I recall reading something about this a long time ago, maybe over 10 years ago, that administering amphetamine as soon as possible(?) after a stroke reduces the number of brain cells that die and improves recovery.
Even back when I first heard of this I assumed that it would translate to at least some other forms of brain injury, and I assumed it had to do with the central nervous system stimulatory effects of amphetamine (increase activity which means increase blood flow).
A quick search on scholar.google.com for the terms amphetamine stroke shows at least a few first page results from the '80s.
Here's one from 1982[1] and 1988[2]
From the second link: Patients treated with amphetamine obtained greater increments in motor scores than the controls.
We ought not discount the possible positive uses of amphetamine and other drugs just because of their bad reputation for recreation use and abuse potential. I suppose.
I've posted here before about helping my girlfriend with her substance abuse problems...
Methamphetamine makes her extremely psychotic for at least 3-5 days. My observation is that Cocaine is a much safer stimulant, as it only makes her "mildly psychotic" until the effects wear off, then she quickly recovers. She's complained to me that cocaine doesn't work anymore, as it doesn't create the euphoria that it used to. Methamphetamine is easier to find, I guess.
My girlfriend is currently being mistreated by "professionals", who have assumed that she's "persistently disabled" because she'd been court-ordered before. They have been completely hostile to treating the underlying causes of their patient's symptoms: alcohol, prescription drugs (anti-psychotics [1] & benzodiazepines), and other substances (stimulants, mainly).
Preliminary evidence found that Progesterone USP also helps people recover from brain injuries. A poorly designed study was hastily implemented, the ineffective method of progesterone administration was found to not help, and the Progesterone USP theory of neuroprotection is not being studied anymore.
as someone who's prescribed amphetamine (i.e. adderall) for [inattentive] ADHD, and have also tried meth-amphetamine, I just want to point out that those are two very different drugs as far as effects and potency go.
Methamphetamine is so strong, I honestly couldn't even tolerate small amounts of the stuff. The few times I've tried it just resulted in dehydration, headaches, and muscle aches, easily outweighing any cognitive effects it had (which weren't even really more noticeable than regular amphetamine's effects for me). Cocaine isn't as bad, but still a bit too much for me as well.
Regular amphetamine on the other hand, the compound this article is about, has given me quite a noticeable improvement in my quality of life. Results do vary even among us adhd people, but for me, I've never experienced anything worse than staying up a bit later than I would like from taking it. Otherwise it just feels like drinking a really strong cup of tea for me, cause even coffee makes me more jittery. So the research in this article doesn't surprise me too much, but it's always nice to have some extra reassurance against all the anti-adhd-medication propaganda that originally made me paranoid about even trying it back when I was first diagnosed.
> I just want to point out that those are two very different drugs as far as effects and potency go.
Eh, you were probably experiencing the effects of improper dosing (as well as - I'm assuming - different means of ingestion).
Methamphetamine is just amphetamine with an additional methyl group, which makes it cross the blood-brain barrier more easily, and means that a lower dosage by weight is necessary for the same outcome.
Methamphetamine is metabolized almost identically to amphetamine, which means that the pharmacokinetic impact is the same.
The main difference is that methamphetamine is generally smoked (or occasionally snorted and injected), whereas amphetamine is prescribed orally. Also, unless you were prescribed Desoxyn, there's the other question of how pure and reliable the methamphetamine is, and what other compounds were present.
> you were probably experiencing the effects of improper dosing (as well as - I'm assuming - different means of ingestion)
For the dosing, you're probably right, since I didn't have a milligram scale at the time, but I tried to eyeball a portion similar to half of an adderall tablet, since the entire reason I tried it in the first place was to make that comparison.
As for the ingestion method, I tried to keep it the same as I would take any other medication and quickly washed it down with water, however it being a powder makes it harder to guarantee none of it was absorbed sublingually, though I've also tried adderall that way, and the effects were still not that intense.
Anyways, I am aware how similar the two compounds, I just tried to highlight the effect differences, since that's usually what gets people up in arms about drugs.
