Andrew Huberman: Adderall, Stimulants and Modafinil for ADHD: Short- and Long-Term Effects (Huberman Lab Podcast)

The video is about the effects of stimulants, such as Adderall, Ritalin, and Vyvanse, on attention deficit hyperactivity disorder (ADHD). The speaker, Andrew Huberman, discusses the science behind these drugs and how they work to improve the symptoms of ADHD. He also addresses common questions about these compounds, such as their addictive potential and their impact on sleep, health, and reproductive health. The speaker emphasizes that this podcast is separate from his teaching and research roles at Stanford and is part of his effort to provide zero-cost consumer information about science and science-based tools to the general public.

This video by Andrew Huberman was published on May 29, 2023.
Video length: 02:02:12.

The video is about the use of stimulants and non-stimulant prescription drugs for the treatment of ADHD.

The speaker, Andrew Huberman, discusses the science behind these compounds and their effects on the brain and behavior. He covers common questions about these drugs, such as their addictive potential and their impact on sleep, hormones, and reproductive health. Huberman also addresses the issue of people using these drugs without a prescription, including the dangers of fentanyl contamination in the black market.

The video is part of Huberman's effort to provide zero-cost consumer information about science and science-based tools to the general public.

• The Huberman Lab podcast discusses science and science-based tools for everyday life
• Hosted by Andrew Huberman, a professor of neurobiology and ophthalmology at Stanford School of Medicine
• Today's discussion focuses on stimulants for the treatment of ADHD
• Stimulants such as Adderall, Ritalin, and Vyvanse are commonly used to treat ADHD
• Non-stimulant prescription drugs like modafinil and guanfacine are also used to treat ADHD
• Stimulants work by increasing the levels of dopamine and norepinephrine in the brain
• These neurotransmitters are responsible for feelings of alertness and focus
• Stimulants also increase the levels of serotonin in the brain, which can help regulate mood and appetite
• Stimulants can interfere with sleep, leading to insomnia and other sleep disorders

Adderall, Stimulants & Modafinil for ADHD: Short- & Long-Term Effects | Huberman Lab Podcast - YouTube

Introduction

• Welcome to the Huberman Lab podcast
• Discussing science and science-based tools for everyday life
• Hosted by Andrew Huberman, a professor of neurobiology and ophthalmology at Stanford School of Medicine
• Today's discussion focuses on stimulants for the treatment of ADHD

Stimulants for ADHD

• Stimulants such as Adderall, Ritalin, and Vyvanse are commonly used to treat ADHD
• Non-stimulant prescription drugs like modafinil and guanfacine are also used to treat ADHD
• These compounds work by improving the symptoms of ADHD
• Common questions about these compounds will be addressed, such as their addictive potential and their impact on sleep, health, and reproductive health

Addictive Potential

• Stimulants like Adderall, Ritalin, and Vyvanse are not addictive
• They are not similar to meth or Methamphetamine
• However, some surveys reveal that as high as 80% of college-age young adults have used prescription drugs like Adderall, Ritalin, Vyvanse, or similar at some point without a prescription
• These drugs are either obtained from those who have prescriptions for them for ADHD or obtained through Black Market sources

Adderall, Stimulants & Modafinil for ADHD: Short- & Long-Term Effects | Huberman Lab Podcast - YouTube

Fentanyl Crisis

• Many black market drugs today are contaminated with fentanyl
• Fentanyl is a very deadly drug
• It is important to be aware of the dangers of using prescription drugs without a prescription or obtaining them through Black Market sources

How Stimulants Work

• Stimulants like Adderall, Ritalin, and Vyvanse work by increasing the levels of dopamine and norepinephrine in the brain
• These neurotransmitters are responsible for feelings of alertness and focus
• Stimulants also increase the levels of serotonin in the brain, which can help regulate mood and appetite

Impact on Sleep, Health, and Reproductive Health

• Stimulants can interfere with sleep, leading to insomnia and other sleep disorders
• Long-term use of stimulants can lead to cardiovascular problems and other health issues
• There is some evidence to suggest that stimulants may have an impact on reproductive health, but more research is needed

Section 1: Introduction

• The video is about the effects of stimulants, such as Adderall, Ritalin, and Vyvanse, on attention deficit hyperactivity disorder (ADHD).
• The speaker, Andrew Huberman, discusses the science behind these drugs and how they work to improve the symptoms of ADHD.
• He addresses common questions about these compounds, such as their addictive potential and their impact on sleep, health, and reproductive health.
• The speaker emphasizes that this podcast is separate from his teaching and research roles at Stanford and is part of his effort to provide zero-cost consumer information about science and science-based tools to the general public.

