Do stimulants also help people without ADHD?

I'm wondering if there is any difference in the way people with or without ADHD react to the stimulants commonly prescribed for ADHD.

My neurologist when I was questioning my Dx said that is I didn't have ADHD the adderall would likely have jittery, hyper, and my general anxiety a lot worse.

As for research evidence...you might consider looking at the performance enhancement literature for both sports and miltiary populations. Clearly there has been a lot of research on the use of stimulants in these populations.

Sunrise,
Not sure what exactly you were looking for regarding stimulants and non-ADHD sufferers. I was checking out another topic on PubMed today (pubmed.gov) and figured I would do a quick search on stimulants while I was there.
Using the Clinical Queries link on left I searched for Therapy articles using "Stimulants and Improved cognition". A lot of hits came up. I didn't have time to look at them closely but... Here is a study looking a the effects of stimulants on a physical test and a cognitive function assessment test. Appearently stimulatants can help ya...get up and go AND possibly help you remember where it is you wanted to go...LOL

Not sure what you were really looking for but PubMed's Clinical Queries might give you some leads.

J Am Geriatr Soc. 2008 Apr;56(4):695-700. Epub 2008 Feb 7. Links
Can methylphenidate reduce fall risk in community-living older adults? A double-blind, single-dose cross-over study.

Ben-Itzhak R, Giladi N, Gruendlinger L, Hausdorff JM.
Movement Disorders Unit, Tel-Aviv Sourasky Medical Center, Tel Aviv, Israel.
OBJECTIVES: To test the hypothesis that methylphenidate modifies markers of fall risk in older adults. DESIGN: Randomized, double-blind, placebo-controlled, single-dose cross-over study. SETTING: Outpatient movement disorders clinic. PARTICIPANTS: Twenty-six community-living older adults without dementia (mean age 73.8) with subjective complaints of "memory problems." INTERVENTIONS: The study examined the effects of a single dose of 20 mg of methylphenidate (MPH) on cognitive function and gait. Participants were evaluated before and 2 hours after taking MPH or a placebo in sessions 1 to 2 weeks apart. MEASUREMENTS: The Timed Up and Go and gait variability quantified mobility and fall risk. A computerized neuropsychology battery quantified memory and executive function (EF). RESULTS: Timed Up and Go times, stride time variability, and measures of EF significantly improved in response to MPH but not in response to the placebo. In contrast, MPH did not significantly affect memory or finger tapping abilities. CONCLUSION: In older adults, MPH appears to improve certain aspects of EF, mobility, and gait stability. Although additional studies are required to assess clinical utility and efficacy, the present findings suggest that methylphenidate and other drugs that are designed to enhance attention may have a role as a therapeutic option for reducing fall risk in older adults.

I don't know what I was looking for either.

Thanks for the article.

I guess I still am not sure whether I have ADHD or not. Not that it matters. Wouldn't stimulants help anyone? They sure help me. They do not make me jittery or hyper or more anxious, and I don't have trouble falling asleep at night when I am taking stimulants. Maybe that just means I am on the right dose. If my PNP prescribed too much, then I would probably be jittery, anxious, etc., right? Paradoxically, I sleep better at night now that I am taking stimulants and wake up feeling more refreshed. I also fall asleep less in the day. It's like the stimulants have helped me segregate my sleep into the nighttime and my wakefulness into the daytime.

I am taking a course this quarter at the university where I work. A big, undergraduate course where you have to do a lot of reading, memorize lots of material, and take multiple choice tests. Yes, I'm taking it for a grade. I actually can't imagine being able to handle this class without being on the stimulants. I would simply fall asleep most days in class or daydream. That realization makes me feel kind of guilty, like I'm taking drugs to aid academic performance. Whoa, I'm taking performance enhancing drugs!

I guess I was wondering if because I am responding so well to the stimulants, does that means I have ADHD? I think we've been over this before and the conclusion I remember is that doing well on stims is not diagnostic of ADHD. Anyone (adult) would do well on stimulants, right? If anyone has not done well, please raise your hand and be counted.

Maybe it's the Puritan in me that feels kind of guilty about taking drugs that make me function and feel so much better. I think that's it. I feel like I'm doing something forbidden and somehow not quite ethical in taking these drugs.