Low recreational doses of dextroamphetamine also give me dehydration, headaches, and muscle aches if I'm not properly hydrated or haven't eaten in a while. So that might've played a role.
Methamphetamine is proven to be more neurotoxic than amphetamine even when accounting for its extra potency, though, so it should ideally only be taken infrequently, in very low doses, or not at all. There are some neuroprotective substances you can take beforehand to mitigate the damage, but it's probably not worth it.
As a general rule in pharmacology: putting a methyl- group on any molecule increases its ability to cross the blood-brain-barrier and have increased psychoactivity (and neurotoxicity):
I was prescribed desoxyn once back in the 90s -- it is methamphetamine, and my body could not handle it.
The Adderall IR tablets however (30mg bid) - i have no problem with tolerating - and would venture to say that my functional life would be difficult without it - I certainly could not be a software engineer and probably would have never even finished my degree.
Why were you prescribed Desoxyn if you're able to function with 30mg of Adderall? That's not at all an unreasonably high dose. Desoxyn is usually only prescribed when the dosage by weight of Adderall would be too high.
I've been prescribed/taking 30mg IR for about a decade now. I don't feel anything after taking it, beyond causally noticing that I'm not causing the problems I do when unmedicated. My doc asked years back if I was interested in taking a 1/day rather than 3/day, but the thought of a single XR dose always seemed like a clock counting down... which doesn't usually jive with my personality type at all. I like the control over the timing; plus, it also enables skipping dose to let my mind go on walks.
Yeah. That's how I feel now that I take XR. I know exactly when I'll become non-functional. Knowing that the clock will hit 0 is distracting and frustrating.
I've tried to get IR, but I think my doctors have assumed I'm just drug-seeking. I'm young and I've only been prescribed for ~1 year.
In my experience, IR builds tolerance way too fast.
I agree that it would be nice to have IR for those times you want shorter bursts. But I ran into its shortcomings too quickly as a daily burner, not so different than trying to therapeutically bump cocaine.
There's also dirt cheap generic IR but there wasn't generic XR back then (still?).
The other part of it was the physician was quite literally, old - and I questioned his ability to practice medicine at that point -- the same guy prescribed methadone to a friend of mine for migraines.
I've never heard of anyone else being prescribed Desoxyn.
That's a high dose, but not unusually or dangerously high (depending on what condition was being treated, since you didn't specify).
I'm surprised that you were able to obtain Desoxyn given that - it's usually tried as a 'last resort' medication, partially because doctors are hesitant to prescribe something that's under even more scrutiny than other Schedule II drugs.
Amphetamine at low (and even increasingly high) doses has also been shown to be neuroprotective. Kind of a wonder drug as far as neurology goes, aside from the addictive and euphoric properties.
Amphetamine is not neuroprotective in a general sense, nor is that what the study shows. The study shows that gradually increasing the dose apparently allows rats to avoid some of the neurotoxicity effects of the amphetamine doses.
Amphetamine is well known to be toxic to rats in high doses, and the study you linked confirms as much. They just identified a dosing scheme which reduced the neurotoxicity through gradual dose increases, perhaps by giving the brains a chance to adapt.
It should not be interpreted to suggest that amphetamine is neuroprotective in general.
IMO the jury on these studies is to be determined. There is evidence of neurotoxicity but at the same time there are studies showing some neuroprotective properties. How about we wait to make claims until after more thorough research has been conducted
Keep in mind you still have the constraint of the Yerkes–Dodson law [0]. Drugs that are neuroprotective at therapeutic doses can easily become neurotoxic at extremely high supratherapeutic doses.
The only exception that comes to mind is memantine, which leads to a clearly disassociative state, but recreational use (again supratherapeutic doses) hasn't been studied thoroughly.
I don't believe amphetamine at therapeutic doses is addictive. You definitely have to ween off of it, because cold turkey means you'll sleep for a week straight. And any trace of euphoria goes away after a few months of daily therapeutic doses. Even if you quit for a week+ and get back on, the euphoria only comes back for, at most, a couple days.
