34 replies to this topic

[sub7]

My simple question is whether regular but responsible use of something like Adderall is possibly healthy or at least its risks are potentially feasible.

Take the following imaginary example:
We have a middle aged person in his/her late 30s -early 40s, who has led a fairly healthy life. Doesn't smoke, drink or engage in recreational drug use; is not a health fanatic but highly health conscious. He/she eats and drinks very well, keeps lean and exercises regularly and properly.

This person has concluded that he/she has a bit of an attention problem, which may not neccesarily qualify as full-blown ADHD. However, this person definitively can get a lot more done and simply lives a more productive and better life by using something like Adderall a few times a week. Addiction or graduation to more potent stuff like metaamphetamine is out of the question.
He or she simply takes Adderrall or a similar amphetamine, say, on Monday, Wednesday and Friday every week; never exceeds three days of use per week and when particularly motivated or when on vacation uses the substance once or twice a week even.

Would you expect long-term issues with this? How about if such use begins at the age of 40 and continues at this pace for 30 uninterrupted years until 70? Sure a controlled study lasting 30 years hasn't taken place, but what is an educated guess as to the long / very long term effects of such a regimen (considering no other medicines are used and thebrain / nervous system is not subjected to any other major impact that can take a tool on it)?

Thank you very much

[Darian]

As long as you keep the dosage low and the use infrequent, amphetamine is not really unhealthy or neurotoxic.

You will need to keep up your nutrition though with things like omega-3 and vitamin D though. Because even low doses of amphetamine over a couple decades may cause undesirable neurological effects.

Personally I'm willing to bet you won't be any worse off than someone who drinks a couple cups of coffee every day, though.

[sub7]

Personally I'm willing to bet you won't be any worse off than someone who drinks a couple cups of coffee every day, though.

How about tolerance?
Do you think after a decade or two, the drug will still continue to be quite effective every (or almost every) time?
(One cannot exactly expect the same potency forever, but is it realistic to hope that after declining some, at least the potency will hopefully stay constant thereafter? Just a guess based on other semi-potent to potent substances, whose effect seems to level off at first but then stay constant)

[Reformed-Redan]

I'd really try to switch to Focalin at least. Seems like the lesser of two evils. Personally I'm still hoping BPAP and selegiline would be a golden combo. BPAP as needed with selegiline constant use.

[Darian]

Personally I'm willing to bet you won't be any worse off than someone who drinks a couple cups of coffee every day, though.

How about tolerance?
Do you think after a decade or two, the drug will still continue to be quite effective every (or almost every) time?
(One cannot exactly expect the same potency forever, but is it realistic to hope that after declining some, at least the potency will hopefully stay constant thereafter? Just a guess based on other semi-potent to potent substances, whose effect seems to level off at first but then stay constant)

Some amphetamine tolerance is due to neurotoxicity. Some long-term tolerance and neurotoxicity can be avoided with NMDA antagonists like dextromethorphan (DXM) and magnesium. Nicotine and caffeine also increase stimulant stimulus discrimination but while nicotine reduces amphetamine neurotoxicity caffeine may increase it.

If you don't mind alternating with modafinil or even taking modafinil with the adderall (which may completely abrogate neurotoxicity because it does for neurotoxic doses of methamphetamine) then yes you could go the rest of your life and still be able to use amphetamine without increasing the dose or using it more often to get the same effects.

[Nootmeup]

Be careful it is addicting which is the least of problem of Adderall. The greatest evil of it is the paranoia and psychological issues it brings. Remember because it is a prescribed drug doesn't mean it will 100% Benefit you just make sure you weigh the pros and cons

[jadamgo]

Switching to a form of methylphenidate is a much safer alternative.

[lourdaud]

Bupropion + modafinil is another alternative.

[sub7]

Be careful it is addicting which is the least of problem of Adderall. The greatest evil of it is the paranoia and psychological issues it brings. Remember because it is a prescribed drug doesn't mean it will 100% Benefit you just make sure you weigh the pros and cons

Do you consider this a substantial risk even with 3 times a week usage? How about using methylphenidate instead? Still a similar level of risk as far as paranoia and psychological issues?

Switching to a form of methylphenidate is a much safer alternative.

