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.
“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.
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.
>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.
> 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.
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.
"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^
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.
There are also people who do it because they find it interesting, or spiritual, or healing in some way. They aren’t really ‘fun’, and are generally not addictive, though ones with dopaminergic activity like lsd or to a larger extent MDMA do cause addictive tendencies occasionally.
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?
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?
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.
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.
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.
No, some of us know it's a completely fake argument, know that people just want it for fun, even support legalization, and still hate the liars.
The amount of half-braindead pot smokers earnestly talking about their medical need to get stoned is so irritating. Legalization happened despite them, not because of them.
Both you and I know that your support or hate are limited to comments on the Internet. No one really worries about that moving the needle. When the thing is done, you'll fall into line with the new norms. I doubt anyone is that concerned one way or another.
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.
Well, everyone hates Big Pharma and gives them what they want, and everyone agrees with honest legalization efforts and doesn't give them anything. You're welcome to aim to be loved. I aim to get what I want.
And come on, healthcare requires you to lie. The head of the NIAID famously lied about mask efficacy in order to get what he wanted and people backed him for it. I don't see myself as any different.
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.
>My understanding is that stimulants do exactly the same thing in a person whether they're "cognitively healthy"
I don’t know a lot about stimulants in general, but I know for caffeine in particular this is not true. As an anecdote, I have a friend that caffeine puts to sleep, she just can’t take it. I’ve come to find out (partly from knowing her) that part of why the FDA doesn’t regulate caffeine, is that it has a very wide range of varying effects on different people.
Well, everyone is different biologically and every drug affects everyone differently, I didn't mean that there's no biodiversity between people. What I meant was that these stimulants don't function differently based on whether you're "cognitively healthy." Methylphenidate doesn't do something different in a person with ADHD versus one without, because it doesn't interact with any mechanisms of the illness, and whether or not you have ADHD you're experiencing similar effects on the drug.
Contrast with, say, SSRIs, which might have some effect in a healthy person but you're looking at a different range of effects compared to someone taking it for depression/anxiety/OCD/whatever.
> 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.
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.
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.
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.
> 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.
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.
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.
I drink coffee every morning and have for pretty much my entire adult life. People might be better off for it because coffee in moderation is healthy and has various bioactive compounds in addition to caffeine that can reduce risk of some diseases... but I don't think the caffeine itself has any cognitive benefits for me at all compared to if I were to never drink coffee. It's just an addiction I'm completely adapted to, and skipping a morning coffee just means I'm a bit extra tired and sluggish through the day. Maybe dopaminergic stimulants are different, especially for people with true ADHD, and they can maintain an effect over time even at a dosage plateau.
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.
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.
"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."
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.
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.
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?
"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. "
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.
> 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?
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.
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.
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.
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.
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.
I agree with you there. But the thrust of the article was using drugs as “cognitive enhancers” not to treat a medical condition of ADHD. Bringing someone up to baseline is one thing, but this is not that.
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.
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.
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.
> 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.
> 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.
True in some cases, but not in mine. I had taken 3 or 4 years off them before getting then in India. As far as I'm aware most tolerances wear off over time. 3 or 4 years seems like a reasonable amount of time to expect some level of restoring sensitivity. But it was as ineffective as the 3 or 4 years earlier.
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.
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.
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.
Most of those do not affect neurogenesis (some exceptions apply), but some can be outright neurotoxic chronically, potentially by excitotoxicity. Which means oxidative stress on neurons impairing their function.
A bunch of strong serotonergics produce such effects. Normally SSRI are screened for it, but that's mostly for acute version...
Dose scheduling is underresearched part of the whole ordeal. Sometimes a pause is necessary to prevent the damage or recerse the tolerance.
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.
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.
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.
Amphetamine is primarily absorbed through the plasma membranes and not DAT since it’s lipid soluble.
Dopamine does not and thus relies on DAT. By inhibiting DAT (as both amphetamine and Modafinil do), you increase extracellular dopamine.
Next, DAT does not “transport amphetamine around the brain”. It only transports it from the post synaptic cleft into the cell.