I'd love to see more research about nicotine and schizophrenia. Something like 80% or schizophrenics smoke, and they do so heavily. This is 3 or 4 times the rate of the general population.
The question is: does smoking cause schizophrenia, is it self-medication, or both?
Scott Alexander has an interesting summary [1].
For what it's worth, my schizophrenic brother says smoking makes his mind feel much clearer.
I think mental hospitals should have a strategy to provide nicotine to patients (in the high dose they need) to minimise the harm of the strong cheap rubbish that schizophrenics inhale all day. Maybe e-cigs should be promoted to smoker patients.
There is theorized to be some synergistic effects between tobacco smoking and the antipsychotic medications that people such as your brother often require. IIRC it really isn't known why that is, but it seems relatively well accepted among people who routinely work with schizophrenia.
> There is theorized to be some synergistic effects between tobacco smoking and the antipsychotic medications that people such as your brother often require.
"Antipsychotics" are palliative medications that do not address the cause of the problematic symptoms. They have repeatedly been shown to cause a very poor long-term prognosis for the unfortunate patients who are put on them.
Nicotine is somewhat similar to Vitamin B3 (Niacin), which has been shown to help schizophrenics recover. Niacinamide supplementation helps my girlfriend reduce her tobacco use.
... Here, we propose a model that a subset of
schizophrenia can respond to niacin augmentation therapy
better than other subsets because these patients have
contributions in their psychotic manifestations from the
neural degeneration resulting from niacin deficiency. We
present a short description of our case report which
showed rapid improvement in schizophrenic psychotic
symptoms subsequent to administration of niacin as an
augmentation therapy. We, thus, propose that niacin
deficiency is a contributory factor in schizophrenia
development in some patients and symptom alleviation in
these patients will benefit from niacin augmentation,
especially in some particular psychotic features."
I've read your story submissions and let me first say that I admire your courage and dedication. I hope this comment is useful and not too blunt.
It sounds like you've gained two passions from your experience: (1) finding the right treatment for mental health issues, instead of long-term palliation, and (2) addressing casual abuses of power and ignorance of the law.
My advice to you is to focus on one passion at a time. You can't make progress on both fronts at once.
Regarding (1), there's a word for people who try to go around the medical establishment and run a business selling a cure-all pill. It's "quack", not "hack". Even if you're right you'll have no credibility and make zero difference to psychiatric treatment, mainstream or otherwise.
The credible approach is to write a case report plus literature review and get it published. I suggest the topic of the literature review should be "low-cost, low-risk interventions to assist in diagnosing subtypes of schizophrenia". You can't do this on your own: you'll need a friendly PhD co-author to edit it brutally and guide you through publication.
(By subtype here I mean the different etiologies, which is an emerging area of study, not the traditional grouping by symptoms)
Regarding (2), your focus should be local and specific, and honestly your best bet may be donating or raising money for existing organisations that work in this area.
Thanks for your comments - they are quite helpful.
> Regarding (1), there's a word for people who try to go around the medical establishment and run a business selling a cure-all pill. It's "quack", not "hack".
I manufactured a supplement once, then I realized it was a legal minefield. I have plans to apply for FDA approval for a claim for a device. This would provide legal protection against the status quo, while destroying their harmful business at the same time.
I gave a bottle of my supplement to a young woman who'd just been not-helped at the hospital. I called her a few days later - she said, "THAT STUFF REALLY WORKS!" I called a few months later, and her sister said she was in the state mental hospital. People need more than a supplement to become truly well.
> The credible approach is to write a case report plus literature review and get it published. I suggest the topic of the literature review should be "low-cost, low-risk interventions to assist in diagnosing subtypes of schizophrenia".
"... for the Emergency Room physician." Yeah, I like that idea. I have some ideas of people to work with.
Robert Whitaker has pointed out to the psychiatrists that their "science" is paid for by the industry whose products they use [1]. He hasn't gotten very far in the last 15 years.