Lately, I've just been feeling so good. Very generous and magnanimous and in a very good mood. It seemed so unusual, I thought it must be the drugs. However, I misplaced my Vyvanse and didn't take it for two days and still felt great. I wonder if I have a brain tumor.

I would hate to go back to being "normal."

Just blathering, as usual.

This is exactly what I was wrestling with last year. YES... I feel better, yes my function and my ability to stay on task is much improved....BUT...do I really have ADHD and should I really be on medication.

I'll try and return the favor and reflect back the advice you gave me back then... If it helps... what is the big deal? As long as the risks are minimal and the side effect manageable, why beat yourself up about taking medication.

yes it can help better feel. but if someone have anxiety it can make more nervous. good luck

I am also ADHA and I can tell you as far as I am concerned, the academic world requires me to be on medication...the right medication. I was diagnosed with ADD when I was about 7yo. I have battled with this my whole life. I just started dental school in july and decided that I would try concerta instead of adderall. For me that was a no go. I almost failed my first biochem exam. I studied like a freak for it also (~2 weeks). After a reality check, I returned to taking Adderall XR and I had the 2nd highest grade on te last exam (100%). I should also add that I only studied about 2 days for that one. I only say all this because some of my classmates have said that it is a preformance enhancer and it is unfair that people be prescribed drugs like adderall...CRAZY TALK. Their mind works in such a way that they can make stellar grades with or with out meds. I on the other hand can show 20-30% increase in my grades with meds. I can't say if it helps everyone concentrate, but I honestly cannot function IN THE ACADEMIC environment without it. Outside of school I can usually manage ok without it, but I am much more efficient with it still.
-rg

I would challenge this statement. I have seen no evidence that a stimulant makes someone...smarter. If I have time I will investigate this notion!--provided I don't forget or procrastinate that is :-)

How would your friends define "performance enhancer"? Do they even have a definition? To to say that Adderall is a performance enhancer it would have to be shown to increase some measurable cognitive performance in "normal" non-ADHD subjects in a randomized control trial. I think people make a lot of assumptions about stimulants that there is little evidence for. If you're not intelligent and motivated to learn something...just taking a stimulant is not going to enhance your chances of passing a written exam.

To me stimulant medication is a performance equalizer, not enhancer. Next time your friends make ignorant statements like that you should show them why your an "A" student. Challenge them to defend their statements or stop talking like an ***.

As for you needing less time to study...Maybe you only needed to study less hours, because you were able to actually study. Instead of: getting up every 15-20 minutes, take 10 minutes to straighten your works space and settle back down, or continually be distracted by minor environmental stimuli that they don't even notice.

I've known people who have illegally taken some kind of stimulant to "help them study", but there is no evidence that it really helped them study. I think it helped them party all night and stay up the next day to study, but the efficacy of this "technique" has not been scientifically proven... lol

I'm with you on this one sunny-- challenge ignorance wherever it exists. Stimulants do not make people smarter. Someone taking stimulants for whom they are not prescribed could actually kill themselves.

Chaotic 13, Simcha,

Thanks for the feedback. I am new to this whole online exploration of my ADD etc...but I've found this site to have some very interesting people on it. I've read several of each of your posts and I value your opinions. As for the previous post...To be continued...I've got a big test in 3.5hrs.

We'll talk later
-rg

>I'm wondering if there is any difference in the way people with or without ADHD react to the stimulants commonly prescribed for ADHD.

No. Improvement on cognitive tasks that require attentional focus improves across the board (and there are many studies on the effects of stimulants in rats with respect to learning / memory). As such response to stimulant medication is NOT diagnostic for ADHD.

I take Concerta for ADHD & it just makes me barely "normal," I also take Provigil to combat excessive daytime sleepiness due to bipolar meds so it makes me able to function at a normal level. Before I was falling asleep while driving.--Suzy

Hi Sunrise,

I'm at the beginning of researching . I thought I read in this group , but it could have been a link from the top, that stimulants have something to do with dopamine . iether the increase of production . and then theres the reinuptake inhibator (sounds like.) thats used as well to concentrate the dopamine . i think im close. I forget what the dopamine does.

So i guess stimulants could help for other problems where dopamine is lacking.