Also Modafinil is a much weaker DAT inhibitor than amphetamine itself as far as we know.
Lastly, drugs don’t “antagonize” other drugs. That word is a specific term used for the action on the receptor level.
The dopaminergic effects of Modafinil aren’t well known and are thought to be mild. It’s simply misinformation to claim that modafinil was somehow blocking the effects of amphetamine on the dopamine receptors.
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.
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.
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.
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.
> 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.
> 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).
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
This isn’t really the case for some college degrees. You cannot be successful in engineering e.g., specifically ME (in my case), through memorization alone.
For many degrees, you’re absolutely correct though. I remember being envious of such workloads in college simply because of the idea that time spent studying directly correlates to your grade. Engineering degrees, in general, simply show that you know how to learn. Memorization is helpful but alone is not enough to understand concepts and apply them.
Memorizing formulas vs. being able to derive them is a good example here.
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.
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.
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.
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".
> 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.
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.
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.
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.
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).
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.
> 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.
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.
> In terms of whether these things actually make a difference in how likely a child is to seem "ADHD" - yes, really.
The reason parents are holding sugar back from kids is they think they're hyper due to a "sugar rush", which is completely placebo i.e. they're just acting like that because they heard you're supposed to.
Interesting, this is one of those things where I was absolutely convinced that it's true and am having some cognitive dissonance reading the study.
I am not trying to move goalposts with the next statement, but I always assumed sugar has a similar effect to caffeine, in that you get a temporary boost that you pay for later. Study pointing to this quoted/linked below.
For me personally, energy drinks very much do seem to improve alertness, at the cost of crashing later. This is especially evident if drinking them two days in a row, where on the third day you absolutely have no energy left. And that's not even mentioning the absurd blood pressure spikes.
Anyway, this isn't an "argument" - I don't have one other than "that seems inconsistent with my experience." Though your own link seems to be pretty inconsistent as well*
* "Caffeine consistently improved marksman reaction time but did not improve marksmanship accuracy. However, there is some evidence that caffeine attenuates performance decrements in marksman accuracy caused by stress and fatigue if optimal dosing strategies are employed. Dosing strategies timed according to hours of wakefulness and time before testing could prevent performance deterioration. Doses of 100-200 mg every 2 hours may effectively improve accuracy during extended duty; however, further research is needed."
* "The literature on CHO effects on cognition suggests that CHOs can improve cognitive functioning, particularly under circumstances where participants are asked to perform cognitively demanding rather than easy tasks (Mantantzis et al., 2017, Scholey et al., 2009, Sünram-Lea et al., 2002). In a similar manner, studies have found the protective effects of CHOs on mood to be more robust when participants perform demanding physical and cognitive tasks. In fact, whereas participants in control groups experience higher levels of tiredness after performing a cognitively demanding task, consumption of CHOs seems to protect subjective ratings of energy against a potential drop-off after high cognitive exertion (Benton and Owens, 1993, Owens et al., 1997). Additionally, exogenous energy supply in the form of CHOs has been shown to increase vigor and reduce fatigue under conditions of increased physical stress (Ali et al., 2017, Lieberman et al., 2002, Markus, 2007, Welsh et al., 2002) and cognitive demands (Owens et al., 1997, Smit et al., 2004). Therefore, it has been hypothesized that, similar to cognition, mood improvement following CHO administration is stronger when participants have to perform demanding cognitive or physical tasks (for a review, see Benton, 2002)."
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"?
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.
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.
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.
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.
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.
> 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.
ADD is not the lack of focus, it's the lack of executive control over focus. You may have a fantastic, nearly inhuman amount of focus, but without any ability to direct it - if you have something engaging to work on you can work on it to the total exclusion of all else for 12 hours at a time, but if such an engagement isn't present you'll just be pulled in every direction at random. At least, that's how it is for me.
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.
My work around for this is to take a walk without headphones. For me, it means that the only thing I can do is think (can't read, can't watch video, etc). And by the time I've finished a 30 mins walk, I've usually got a bunch of things that I'm enthused about working on.
> 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"
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
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).
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.
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.
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.
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?
> 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.
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.
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?
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.
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.
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.