Section 2: Stimulants for ADHD

• Stimulants, such as Adderall, Ritalin, and Vyvanse, are commonly used to treat ADHD.
• These drugs work by increasing the levels of dopamine and norepinephrine in the brain, which can improve focus and attention.
• The effects of stimulants can vary depending on the individual and the specific drug used.
• Stimulants can be taken orally or as a nasal spray.

Section 3: Short-Term Effects of Stimulants

• Stimulants can provide immediate relief from ADHD symptoms, such as increased focus and attention.
• The effects of stimulants can last for several hours, depending on the individual and the specific drug used.
• Stimulants can also improve mood and energy levels.
• However, the effects of stimulants can also lead to side effects, such as insomnia and anxiety.

Section 4: Long-Term Effects of Stimulants

• Long-term use of stimulants can lead to tolerance, which means that the body becomes used to the drug and the effects become less pronounced over time.
• Stimulants can also lead to dependence, which means that the body becomes reliant on the drug and experiences withdrawal symptoms when it is not available.
• There is some evidence to suggest that long-term use of stimulants can lead to changes in the brain, such as reduced gray matter density.
• It is important to note that the long-term effects of stimulants can vary depending on the individual and the specific drug used.

The Prefrontal Cortex and ADHD

• The prefrontal cortex is not necessarily deficient in any specific way in people with ADHD, but it is not as good at orchestrating the activity of other brain networks operating in parallel with it.
• The prefrontal cortex has the ability to quiet other brain areas through top-down inhibition, allowing for focused attention and suppression of distractions.
• The prefrontal cortex also coordinates with other brain networks involved in generating salience or attention to particular signals, allowing for selective focus on relevant information.
• The prefrontal cortex can point to specific brain structures and say "I'd like to hear more from you right now," enhancing the salience of other neural circuits involved in creating our Spotlight of attention.
• ADHD is not necessarily a deficit in prefrontal cortical function, but rather the prefrontal cortex's ability to communicate with other brain areas in the proper ways.

The Default Mode Network and ADHD

• The default mode network (DMN) is a brain network that is active when we just sit in place and don't think about much, and tends to be very autobiographical.
• The DMN is involved in our imagination and the spooling together of different experiences we've had, but is not necessarily focused on anything external in particular.
• When we start to attend to something externally, such as a conversation or something written on a page, the activity of the DMN is suppressed somewhat due to the prefrontal cortex's active suppression.
• In people with ADHD, the DMN is often still active at a robust level even while trying to attend to things, causing internal distractions and making it difficult to focus on external tasks.
• Other networks in the brain, such as the true salience network and the dorsal attention network, also play a role in attention and focus, but the prefrontal cortex's ability to actively suppress and enhance the activity of these multiple brain networks is central to ADHD.

Section 1: Introduction

• The speaker is Andrew Huberman, discussing the effects of stimulants on attention deficit hyperactivity disorder (ADHD).
• The speaker discusses the science behind these drugs and how they work to improve the symptoms of ADHD.
• The speaker addresses common questions about these compounds, such as their addictive potential and their impact on sleep, health, and reproductive health.
• The speaker emphasizes that this podcast is separate from his teaching and research roles at Stanford and is part of his effort to provide zero-cost consumer information about science and science-based tools to the general public.

Section 2: How Stimulants Work

• Stimulants, such as Adderall, Ritalin, and Vyvanse, improve the symptoms of ADHD by increasing the activity of the prefrontal cortex.
• The prefrontal cortex is responsible for coordinating the actions of other circuits in the brain, and stimulants help it to be a better conductor.
• The prefrontal cortex needs to be flexible and able to pay attention to different things, and stimulants help it to do this more efficiently.
• The prefrontal cortex is an important part of the adaptive life, and stimulants help it to be more effective at self-directing attention.

Section 3: Stimulants and ADHD

• Stimulants, such as Adderall, Ritalin, and Vyvanse, are used to treat ADHD because they increase the activity of the prefrontal cortex.
• The prefrontal cortex is responsible for coordinating the actions of other circuits in the brain, and stimulants help it to be a better conductor.
• The prefrontal cortex needs to be flexible and able to pay attention to different things, and stimulants help it to do this more efficiently.
• The prefrontal cortex is an important part of the adaptive life, and stimulants help it to be more effective at self-directing attention.