But less efficacy as well, or not necessarily? Based on the little that I know, it is indeed safer. I am wondering if alternating the two is a proper course, with Aderall and methylphenidate used on alternate days of use (which still would total 3 times a week)

Bupropion + modafinil is another alternative.

Hmmm... is there a synergy between Bupropion and Modafinil? Or is the Modafinil meant to simply reduce toxicity of the Bupropion? Would you expect the improvement in focus and concentration with this combo to be comparable to that achieved by using Addrrall?

[lourdaud]

Do you consider this a substantial risk even with 3 times a week usage? How about using methylphenidate instead? Still a similar level of risk as far as paranoia and psychological issues?

Methylphenidate is better at inducing paranoid and psychotic behavior than amphetamine. There may be more problems with 'phet use over time though.

But less efficacy as well, or not necessarily? Based on the little that I know, it is indeed safer. I am wondering if alternating the two is a proper course, with Aderall and methylphenidate used on alternate days of use (which still would total 3 times a week)

It's known to give you a more laser-sharp kind of focus than Adderall.. Very good focus and attention to detail but personally I can't think straight on methylphenidate.

Hmmm... is there a synergy between Bupropion and Modafinil? Or is the Modafinil meant to simply reduce toxicity of the Bupropion? Would you expect the improvement in focus and concentration with this combo to be comparable to that achieved by using Addrrall?

Well they are both DRI's (partially) so they stack well together. From personal experience I'd say there's less risk of running into problems such as loss of efficacy, altered behavior, "adrenal burnout" etc with these two compared to traditional stimulants.
Modafinil won't reduce possible toxicity from bupropion but I don't think you have to worry about that.

I find you can't really compare them to Adderall in treating ADHD but unlike Adderall they really enhance my cognition. Adderall enhances some aspects of cognition as well but it makes me too narrow-minded and impairs judgement a lot. I also don't get nearly as tense, weird and paranoid as I do on amphetamine.
Selegiline will enhance both bupropion and modafinil btw.

[sub7]

I find you can't really compare them to Adderall in treating ADHD but unlike Adderall they really enhance my cognition. Adderall enhances some aspects of cognition as well but it makes me too narrow-minded and impairs judgement a lot. I also don't get nearly as tense, weird and paranoid as I do on amphetamine.

Very insightful and interesting
Anyone else want to chime in about this? Other similar experiences at all?

[nightlight]

One of most prolific mathematicians ever, Paul Erdos, has used amphetamines daily for the last 25 years of his life (at least). He also drank huge quantities of coffee.

[Nobility]

- Safe Dosage
- Diet,Exercise,sleep
- TAKING BRAKES. YOU MUST TAKE BRAKES of the medication. Every Christmas,Easter,Summer,etc ALONG WITH Every now and then AND some Doctors say not to take it on the weekends, and or if you do -> Have it on where on DEFAULT = No adderall on weekends, but sometimes you may....

Also, avoid Coffee(Caffeine) and any other Stimulants, please do not use other drugs/medications with it unless told so by a doctor,etc.

Was on MPH myself. Thing is to make sure your dosage is low, and that your taking brakes from the medication, AND to at least take(must) each Sunday without it ALONG with Summer,Christmas,etc AND every now and then to take brakes from it.

- Taking brakes from the Medication (couple of weeks) every now and then, is great. It's like it really refreshes your brain, and what not. Just don't take it and not take brakes.

Remember, to get at least 9 hours of sleep. 10 of sleeps if you can... And eat a good a very good diet.... also, make sure you eat each day along with drinking a good amount of water each day. 70 calories are needed per hour by the body also, so make sure you eat a good diet such as fish,fruit,veg,porridge,etc,etc.

ONE OTHER THING, VERY IMPORTANT: Check your GP/Health Doctor to do regular checkups on your blood,heart,etc.... In general, anyway make sure you have your heart checked every now and then, along with your blood, etc.

Edited by Nobility, 28 January 2014 - 06:14 PM.

[jadamgo]

Do you consider this a substantial risk even with 3 times a week usage? How about using methylphenidate instead? Still a similar level of risk as far as paranoia and psychological issues?

Methylphenidate is better at inducing paranoid and psychotic behavior than amphetamine. There may be more problems with 'phet use over time though.

This is a significant problem in overdoses of either compound. However, the right way to dose a stimulant is "as much help as I need, but without serious side effects." No matter the circumstance, if whatever drug you're taking is causing any serious abnormal behaviors/thoughts/emotions, you should reduce the dose to a level that doesn't cause the problem.