Ritalin is another . I was talking with a woman at a store who had a relative caught stealing her autistic childs ritalin to use for herself so she could loose weight.

A sad story.

Patricia

Hi Kim ,

I thought you were saying that stimulants did not help with focus . Had to reread . Okay so that means a doctor can't judge on whether you have ADHD by improvement alone after taking stimulants becaue everyone focus can can benifit. So what else is used to determine the differences apart from some computer tests and a history .

Brain scans?

Patricia

Brain scans are not diagnostic for depression, anxiety, ADD, schizophrenia, bipolar etc.

> So what else is used to determine the differences apart from some computer tests and a history .

Behavioral symptoms (including self report). And more in particular, how problematic the person and significant others takes the behavioral symptoms to be.

There is controversy over how much ADD is a 'culture bound' syndrome that is particular to the US (though gaining ground in other nations such as Canada, the UK, Australasia etc admittedly).

One thought is that it has more to do with the pathologizing of a spectrum that is more appropriately thought of as being within normal range. There are individual differences in such things as ability to focus attention etc, you see. Not sure on the prevalence of ADD... Guess if you fall however many standard deviations below the mean (or you or someone else kicks up a fuss about it) then hey presto you get to have ADD and stimulant medication to improve your attentional focus / control. At least... In the short term (before habituation).

Dopamine, yup.

I think in ADHD as with most other disorders there are a lot of confounding factors that make diagnosing and studying the disorder particularly challenging. The higher prevalence of ADHD in the US may have nothing to do with environmental or social issues, it could simply be that there is more money and/or interest to conduct the studies. Age, gender, genetics, cultural background, exposure to TV, family and social structure, diet, presence of other conditions, IQ, emotion intelligence,... the list goes on. No matter how great the study design was there will be limitations and you have to be careful how you apply the findings. Also, just because something was found to be effective in a controlled experiment, doesn't mean that it will be similarly effective when used in actual clinical practice.

To answer the question the original question at the very least there would need to be a several studies where a large diverse groups of "norma"l health subjects were assessed using some standardize cognition test(s) and then given some stimulant medication and reassessed. This study would likely not make it though the IRB process. It would be difficult to justify giving normal healthy individuals stimulant medication just to see what affect it may have on them.

As for the diagnositic process... at this point there is no single measure that has high specificity and sensativity to differenciate between those you have and those who don't have the disorder. The best we can do at this point is conduct a series of assessments, look at the combined results and use this information to make an educated guess.

> there would need to be a several studies where a large diverse groups of "norma"l health subjects were assessed using some standardize cognition test(s) and then given some stimulant medication and reassessed.

Been done, dude. Also been done in rats (with respect to the impact of stimulants on learning / memory for maze running).

You seem to be assuming that there is some inner dysfunction that will show up in the brain. Some categorical difference that marks whether people have ADD or not. Maybe ADD is more like... Blood pressure. Which is to say that there is a continuum... It might be that the population exhibits something of a bell curve with respect to both outer manifestation (ability to focus, blood pressure) and inner causes (e.g., number of dopamine receptors and / or amount of dopamine etc). If that is the way it is (and that is the way it seems to be) then there simply won't be a magical dividing line between people who have and people who don't have. Where do we choose to draw the line? How high do we want prevalence to be? When do we decide to say that a difference is a dysfunction? Is that a decision or a discovery?

Difficult questions...

Stimulants are a popular drug of use / abuse for people who need to focus for extended periods. I used low levels of methamphetamine (a kind of stimulant) to assist my one week of 20 hours of writing per day in the week before I submitted my thesis, and it isn't uncommon for students to use it to help them cram before an exam. Not the wisest move, perhaps. Risk of addiction, risk of taking too much and developing symptoms that are indistinguishable from paranoid schizophrenia...

But that being said, some people simply are able to pull a week of studying / writing for 20 hours a day and sleeping for 4. They can do that without stimulants. I can't. I need stimulants to do that. Does that mean I'm disordered or dysfunctional or impaired somehow? Maybe I have ADD... A prescription for stimulant medication would be a great deal more socially acceptable than my hunting out methamphetamine from the dodgey guy down the road...