I'd just like to echo what tominous said. I'll be honest, and say that your post set off what I'd call my "Crank/Crackpot Detector". By no means is that detector anything approaching perfect, but if I had to describe why it went off, tomimous' post gets right to the heart of it.
To be clear, I don't disagree with your characterization of antipsychotics as being potentially (often) devastating in the long term. When you meet people with drastic manifestations of tardive dyskinesia from their medications for example, that fact becomes exceedingly clear.
The problem is that it becomes equally clear upon careful examination, that the only worse outcome than a lifetime of antipsychotic therapy, is psychosis. Each psychotic break is correlated with increasingly grim outcomes, such as a homelessness, permanent care, and suicide.
I see your argument as very impassioned, but fundamentally in the same vein as people who tell you to avoid chemotherapy because it's bad for you. It's true, chemotherapy is poison, but oftentimes it's the best we have to work with. The problem then, is that recognizing the limitations of current therapies doesn't imply that a better "natural" alternative exists right now.
Hi, thanks for posting and sharing your reaction to what I'd said. I'm going to respond to tominous next, so check for that comment too.
> I'll be honest, and say that your post set off what I'd call my "Crank/Crackpot Detector".
I know, right? It's usually safe to assume that conventional practices are what they are because they're the best we have, at the present time.
> Each psychotic break is correlated with increasingly grim outcomes, such as a homelessness, permanent care, and suicide.
Robert Whitaker proposes that patients did much better before the psychiatrists had drugs to put them on: people had "episodes" from which they frequently recovered. Page 7 of "The Case Against Antipsychotics" [1] begins a discussion of studies of psychotic illnesses in the pre-drug era.
> It's true, chemotherapy is poison, but oftentimes it's the best we have to work with.
Sometimes science takes detours before it rediscovers that which was previously unpopular. This article demonstrates that progressive oncologists are beginning to recognize the errors of their predecessors:
Betel nut and arecoline (one of the primary constituents, similar to nicotine) are ridiculously carcinogenic. Bad idea touching that stuff.
A contract manufacturing lab in the supplement industry tried to bring it into supplements with celebrity athletes promoting it. I did my research and decided it was a BAD idea outside of hardcore /well-researched circles and went on the attack.
I had some legal threats but was in communication with toxicologists over the issue and was ready to take it all the way to court to protect my first Amendment rights. One major retailer then also got toxicologists involved. After much tension, the supplements were removed from the market.
And interestingly, the owners of the company that tried to bring it to market are now facing serious jail time for other things.
Point being?
1. Do not touch that stuff with a ten foot pole.
2. You can make a difference and protect consumers who do not know how to do the research themselves.
Sorry for the offtopic rant. I am a huge fan of stimulants but I do not believe in promoting all of them to everybody and urge you all much caution with them. Especially that Betel nut / arecoline poison.
I remember Dr. Dean Edell said more than a few times, 'nicotine/tobacco has been so vilified in the U.S., we will never know if it has any medicinal value.'
Exactly. It has a ton of valuable, useful characteristics. It's a REALLY good hack for fitness--every day, wear a nicotine patch and go to the gym (at the same time/trigger each day). You RAPIDLY get addicted to fitness.
Nicotine has similar effects to Vitamin B3. Niacinamide (a no-flush B3 supplement) has helped my girlfriend reduce her tobacco intake, when she gets it...
"Uninjured and resilient animals performed worse after the drug, but chronically impaired animals responded with increased accuracy and less impulsivity on the behavioral test."
But, my experience with the broader classification of brain drugs and medical professionals that prescribe them is that "unless it's broke don't ask to fix it, and even then put whatever we tell you into your body and let's see ehat happens."
There are some excellent studies showing modafinil to benefit all doctors when performing while sleep deprived. Modifinil is pretty much as safe and addictive as caffeine. Now, try going into a doctor's office with this info and asking for a script. My experience is that 9 out of 10 times you'll be seen to be displaying addictive behavior.
There are a bunch of drugs that, if properly taken, will do wonders for your mental life. Intunive, selegiline, methylphenidate, to name only a few. But, while it's legal to smoke, drink, watch tv, or eat yourself to death or into depression, acting on your own to take these drugs could land you in jail.