Section 4: Common Questions About Stimulants

• Stimulants, such as Adderall, Ritalin, and Vyvanse, are not addictive when used as directed.
• Stimulants can be used briefly or from time to time, but it is important to understand the potential risks associated with these drugs.
• Stimulants can be used to teach the prefrontal cortex of a young child to be a better conductor.
• The use of stimulants in children should be carefully considered and monitored by a healthcare professional.

Sympathomimetics and Stimulants

• Sympathomimetics are drugs that mimic the effects of the sympathetic nervous system.
• Stimulants are a subcategory of sympathomimetics that increase the activity of the sympathetic nervous system.
• Methamphetamine is the most potent sympathomimetic that is not commonly prescribed for ADHD.
• Adderall and Vyvanse are commonly prescribed for ADHD and are similar to methamphetamine in their pattern of action.

Adderall

• Adderall is a combination of amphetamine salts, which are two major forms of amphetamine: D and L amphetamine.
• D amphetamine is potent and increases certain neurochemicals in the brain, while L amphetamine tends to be less potent and has peripheral effects.
• The major effect of Adderall is to increase the transmission of dopamine and norepinephrine, which are neuromodulators that increase or decrease the firing patterns of brain circuits.
• Dopamine is released at sites within the brain and increases the activity of brain networks that lead to increases in motivation, pursuit, and mood.

The Role of Dopamine and Norepinephrine in ADHD

• Dopamine and norepinephrine are neurotransmitters that work together to increase motivation, focus, and alertness.
• They are released in the same sites where ADHD drugs are effective, and their main function is to increase the activity of neural networks involved in attention and focus.
• Dopamine and norepinephrine are neurochemically similar and can be converted into each other with one chemical conversion.
• Sympathomimetics, such as Adderall, increase dopamine and norepinephrine by affecting specific operations at the synapse.

The Mechanism of Sympathomimetics

• Sympathomimetics, such as Adderall, act by inhibiting or disrupting the activity of transporters in the presynaptic terminal.
• This allows more dopamine and norepinephrine to stick around and bind to receptors on the postsynaptic cell.
• Adderall also disrupts the activity of a different piece of machinery in the presynaptic neuron called a vmat, which packages dopamine and norepinephrine into vesicles.
• This buildup of dopamine and norepinephrine in the presynaptic terminal increases the amount of dopamine and norepinephrine released when an electrical signal travels down the neuron.

The Effects of Sympathomimetics on ADHD

• Sympathomimetics, such as Adderall, increase the amount of dopamine and norepinephrine present in synapses, allowing them to act on other neurons.
• This increase in dopamine and norepinephrine leads to improved attention, focus, and alertness.
• Sympathomimetics also increase motivation, which can be beneficial for individuals with ADHD.
• The effects of sympathomimetics on ADHD are short-term, and their long-term effects are not well understood.

Additional Information

• Sympathomimetics, such as Adderall, can be addictive and may have negative effects on sleep, health, and reproductive health.
• It is important to note that this podcast is separate from the speaker's teaching and research roles at Stanford.
• The speaker emphasizes that this information is provided for educational purposes only and should not be used as medical advice.

Adderall and its Effects on ADHD

• Adderall is a sympathomimetic drug that can increase dopamine levels in the brain, making it an effective treatment for ADHD.
• It also increases noradrenergic release and transmission in the synapse, which can improve focus and productivity.
• The major effects of Adderall that have made it attractive to many people are its ability to increase dopamine levels and improve focus and productivity.
• Adderall is not as effective at increasing noradrenergic release and transmission as other treatments for ADHD.
• It is important to note that most of the effect of Adderall is due to its ability to increase dopamine levels, rather than noradrenergic release.

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Levo-Amphetamine and Adderall

• Levo-amphetamine is present in Adderall but at one quarter the amount of D-amphetamine.
• There is a little bit of L-amphetamine and a lot of D-amphetamine in Adderall.
• Many of you are probably familiar with Vivance, which is a commercial name for what many people think is extended release Adderall.
• Vivance is not extended release Adderall, it is a drug in which the pharmaceutical industry has taken one component of Adderall, just the D-amphetamine component, and attached to it an amino acid called lysine.
• The amino acid lysine is a big amino acid and the attaching of Lysine to D-amphetamine makes it what's called a pro-drug.