I'm just saying that aside from the studies that have been done on both humans and animals it is common knowledge that stimulants assist learning and memory. Like anything... Too high a dose wrecks havoc. But lower doses... Common knowledge these days and the science backs that. People with ADD have improved performance but then so do people without ADD. So... Response to medication simply isn't diagnostic. The medication works on dopamine so you might think that differences in the production, release, uptake, or metabolization of dopamine would be forthcoming either in living patients or upon autopsy. Once again... Nope. There are individual differences to be sure but you can't diagnose any more reliably from autopsy than you can from the behavioral symptoms or from the response to medication.

Many diagnoses are like that... Depression, schizophrenia, anxiety, and so on and so forth.

I like your comparison to BP. I also agree that using your reaction to medication as a way to confirm the ADHD diagnostic lacks validity. But has you've mentioned EEG's, CT scans, self reported surveys, computerized tests, these are also problematic. I think at the moment determining if you have ADHD enough to warrent treatment is very tough to determine. At this point for me... I lived 40 years with my symptoms, suvived and actually did pretty well for myself. The last 2 years some other aspects of my life changed leaving me less able to cope. I am gratiful that I was able to then find someone who would treat me and give me the help I needed to rebalance. I don't know how long I will choose to continue my current treatment. I continually re-evaluate my situation, I foresee a time when I will try and move myself back to managing my symptoms without stimulant medication.

I've also wondered if I have ADD or if it is the result of my anxiety disorder (OCD). I take Provigil and it helps so much. I have a lot of difficult with motivational issues and I can't imagine working without taking Provigil. I'm at the point now where I don't care what I have, as long as the medication I'm taking makes my symptoms better. My Pdoc told me that some people are sensitive to stimulants like Adderall, it depletes them of serotonin. I guess they have to also take an antidepressant. This happened to me, I took Adderall for about 3 months and became totally depressed. Provigil doesn't do this to me.
Be well.

I agree with the spectrum model. In many cases, it's not black and white that you either have something or don't. I think that's why I often say that I have "ADHD-like symptoms" rather than that I have ADHD. I think there is a similar spectrum for hypertension, autism, depression, anxiety, etc. In my heart of hearts I actually do not think I have ADHD. But I have some similar symptoms. And meds are helping them. I was much more willing to take meds for ADHD-like symptoms than I ever was for depression (would not take anti-depressants) or anxiety. Why is that?

I think one of my issues may be a sleep "disorder", and the stimulants really help with that. And with that under control, I can be alert, focus better, get things done, be more organized, etc. I guess in the end, if you are open to taking meds, it doesn't matter what the diagnostic label is. The question is "are you being helped by these meds?"

I am wondering if I was reluctant to take meds for anxiety and depression because I saw them as likely to cause some fundamental change in my personality. I actually like who I am and don't want to change something that helps define me. Recently, when I saw my PNP, she was satisfied with my response to the stimulants and my new functionality. She then asked if I wanted to work on one of my other problems (social anxiety). She was ready to discuss a drug solution for that. I wasn't. I'm OK being shy and having some anxiety in crowds. I am not an outgoing person. I am not the life of the party. Yes, big social gatherings intimidate me and I have trouble going to the cafeteria at work. But I'm OK with that. Part of it is being comfortable in my own skin. I have worked for decades on that, as we all do every day. I am content to be an introvert even if society doesn't value that.

I think it is important to accept that we are all different. I believe there is a REASON for that. We need introvert just as much as we need the charismatic life of the party. Just like in many situations... we need energizer bunnies too.

I don't think I could handle being on a medication that altered my overall personality. I don't think my use of Adderall does that. People don't seem to notice when I am on it or off it. I notice, but I don't think the outside world really does.

I agree. Stimulants (vyvanse in my case) do not alter my personality. But I feel that an anti-depressant might. That's my rationalization, I guess. It's a slippery slope and maybe I'm in denial a bit that I've slid to the bottom. On the other hand, my PNP has told me that stimulants are a highly effective anti-depressant. So who am I kidding?

Thanks for this . I have a work book for adults with ADD that Im working through thats helping me gather behaviors and some history.

I did read where some children had been diagnosised with ADHD , given Ritalin and had seizures. They had epilepsy , absence sesuires , that went undetected.
So that might be a reason to have a brain scan done to rule that out.

It's been an intresting discusion to follow and helpful. Thank you all .

Patricia