If the US is so gung-ho on personal responsibility, let us take responsibility for our actions then, and let doctors be partners, not parents. In an age where inhanced mental or physical condition make an enormous difference in ones quality of life, stop hamstringing us from taking action so we might better ourselves.
A doctor is generally someone who is trying to maintain your current level of health, or manage any issues with that health which do arise. They're not there to take even minimal risks so that you can improve your working memory, even if that risk is slight. Maybe there should be a new field of doctors who aren't there to keep you healthy, who don't abide by the 'no harm' principle, and who will happily prescribe you anything that hasn't been proven to be dangerous.
It's not reasonable to expect that of doctors in their current position, with their current professional and ethical framework however.
Sports medicine? An entire sub-field of the profession dedicated to improving performace beyond average or baseline.
I think you missed half my point, as well. Doctors do take risks with patient's persons all the time. The risks are often taken with the patient's person over the doctor's credentials. My father is on 3 blood pressure meds and hus doctor refuses to try a new regimine that would only require 1. Wtf. The number of complications that are introduced with 3 medications is absurdly risky, but the doctor won't risk a switch. And this is all covered during a 5 min conversation. People soend more time arguing with mechanics about automobile work.
As a society we praise workaholics for being productive, look up to PhDs for casting off years of relationships and life experiences in order to become an expert, and put athletes on pedestals for pushing their bodies to the limit. And even though for the vast majority of people for whom which increased working memory and attention span would mean better education, better professional results, and thus better pay, healthcare, and better general quality of life, and we just shut down the conversation. No, we are told. You can't. Discussion over. Period.
I say, f-ck that. If that's the nor, I challenge it. If that is because doctors don't want to have the responsibility rest on them, I say lay the responsibility with me.
So ask for a referral to a sports medicine specialist and see how it goes. I'd point out though, that sports medicine is also the field that "protects" athletes so well... so very well.
That said, whether it's a football player shooting cortisone and lidocaine between kickoffs, popping opiates, or just having their concussions ignored for decades... or someone who wants to work themselves to death, the outcome is the same.
Regret and pain later in life, when you mature a bit and realize that your supposed gains were not really worth it.
I pointed to sports medicine specifically as a counter point to your claim that doctors generally prrform only the function of getting one back to normal.
And to say that "when I mature" I might choose differently... One can be mature without being moribund. One can be wise and still be progressive or even radical. Most to your point though, you're still moralizing, suggesting that when I know what you know, I'll finally grant that you were right all the time.
Nothing you mentioned in your previous post spoke to anything like wisdom, just competitiveness. As for moralizing, there isn't a moral dimension to this for you, so I'm not sure where you're getting that from. The bottom line is just that doctors who are in the business of their patients' business don't act in those patients' best interests from a medical standpoint.
If you want to achieve greatness with drugs at the potential expense of your health, that's fine in my opinion, but it's crazy to think that a doctor should help you.
Sigh, exhaustion, your rhetoric is all over the place. I'd need a keyboard. Alas, I've only my smartphone. Butttt, I would suggest you get your learn on, study logic, and reread your comments.
"Freedom" and personal responsibility in America is largely a shibboleth-- an idea to which only empty homage is paid.
In reality the USA is a highly regulated, conformist, and centrally planned society and has been since the days of "manifest destiny." This for those who don't know was the federal push to settle coast to coast and was sort of America's first centrally planned megaproject.
Of course most other nations are at least as much this way if not more so. Just pointing out that America is not really special in this regard.
"Two other drugs, atomoxetine and amantadine, which have been used to treat impulse control disorders in patients, offered no significant benefits." - Ups
I've had ADD and slow executive function all of my life, along with a few other problems.
I was in denial or at least unsure about it for years. I'd had docs diagnose me with ADD, one who tested me extensively who though ADD was overdiagnosed that said I didn't have it, and had tried natural remedies, attempted to self-treat with caffeine- probably 5-12 cans of soda a day or several cups of coffee- and had a few really bad experiences and reactions with the meds that I tried.