But less efficacy as well, or not necessarily? Based on the little that I know, it is indeed safer. I am wondering if alternating the two is a proper course, with Aderall and methylphenidate used on alternate days of use (which still would total 3 times a week)

For 7 out of 10 people with classic ADHD, AMP and MPH work equally well once the final appropriate dose is reached. Of the remaining 3 out of 10 people, one will respond better to MPH, one to AMP, and one's symptoms won't be helped by either.

There is one important exception to that finding: It does NOT apply to the only-inattentive variety of ADHD, which is probably a completely different condition from the classic inattentive-hyperactive-impulsive ADHD. This other condition doesn't respond well to MPH because at safe doses MPH mostly hits just dopamine, whereas people with the only-inattentive disorder don't need dopamine boosters. They respond to alertness-promoting drugs like modafinil, AMP, bupropion. Anecdotally it also appears that the racetam family and CILTEP stack are also pretty helpful.

As for alternating AMP and MPH, it doesn't make that much sense. If MPH works for you (I'm speaking as if talking to the hypothetical person) then since it's safer, why not skip the amphetamine altogether?

And if MPH doesn't work at all, then drop it and try modafinil, bupropion, the nootropics, and meditation. Or, if MPH helps somewhat but not enough, you could try combining those other things with it. Since you don't have a very severe problem with attention, some combination of these safer drugs is simply a better idea than gambling with amphetamine. Sure, some people use amphetamine for long periods and they're totally fine, but others aren't, and you can't predict ahead of time whether or not it'll happen to you. So by this train of thought, it's just not worth it to risk the chance of insidious brain damage with frequent amphetamine use -- your symptoms just aren't severe enough.

Now, if you had severe ADHD that impacts your ability to function, and you've already tried the safer drugs and nothing worked, then amphetamine would be justified. Why? Because at that point you'd be gambling the known harms of severe untreated ADHD with a possible harm from amphetamine. Just like it's worth it for cancer patients to take chemo, even though it may cause some mild brain damage -- it's better than dying. Or in the case of severe ADHD, it's better than not being able to live your life. But if you can already live your life without too much trouble from the symptoms, it's no longer worth the risk.

[3AlarmLampscooter]

For any amphetamine fans, I'd definitely recommend the amphetamine+modafinil combo on lower doses.

Does away with the majority of side effects (including reducing neurotoxicity), while keeping the majority of desired effects. Clonidine is another fairly good adjuvant here at a low dose.

[sub7]

Since you don't have a very severe problem with attention, some combination of these safer drugs is simply a better idea than gambling with amphetamine. Sure, some people use amphetamine for long periods and they're totally fine, but others aren't, and you can't predict ahead of time whether or not it'll happen to you. So by this train of thought, it's just not worth it to risk the chance of insidious brain damage with frequent amphetamine use -- your symptoms just aren't severe enough.

Absolutely wonderful post jadamgo. thank you very much

Do you think that 2-3 times a week (but a long period of time on this regimen) use of amphetamine qualifies as frequent and does result in risk of brain damage? Or, when making this comment, did you have the possibility of 3-days-a-week use potentially escalating into everyday use?

[jadamgo]

Since you don't have a very severe problem with attention, some combination of these safer drugs is simply a better idea than gambling with amphetamine. Sure, some people use amphetamine for long periods and they're totally fine, but others aren't, and you can't predict ahead of time whether or not it'll happen to you. So by this train of thought, it's just not worth it to risk the chance of insidious brain damage with frequent amphetamine use -- your symptoms just aren't severe enough.

Absolutely wonderful post jadamgo. thank you very much

Do you think that 2-3 times a week (but a long period of time on this regimen) use of amphetamine qualifies as frequent and does result in risk of brain damage? Or, when making this comment, did you have the possibility of 3-days-a-week use potentially escalating into everyday use?

I'm glad you're finding this helpful.

The answer for "how much is too much" is a bit complicated. From my understanding, brain cells are able to recover from single doses of amphetamine, even moderately large ones, as long as there's enough time before another dose is taken. It takes anywhere from 1-3 days for the repairs to happen, starting from the time the AMP wears off. The recovery period should include two full nights' sleep.