> 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.
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.
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.
> 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.
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.
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.
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.
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.
> 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.
> 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).
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."
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."
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."
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.
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.
Noopept is a potential candidate for another replacement. It’s basically has a similar safety profile but it’s more potent and requires much less to achieve the desired effect.
Noopept is essentially a peptide chemical mimic. Price wise Piracetam is cheaper and easier to make. Metabolism is similar enough, potency while higher likewise runs into the same side effect profile at too high dosage so is no good.
Noopept should be a bit lighter on the liver and kidneys.
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.
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.
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.
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.
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)
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.
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.
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.
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.
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.
> 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."
> 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.
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
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.
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.
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.
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.
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.
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.
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.
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
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.
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?
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.
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?”
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.
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.).
> 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.
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.
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.
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
I think for some, it can definitely be called a high. For a person with ADHD, modafinil-induced hyperfocus can feel like an absolute trip. For a boring weekend with no energy to do anything, modafinil can mean the difference between doing something for hours and just browsing Instagram till you feel sick.
If the above examples sound beneficial, they may be - in part. But I'm sure clinicians and mental health practitioners can see how such a substance embedding itself in your life can yield undesirable outcomes, perhaps mirroring addiction.
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?
I don't have antagonism towards it - just tentative caution. I'd advise the same to any DYOR-er.
Personal experience plays some part: I've been a regular user since 2016. Initially weekly, for a while daily, then back to weekly.
It hit me that what was initially a minor perceived upgrade to my chaotic workflow had become an almost regular part of my life. I'm still not entirely sure if I would call myself addicted - I seem to be able to walk away from it but among ADHD crutches it is the most desirable at present. That said, I've been careful to never exceed 200mg a day and to take breaks from it if I've taken it for more than 3-4 days at a time.
In terms of its actual benefit, it seems to be quite hit and miss. I find it just puts me in a more conducive state for focus, but only 3/10 times.
I don't think medical or media coverage has quite documented how much modafinil is used these days by working professionals and people without narcolepsy - situations where modafinil can be used in endless combination of 'other things that we don't yet understand an interaction with'.
What is the effect of 3 days disturbed sleep with 200mg modafinil daily? What effect on people with other mental health comorbidities? What is the effect on the liver and kidney for frequent use (the foul-smelling urine it results in is honestly anxiety-inducing).
What worries me is that since 2016, there appears to be a scarcity of research on modafinil, even though anecdotally its use has exploded.
It feels safe in much the same way I imagine aspartame may have seemed safe when first synthesised. It may be a 'safer' smart drug than alternative medications, much like how aspartame is probably still 'safer' than abusing sugar. But the truth is that perhaps we still do not know.
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"
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.
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.
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.
Even in the '90s, I heard that a large percentage of CS undergrads were on prescription meds, such as Ritalin. A much larger percentage than you'd think would have an abnormal condition. I didn't ask many students about it, but my guess at the time was that it was for performance enhancement above typical human capability.
And this was a bit before the current FAANG pressure to spend lots of time on Leetcode memorizing and rehearsing, in addition to coursework -- CS students only needed to get through their time-consuming lab-heavy courses, and then they could get a good job. (This was slightly before CS became one of the very high paying upper-middle careers, like medicine and law, which seemed to put high-stakes demands on undergrads' school performance.)
Large numbers of people drugged-up for years, simply to pass status-career gatekeeping, doesn't seem like a great situation.
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.
> 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.
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.
First time I hear someone calling amphetamines smart drugs. Modafinil itself has weak to non-existent nootropic effect as well, and it only partially abates sleep deprivation.
This effect of amphetamines on creativity and work quality is expected and has been described in the literature before. It gets worse when sleep deprived.
They are best for repetitive boring work that requires alertness, not learning.
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!
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.
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.
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.
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.
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.
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”.
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.
Hey, I'm not the one who chose the analogy or the “with both"; if you would read what you wrote with more discernment before posting it, maybe we would have avoided this whole discussion.
>The problem with both [examples of taking performance enhancing drugs, implied] is it requires other people to also take those drugs to be competitive.
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.
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
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.