Vivance and its Effects

• Vivance is a drug in which the pharmaceutical industry has taken one component of Adderall, just the D-amphetamine component, and attached to it an amino acid called lysine.
• It is called a pro-drug because it can't have any effect on its own but when one takes Vivance and it's broken down in the gut, the lysines are cleaved off slowly over time.
• Vivance is basically timed release D-amphetamine.
• It is important to note that I think a lot of people think V

  The Science Behind Stimulants for ADHD

  • Stimulants, such as Adderall, Ritalin, and Vyvanse, are commonly used to treat attention deficit hyperactivity disorder (ADHD).
  • The effects of stimulants can extend over anywhere from 12 to 16 hours, depending on how quickly someone metabolizes it.
  • There is no way to predict how quickly one will metabolize any of these drugs except by trying them.
  • Adderall is really two drugs: DNL (amphetamine) and D amphetamine (also called dexedrine), which is created by lumping a lysine on it.
  • Ritalin, also known as Concerta, is a stimulant used to treat ADHD. It works in a lot of ways that are similar to the way that Adderall and Vyvanse work, but it is not as potent an inhibitor of the noradrenergic transporter.

  The Effects of Stimulants on ADHD

  • The effects of stimulants can extend over anywhere from 12 to 16 hours, depending on how quickly someone metabolizes it.
  • Adderall is really two drugs: DNL (amphetamine) and D amphetamine (also called dexedrine), which is created by lumping a lysine on it.
  • Ritalin, also known as Concerta, is a stimulant used to treat ADHD. It works in a lot of ways that are similar to the way that Adderall and Vyvanse work, but it is not as potent an inhibitor of the noradrenergic transporter.

  The Addictive Potential of Stimulants

  • There is no way to predict how quickly one will metabolize any of these drugs except by trying them.

  The Impact of Stimulants on Health and Reproductive Health

  • The effects of stimulants can extend over anywhere from 12 to 16 hours, depending on how quickly someone metabolizes it.

  The Science Behind Stimulants for ADHD

  • Stimulants, such as Adderall, Ritalin, and Vyvanse, are commonly used to treat attention deficit hyperactivity disorder (ADHD).
  • These drugs work by increasing the levels of dopamine and norepinephrine in the brain, which are neurotransmitters involved in attention and focus.
  • Dopamine is the primary neurotransmitter affected by these drugs, and it is responsible for noise reduction in the brain.
  • Norepinephrine is also affected by these drugs and is responsible for boosting signals at synapses to increase communication between neurons.
  • The increase in dopamine and norepinephrine leads to a reduction in noise and a quieting of the circuitry in the brain, which improves attention and focus.

  The Impact of Stimulants on Executive Function

  • Stimulants, such as Adderall, Ritalin, and Vyvanse, differentially impact the various aspects of executive function of the prefrontal cortex.
  • Increasing dopamine at particular synapses and networks in the brain can serve as noise reduction, which helps further enhance the quieting of all that background stuff that can be attention to things in your environment like noises or visual cues.
  • Dopamine also impacts interoception, which is the ability to attend to things outside of us, such as exteroception, as well as an ability to attend to things inside of us, such as thoughts and internal bodily states.
  • Norepinephrine is released from multiple sites in the brain and body, but within the brain, there's one major site of neurons that manufacture norepinephrine, called Locus ceruleus.
  • Locus ceruleus is a relatively small collection of neurons that extend their little axons to multiple locations in the brain and release norepinephrine at those locations, which boosts signals at synapses to increase the amplitude and frequency of communication between neurons.

  The Role of Stimulants in Focus and Learning

  • The practice of focus and learning often involves suppressing the fact that our foot is a little bit cramped or that we might need to use the restroom for a few minutes, even though it might be fairly urgent.
  • Dopamine, one of the main functions in the context of all this prefrontal cortex and attention stuff, is to quiet the amount of noise that is it helps the prefrontal cortex suppress the signals that would otherwise distract us into thinking about oh yeah I'm kind of thirsty right now or I need to use the restroom or I really want to make this caller I really really want to pick up my phone all of that stuff all of that is central to our ability to attend and focus.
  • Suppression of background chatter related to things external and internal to us in our head and our body is greatly facilitated by having more dopamine present in the synapses that allow for what we call noise reduction.
  • Norepinephrine is also released from multiple sites in the brain and body, but within the brain, there's one major site of neurons that manufacture norepinephrine, called Locus ceruleus.
  • Locus ceruleus is a relatively small collection of neurons that extend their little axons to multiple locations in the brain and release norepinephrine at those locations, which boosts signals at synapses to increase the amplitude and frequency of communication between neurons.

  The Impact of Stimulants on Sleep, Health, and Reproductive Health

  • The long-term effects of stimulants on sleep, health, and reproductive health are not well understood.
  • Some studies suggest that long-term use of stimulants may lead to sleep disturbances, weight loss, and cardiovascular problems.
  • There is also some evidence to suggest that long-term use of stimulants may affect reproductive health, but more research is needed to confirm these findings.
  • It is important to note that the addictive potential of stimulants is a concern, and individuals should be monitored closely when using these drugs.
  • It is also important to note that stimulants should not be used as a substitute for other treatments for ADHD, and individuals should consult with a healthcare professional before starting any new medication.