It's faster for a person who:
- Generally eats healthy and exercises frequently
- Specifically eats a good supply of protein- and nutrient-rich foods during the amphetamine use and recovery period
- Takes a smaller dose of amphetamine
- Takes an instant-release adderall or dexedrine instead of an extended-release adderall XR or vyvanse
- Is not under medium- or long-term stress, either physical, cognitive, or emotional/social. (If you know about the General Adaptation Syndrome, a.k.a. the stages of the stress response, then remember that recovery from any stress, such as amphetamine use, would take longer in the Resistance stage, and much longer in the Exhaustion stage.)

So what's the final answer? Basically, it means allow a minimum of 1 full day, including the night's sleep before and at the end of that day, between using amphetamine. The dose should be low enough that you don't have rebound fatigue or brain fog on the days you aren't using it.

Also, I suggest bumping it up to a 2-day rest period (meaning 3 nights of sleep) between uses when you're under greater stress, not able to eat well, recovering from a sickness, etc.

The studies that have shown brain damage from amphetamine were either of daily use for periods of weeks to months, or they were binges where amphetamine was continually given for long periods. This is why amphetamine should be a last resort for severe ADHD, because it would need to be used every day and that's just not a great idea. But if used 3 times per week when healthy, and only 1-2 times per week when stressed for any reason, it's not likely to cause any problems.

If it did cause problems, you'd notice them on the off-days as rebound fatigue or worsening of the attention problems. That would be a sign to take several days off.

[sub7]

Again, very helpful, insightful and thoughtful...
Thanks a ton

[nells]

I really dont see how long term use could be anything other than negative

[lourdaud]

I think you made a great post, jadamgo, but I have to disagree slightly on a few points.

This is a significant problem in overdoses of either compound. However, the right way to dose a stimulant is "as much help as I need, but without serious side effects." No matter the circumstance, if whatever drug you're taking is causing any serious abnormal behaviors/thoughts/emotions, you should reduce the dose to a level that doesn't cause the problem.

Agreed. Still though, MPH is worse in this regard. And even if you're keeping the doses low, both compunds may alter your behavior over time. If you have any co-morbidities you probably run a much higher risk.

For 7 out of 10 people with classic ADHD, AMP and MPH work equally well once the final appropriate dose is reached. Of the remaining 3 out of 10 people, one will respond better to MPH, one to AMP, and one's symptoms won't be helped by either.

I'm sure this applies for staying focused but I doubt they can be considered equal for shifting ones attention. Don't have any studies to back this up but anecdotally more people seem to complain about MPH induced hyper-focus etc. I'm not sure any of the two will really improve attentional set shifting though (unlike modafinil for example).
Also worth noting is that amphetamine should give you a better cognitive/performance boost.

As for alternating AMP and MPH, it doesn't make that much sense. If MPH works for you (I'm speaking as if talking to the hypothetical person) then since it's safer, why not skip the amphetamine altogether?

And if MPH doesn't work at all, then drop it and try modafinil, bupropion, the nootropics, and meditation. Or, if MPH helps somewhat but not enough, you could try combining those other things with it. Since you don't have a very severe problem with attention, some combination of these safer drugs is simply a better idea than gambling with amphetamine. Sure, some people use amphetamine for long periods and they're totally fine, but others aren't, and you can't predict ahead of time whether or not it'll happen to you. So by this train of thought, it's just not worth it to risk the chance of insidious brain damage with frequent amphetamine use -- your symptoms just aren't severe enough.

Now, if you had severe ADHD that impacts your ability to function, and you've already tried the safer drugs and nothing worked, then amphetamine would be justified. Why? Because at that point you'd be gambling the known harms of severe untreated ADHD with a possible harm from amphetamine. Just like it's worth it for cancer patients to take chemo, even though it may cause some mild brain damage -- it's better than dying. Or in the case of severe ADHD, it's better than not being able to live your life. But if you can already live your life without too much trouble from the symptoms, it's no longer worth the risk.

Why not just try out bupropion and/or modafinil first? The fact that the OP responded well to Strattera suggests you may want to look into more alert-promoting drugs.
And if they don't cut it, you could try adding Focalin (dexmethylphenidate).
The problem with MPH and AMP as I see it is that is that they'll wear you out over time (think "adrenal burnout").

