There are so many kinds of chemical stimulants why are amphetamines the thing ADHD patients need?
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There are two stimulants currently used to treat ADHD. Methylphenidate(Ritalin/concerta) and amphetamine salts(adderall/vyvanse). Methylphenidate works by telling your brain to slow down its reuptake of dopamine. After dopamine is released into the synapse, a transport molecule will come by after a little while and retrieve that dopamine and put it back into a storage area called a vesicle. Methylphenidate slows down the transport of dopamine out of the synapse which is proven to increase activity in areas of the frontal lobe of the brain(the areas that adhd effects most). Amphetamine works similarly but also effects norepinephrine and not only slows the reuptake of dopamine but actually seems to reverse reuptake and release some of the stored dopamine back into the synapse. Cocaine effects dopamine and norepinephrine as well I believe but the main reason it wouldn’t work as an adhd med is because it’s got an insanely short window of usable effects. I’m ADHD and I’ve tried cocaine and I’d say it is semi effective at clearing the noise from my mind in a similar way as amphetamine but only for about a 30 minute window before you have to redose. The real problem with adhd isn’t moment to moment fidgeting and forgetfulness. That’s a problem too but not life crippling, the real issue is the ability to sustain motivation over months or even years at a time. Before I started medication it was sort of like I was constantly chasing this window of motivation throughout the year. For example I’d get really inspired all of the sudden to finally go back to school and work really hard on it for 3-6 weeks and then one day I’d wake up and my motivation would be 100% gone. No matter how hard I tried I could not get my brain to properly devote itself to this task any longer, not in any meaningful way. So I’d spend a week or two feeling aimless and then all of the sudden I’d feel really inspired to start working out again and get back in shape. I’d chase the window for a few weeks and rinse and repeat. I knew that the only way I’d ever get anything done is if I just went with the flow and followed those motivational windows. With medication I determine those windows myself because every day when I wake up and that stimulant starts to kick in that motivation is mine to use however I want. I’m not chasing windows of motivation any more. Basically cocaine wouldn’t work because therapeutic stimulants need to be long lasting.
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