  The Effects of Stimulants on ADHD

  • Stimulants, such as Adderall, Ritalin, and Vyvanse, can increase dopamine and norepinephrine levels in the brain.
  • This can reduce the amount of noise in the brain and increase the amount of signal related to things that we want to attend to.
  • The net effect of this is a heightened subjective sense of ability to decide what we want to focus on and sit or stand and just focus on it.
  • However, the appropriate dosage, sensitivity, and stage of development of a person can affect the effects of these drugs.
  • If dopamine is increased too much, it can lead to euphoria, mania, and even psychosis. Similarly, if norepinephrine is increased too much, it can lead to anxiety, panic attacks, and peripheral symptoms like elevated heart rate and sweating.

  Why Stimulants Calm a Kid Down

  • Not everyone with ADHD has impulsivity and hyperactivity, and some may have challenges with focus alone.
  • Children and adults with ADHD may have a harder time getting into a forced state of focus for things they don't enjoy doing.
  • Kids and adults with ADHD exhibit an extreme variation in their ability to focus, depending on the activity.
  • The point is that these brain networks and neuromodulators like dopamine and norepinephrine that we've been talking about in fairly straightforward terms as it relates to a drug's ability to increase their transmission and therefore an improved ability of focus presumes two things.
  • The dosing is right, meaning that the levels of increases in these neuromodulators is just right.

  The Complexity of ADHD

  • ADHD is not an inability to focus at all, but immense challenges in focusing on lots of different things as required for normal life progression.
  • There is no one specific pattern of ADHD that applies to everyone with ADHD.
  • Some people with ADHD will exhibit hyperactivity but not impulsivity, while others will have a challenge in focus without hyperactivity or impulsivity.
  • There are more drugs to treat ADHD than any other psychiatric condition.
  • Among those drugs, Adderall, Vyvanse, Ritalin (also called methylphenidate), and State are commonly used to treat ADHD.

  Section 1: Different Variations of ADHD Medications

  • There are different variations of ADHD medications, including straight dexedrine, which is prescribed for ADHD in some cases.
  • These drugs are stimulants or sympathomimetics, which are more effective at treating ADHD than any other collection of drugs for treating other psychiatric disorders.
  • The large kit of drugs that's out there is designed to be assessed with the careful consult of a very qualified psychiatrist in order to allow the child or adult to arrive at the specific drug and the specific dosage that's ideal for their particular pattern of ADHD.

  Section 2: Why Giving Stimulants to a Hyperactive Child Calms Them Down

  • The hyperactivity, impulsivity, and focus issues present in ADHD in children and adults are the consequence of the brains of children and adults with ADHD having all of these networks functioning but those networks are actually hyperconnected.
  • The brains of children and adults with ADHD have all of these networks functioning, but those networks are actually hyperconnected.
  • The answer to why giving stimulants to a kid that is hyperactive would calm them down is that the hyperactivity, impulsivity, and focus issues present in ADHD in children and adults are the consequence of the brains of children and adults with ADHD having all of these networks functioning but those networks are actually hyperconnected.
  • It's easy to get the impression that ADHD is just a deficiency in dopamine or deficiency in norepinephrine, but that's not the case.

  Section 3: How Stimulants Work to Treat ADHD

  • The way these drugs work when they are used effectively to treat ADHD is to tune the amount of dopamine and norepinephrine that are present in particular brain networks in order to allow the person to arrive at just the right balance between the activation of these different neural circuits causing them largely to be less synchronous in their firing.
  • These drugs increase levels of overall autonomic arousal, but more importantly, they activate the prefrontal cortex in a way that allows it to be more of a coordinator of that Orchestra conductor or if you prefer the analogy to a teacher in the classroom to ramp up the activity of certain neural circuits in a given moment and quiet down the activity of other neural circuits such that the default mode Network can still perform its incredible actions after all the default mode network is involved not just in self-referencing and kind of daydreaming but also creativity and Imagination.
  • The goal of prescribing these drugs to a child or adult with ADHD is to adjust dosage, timing, and the duration over which somebody takes it in their lifespan in order to allow those neural circuits to work in the proper way.

  Section 4: Other Key Aspects of ADHD Medications

  • Dopamine and norepinephrine are all allowing these networks to be activated to the precisely correct levels and in the precisely correct sequence.
  • Other key aspects of drugs like Adderall, Vyvanse, Ritalin, and similar to tree ADHD have everything to do with these neuromodulators dopamine and norepinephrine.