[Reformed-Redan]

If you're smart you'll take DHEA, selegiline or bacopa for ROS protection, as well as ALCAR for mitochondrial protection and modulation of the DA influx. It's not like its good to take AMP; personally, I'm going to switch to dex-MPH or Strattera. I hope I can get some 2-DPMP for those all nighters, seems like a decent drug, only not push forward because big pharma could milk more money off a shorter half life compound. Also its pretty dangerous in an idiot's hand.

Edited by yadayada, 07 February 2014 - 10:54 AM.

[lourdaud]

For any amphetamine fans, I'd definitely recommend the amphetamine+modafinil combo on lower doses.

This!
5 - 10 mg racemic amphetamine and 200 mg modafinil and I'm good to go. For me, the two seem to cancel each other out a bit for the first few hours but after 5 - 6 h, my performance is at its very best.
Really wish someone were to isolate the levo-isomer of amphetamine..

Clonidine is another fairly good adjuvant here at a low dose.

Although it should help with hyper-activity, clonidine may actually impair working memory. http://www.sciencedi...893133X98001274

[Reformed-Redan]

Overall AMP isn't a good option. As already mentioned there are plenty of other safer options. It's just doctors tend to be biased towards what everyone else is prescribing or whatnot. It's too much wear and tear on a system.

[sub7]

For any amphetamine fans, I'd definitely recommend the amphetamine+modafinil combo on lower doses.

Why not just try out bupropion and/or modafinil first?

Is it woth trying combos involving modafinil if it has done very little to nothing at 100 mg and even 200 mg when used alone. Can there be synergies and it start working well in those combined?

[lourdaud]

For any amphetamine fans, I'd definitely recommend the amphetamine+modafinil combo on lower doses.

Why not just try out bupropion and/or modafinil first?

Is it woth trying combos involving modafinil if it has done very little to nothing at 100 mg and even 200 mg when used alone. Can there be synergies and it start working well in those combined?

What do you notice from 200 mg?
If I don't have any tolerance, I get a great boost from 200 mg modafinil alone, but over time I don't notice much more than increased speed of thought and being more alert. Definitely not enough to control my ADHD.
However, combine it with bupropion and a MAO-B inhibitor and it's a different story entirely - ADHD under good control and I'm able to think/study/perform much better than I am on high doses of AMP/MPH alone.

[sub7]

200 mg modafinil gives only a mild energy for a few hours but hardly notable
if I am sleepy, it will provide wakefulness; but after a good night of sleep 200 mg won"t do much other than a mild energy boost
(and I have never abused anything ever -am also pretty sensitive to stimulants in general)

[lourdaud]

Just stick to Adderall man, shit's good for you anyway

[sub7]

Just stick to Adderall man, shit's good for you anyway

Saying this half jokingly, or is there some truth in that?
I wouldn"t have asked if it was coming from a random someone, but you definitely have looked into this, have theoretical knowledge as well as first hand experience; so what you really and honestly think does matter to me...

[Nobility]

Well, really.

Firstly, this is up to you and your doctor.

But regarding discussion,

We should take into account regarding,

your current health,age,etc (heart,blood,age,etc).
your job, your life and all this.


then, your diet, your sleep and exercise.

and I will tell you something, AVOID coffee and any caffeine containing products with the medication, really it makes a good difference.

you also, its a MUST. to take brakes off the medication.
every Saturday/Sunday doctors say, AND MUST summer,Christmas,Easter,etc..

and to take brakes in general.


and every 6 months to a year get your blood pressure and heart checked by your gp.
and that your NOT on a high dosage. and that its NOT producing any strong effects.

well, in general. how its effecting you too.


there's other medications too, MPH (Rita) ; its not as strong as adderall.

but you must also remember; like I don't think you would want to be taking it forever. you know... so like...

[noopept-user-123]

Amphetamines downregulate your dopamine receptors. The day after amphetmine usage, you will have less dopamine than your baseline amount of dopamine because your receptors have to upregulate.

My advice: No amphetmines even occasionally are not healthy and they are just an easy way out with long term conequences.

As a previous person said, "Lesser of two evils" -- I would agree that amphetmines are "evil" in a sense. Why do you think ppl can get high off of them is because they increase dopamine and cause you to be less productive on the days that you do not take them.

Something like Piracetam, you do not really get high, so that is a real nootropic and very compatible with healthy living.