Then I finally went to a psychiatrist that had been recommended to me by my doc and an friend of a friend and took GeneSight tests for genetic markers that indicate problems with different types of medications. I found one for ADD that was recommended and was prescribed that. It was Vyvanse which is amphetamine-based. It is lisdexamfetamine which is basically like a time-released dextroamphetamine. It becomes dextroamphetamine when the body cleaves off the lysine.
I took Vyvanse and within an hour, I had a lot more energy and felt like I was "on". I didn't have any trouble focusing and it revved up my executive function so I was not thinking as slowly. I felt like it was going to solve all of my problems. However, even though I felt great and helped with some depression I was having also, I had some negative interactions at work. After getting "called into the office" after one of those, I knew I was going to have to do something else. Away from work, though, it was a great medication to be on, and since it was time-released, so I only had to take one in the morning. I still don't think it's a bad med.
I went back to the psychiatrist. She put me on Evekeo. It contains 50% levoamphetamine salts and 50% dextroamphetamine. On it, I can focus on what I'm doing like what I think a normal person does- or maybe better. I still will hear what others are saying and get distracted, but when I want to, and with help of music, I can really focus on my work. I can even focus more that I think that I could when I was younger and ADD wasn't affecting me as much. I still feel a little slower and am considering taking it and a smaller dose of dextroamphetamine. For me, it's a little like the real-world clear pill from Limitless.
I think eventually what I'd like to be on would be a combination of lisdexamfetamine and levoamphetamine (or a time-released version of it). It's possible that the L-lysine of lisdexamfetamine was also having some positive affects: https://www.drugs.com/npc/lysine.html
The way you talk about it exactly mirrors my experience. I have ADD as well, and I take Adderal-XR. Without it I'm scattered, "double back" on my thoughts a lot, can't focus, and generally have no motivation.
With it I'm a different person. I can focus, I can finish a thought process, I'm motivated, things become clear. I can actually "keep up" with others in "normal life", and it makes me a great programmer.
It really does feel like the magic pill from limitless.
Now, I tried alternatives when I was younger, and none really worked that well. Vyvanse put me to sleep, concerta (sp?) Didn't work at all. adderal-xr worked, but the "come down" sucks, it ruins my appetite, and its almost impossible to get around here (every place never has it).
I'm afraid to start trying others as I feel entirely useless without my medicine, and I know that because of the legal issues around these drugs, trying one out but keeping my backup of my old medicine is not going to fly. So I just deal with it.
> Vyvanse put me to sleep, adderal-xr worked, but the "come down" sucks
Adderall does have a bad come down. Often depressive even on low XR doses.
Vyvanse is still amphetamine, so if it put you to sleep, are you sure you took enough?
20mg Adderall XR is about equivalent to 50mg Vyvanse, which is what I take.
Everyone I know switched from Adderall to Vyvanse and we all report the same thing -- much more gradual curve throughout the day and far less depressive on the come down. I'd consider Adderall XR to be a real tweak compared to Vyvanse and far less therapeutic for a day-to-day drug.
I may be mixing them up, I was around 15 when I last "experimented" with the different drugs.
I might talk to my doctor about my options next time I'm in there. The comedown doesnt bother me all that much, but I think it is starting to bother my wife as I can get a bit "cranky".
Even back when I first heard of this I assumed that it would translate to at least some other forms of brain injury, and I assumed it had to do with the central nervous system stimulatory effects of amphetamine (increase activity which means increase blood flow).
A quick search on scholar.google.com for the terms amphetamine stroke shows at least a few first page results from the '80s.
Here's one from 1982[1] and 1988[2]
From the second link: Patients treated with amphetamine obtained greater increments in motor scores than the controls.
We ought not discount the possible positive uses of amphetamine and other drugs just because of their bad reputation for recreation use and abuse potential. I suppose.
1. http://science.sciencemag.org/content/217/4562/855
2. http://onlinelibrary.wiley.com/doi/10.1002/ana.410230117/ful...