  Neuroplasticity

  • Neuroplasticity is the brain and nervous system's ability to change in response to experience.
  • There are many ways to induce neuroplasticity, but most involve strongly activating certain brain networks and elevated release of certain neuromodulators.
  • Dopamine and norepinephrine are two of many neuromodulators that do different things in the brain.
  • Any dramatic elevation in dopamine and norepinephrine relative to baseline has a tendency to promote neuroplasticity at particular synapses.
  • Neuromodulators are different than neurotransmitters. Neuromodulators modulate the activity of neurotransmitters, causing a given amount of neurotransmitter to have an even greater effect.

  Sympathomimetic Stimulants

  • Sympathomimetic stimulants, such as Adderall, Ritalin, and Vyvanse, are used to treat ADHD by reducing noise and increasing signal in brain networks.
  • These drugs work by strongly activating certain brain networks and elevating the release of certain neuromodulators, such as dopamine and norepinephrine.
  • Dopamine is broadly involved in motivation, craving, and pursuit, while norepinephrine is involved in signal detection and drawing of focus or salience to something in our environment.
  • When dopamine and norepinephrine are increased, there is a higher probability of strengthening connections where these neurotransmitters are released.
  • The original purpose of prescribing sympathomimetic stimulants to children with ADHD during development was to help them focus and reduce their hyperactivity, while also promoting neuroplasticity in the brain networks responsible for focus.

  General Answers

  • Parents should consult a qualified psychiatrist before putting their kids on ADHD medications.
  • Whether or not a child should stay on these drugs over time depends on their individual needs and circumstances.
  • Increasing dopamine and norepinephrine with these drugs can provide some general answers as to whether or not parents should put their kids on these compounds in the first place.
  • It's important to remember that when dopamine and norepinephrine are increased, there is a higher probability of strengthening connections where these neurotransmitters are released.
  • Parents should not medicate their kids unless they have to, and kids should not be medicated unless they absolutely need to be.

  Section 1: Effects of ADHD Treatment on Performance

  • Children with ADHD who are treated with appropriate doses of drugs like Adderall, Ritalin, or Vyvanse are far better in childhood and later in life when it comes to performance in school, performance in terms of focusing on anything, and in terms of general outcomes.
  • Treatment with these drugs can improve the symptoms of ADHD, leading to better academic performance and overall outcomes.
  • Studies have shown that children with ADHD who are not treated correctly with drugs and behavioral treatments have a higher tendency towards illicit drug use and addictive potential in their adulthood.
  • There is a real danger to not treating ADHD during childhood, and the reverse is also true.

  Section 2: Effects of ADHD Treatment on Brain Development

  • Early treatment with these drugs can lead to increased dopamine transmission in the forebrain later in life at a lower level or a lower threshold.
  • This normalization of the circuits across time by the application of these drugs early in life can have a positive effect on brain development.
  • Neuroimaging studies, such as positron emission tomography (PET) studies, have shown these effects.

  Section 3: Importance of Accurate Diagnosis

  • Getting an accurate diagnosis of ADHD is critical for effective treatment.
  • Diagnostic criteria for ADHD in children include multiple criteria for each of the categories relating to impulsivity, hyperactivity, and other symptoms.
  • A well-qualified psychiatrist will do a careful diagnostic evaluation of a child and prescribe both appropriate pharmacologic treatments for ADHD and other types of prescriptions, such as behavioral prescriptions, nutritional guidelines, and supplementation.

  Section 4: Sponsorship and Personalized Nutrition

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  Section 1: Introduction

  • The speaker is Andrew Huberman, who discusses the effects of stimulants on attention deficit hyperactivity disorder (ADHD).
  • The speaker emphasizes that this podcast is separate from his teaching and research roles at Stanford and is part of his effort to provide zero-cost consumer information about science and science-based tools to the general public.
  • The speaker mentions that he will be discussing the science behind these drugs and how they work to improve the symptoms of ADHD.
  • The speaker addresses common questions about these compounds, such as their addictive potential and their impact on sleep, health, and reproductive health.

  Section 2: Effects of Stimulants on ADHD

  • The speaker explains that the use of stimulants to treat ADHD is designed to accomplish two things: improve the function of those neural circuits that allow a child to focus and increase the strength of those circuits to effectively teach the circuits how to learn what focus is.
  • The speaker mentions that these drugs are designed in some cases to be used and then withdrawn later because the circuits that they help build up are functioning well.
  • The speaker explains that the circuits that underlie focus are not going to be able to function at the level required for normal, healthy life progression unless there's continued application of the drug.
  • The speaker mentions that the circuits that are related to all the things we call focus involve different cognitive operations depending on what we're focusing on.

