to college despite being on meds.

Did you go to medical school?