  Section 3: Tapering Off Stimulants

  • The speaker mentions that any child or adolescent or person younger than 25 who has taken these drugs has no doubt achieved some level of neuroplasticity of the neural circuits related to all the things we call focus.
  • The speaker mentions that there is a withdrawal potential of simply stopping these drugs very quickly because they do ramp up dopamine and norepinephrine.
  • The speaker mentions that reductions in dosage over time are often optimal for a patient.
  • The speaker mentions that reductions in dosage over time should be done in close communication with a board-certified psychiatrist.

  Section 4: Dosage and Individual Basis

  • The speaker mentions that dosage ranges for stimulants vary widely and depend on the individual.
  • The speaker mentions that the dosage of stimulants should be worked out on an individual basis.
  • The speaker mentions that the dosage of stimulants should not be dictated by what he says.
  • The speaker mentions that the dosage of stimulants should be determined by a board-certified psychiatrist.

  Section 1: Vyvanse and Adderall

  • Vyvanse is a stimulant used to treat ADHD, typically in the hundreds of milligram ranges.
  • 100 milligrams of Vyvanse is not the same as the same amount of Adderall.
  • It is difficult to predict how a child or adult will react to a given dosage of these drugs.
  • One patient achieved tremendous relief from just 2.5 milligrams of Adderall per day.
  • Two sisters, genetically related and in the 120-140 pound range, did not respond well to ADHD medication until their dosages were very high.

  Section 2: Adderall Dosages

  • Neither of the two sisters responded to ADHD medication until they achieved dosages in the range of 180-240 milligrams per day.
  • Such high dosages can cause cardiac arrest or send someone into an absolute psychotic fit.
  • A good psychiatrist will always assess dosage as it relates to positive benefits.
  • Side effects and uncomfortable adverse effects should also be considered when assessing dosage.
  • There is no simple blood test or saliva test to predict how someone will respond to these drugs.

  Section 3: Genetic Differences

  • The major underlying factor for why people require such vastly different dosages of these sympathomimetics for the relief of ADHD is due to genetic differences.
  • Different enzymes or levels of enzymes that people make can affect how these drugs are metabolized in the brain and body.
  • There is no simple blood test or saliva test to predict how someone will respond to these drugs.
  • The most logical and safe way to assess dosage is to start with the lowest possible effective dose and increase only as necessary.
  • It is important to pay attention to any side effects that might arise when increasing dosage.

  Section 4: Long-Term Effects

  • It is a logical question to ask whether or not drugs like Adderall, Ritalin, and Vyvanse can negatively impact height or growth or development in some other way.
  • Chronically elevating stress over long periods of time can reduce the effectiveness of our immune system and cause certain forms of brain degeneration.
  • There aren't a lot of longitudinal studies on the heights of kids with ADHD who are treated with these drugs.
  • It does not appear that treatment with sympathomimetics during development, provided that dosages are kept in the appropriate ranges, is going to limit overall height.
  • Children with ADHD who are treated with ADHD meds actually arrive at slightly higher BMI body mass indexes compared to those without ADHD meds.

  The Effects of ADHD Meds on Body Mass Index

  • Body mass index (BMI) does not necessarily correlate with height.
  • Someone could be heavier due to bone, fat, or muscle growth.
  • Appropriate use of ADHD meds during development does not stunt development in any overall way.
  • Long-term elevations of sympathetic nervous system activity carry some risk.
  • Cardiovascular risk is one of the primary risks associated with sympathomimetics.

  Cardiovascular Risk and ADHD Meds

  • Increasing sympathetic nervous system activity can lead to increased blood pressure and heart rate.
  • In some cases, peripheral sweating may also occur.
  • One major study found a subtle increase in cardiovascular risk with ADHD meds.
  • The results did not point to anything so dramatic that the authors warned against taking these drugs.
  • Arriving at minimal effective dosage is important to reduce cardiovascular risk.

  Improving Cardiovascular Health with ADHD Meds

  • Avoiding smoking or vaping nicotine can improve cardiovascular health.
  • Regular exercise is encouraged to improve cardiovascular health.
  • Alcohol consumption should be avoided, especially in children and adults.
  • Combining alcohol with sympathomimetics can be detrimental to the brain and body.
  • Benzodiazepines and similar medications should be avoided unless prescribed by a physician.

  Combining ADHD Meds with Alcohol

  • Alcohol consumption can be detrimental to the brain and body when combined with sympathomimetics.
  • Combining alcohol with sympathomimetics can increase the risk of cancer, neuron loss, and degeneration.
  • The sympathomimetics drive up sympathetic nervous system activity, while alcohol depresses it.
  • Combining alcohol with sympathomimetics can be more detrimental to the brain and body than simply taking those drugs on their own.
  • It is important to avoid drinking alcohol at any time when taking ADHD meds or any other reason.

  Combining ADHD Meds with Benzodiazepines

  • Benzodiazepines and similar medications should be avoided unless prescribed by a physician.
  • It is important to avoid combining ADHD meds with benzodiazepines or similar medications.

  The Effects of Stimulants on ADHD

  • Stimulants, such as Adderall, Ritalin, and Vyvanse, are commonly used to treat ADHD.
  • These drugs work by increasing levels of cortisol, a stress hormone that plays important roles in the body.
  • Cortisol is released early in the day to improve focus and alertness, but if it is released too late in the day, it can disrupt sleep and other hormones.
  • The time course of action of these drugs varies, with Ritalin being short-lived and Vyvanse being long-lasting.
  • Different drugs have different sensitivities to the body, leading to vastly different requirements for dosage and timing of intake.

  Hormones and Sexual Health

  • Cortisol is a hormone that can act as a neurotransmitter in the brain and body.
  • It can enhance levels of focus and alertness, activate the immune system, and amplify or mobilize the release of anti-inflammatory molecules.
  • Cortisol is involved in setting mood and has interactions with thyroid hormone pathways.
  • Elevations in cortisol late in the day are a strong correlate of depressive symptoms.
  • It is important to limit levels of overall alertness and stress late in the day to avoid disrupting other hormones in the endocrine system.

  Different Drugs and Their Effects

  • Ritalin is a short-acting drug that can be taken in the morning and still get to sleep at night or taken throughout the day and maybe even again in the evening depending on the person.
  • Vyvanse is a long-duration release of amphetamine that can inhibit sleep and make it difficult to fall asleep at night.
  • Adderall has a somewhat intermediate time course of action between Ritalin and Vyvanse.
  • Some people may take as little as 2.5 milligrams of Adderall at 6:00 am and have a hard time falling asleep later that night at 11:00 pm.
  • Different drugs have different sensitivities to the body, leading to vastly different requirements for dosage and timing of intake.

  Conclusion

  • The effects of stimulants on ADHD vary depending on the drug and the individual's body.
  • It is important to work with a psychiatrist or child's psychiatrist to determine the best drug and dosage for each person.
  • Cortisol plays important roles in the body and can affect sleep and other hormones.
  • It is important to limit levels of overall alertness and stress late in the day to avoid disrupting other hormones in the endocrine system.
  • Different drugs have different sensitivities to the body, leading to vastly different requirements for dosage and timing of intake.

  The Effects of Stimulants on ADHD

  • Stimulants, such as Adderall, Ritalin, and Vyvanse, are commonly used to treat ADHD.
  • These drugs work by increasing the levels of dopamine, norepinephrine, and serotonin in the brain, which can improve attention and focus.
  • However, the long-term effects of stimulants on ADHD are not well understood.
  • Some studies suggest that chronic use of stimulants may lead to a decrease in the total amount of testosterone and estrogen in the body.
  • This can result in reductions in libido, muscle and bone mass, and other aspects of testosterone-related psychology and biology.

  The Addictive Potential of Stimulants

  • There is a risk of addiction to stimulants, but this is generally low when the drugs are used appropriately under the supervision of a board-certified qualified psychiatrist.
  • Kids and adults who take medication for ADHD are not predisposed to psychosis or other forms of addiction.
  • Withdrawal symptoms can occur when someone stops taking a stimulant or tapers off the drug, but it is unclear whether these symptoms are caused by the withdrawal or by the fact that the systems in the brain are not activated in the same way as before.
  • It is important to note that the effects of withdrawal from stimulants can be similar to those of a hangover, but the sober state after recovery from a hangover is not a state of withdrawal.

  The Impact of Stimulants on Hormones

  • Chronic elevations of cortisol can reduce the total amount of testosterone and estrogen in the body.
  • This can lead to reductions in libido, muscle and bone mass, and other aspects of testosterone-related psychology and biology.
  • There is no direct link between taking a given treatment for ADHD and preventing a woman from ovulating or ceasing menstruation entirely.
  • It is important to be careful when discussing hormones and their levels, as all of these hormones are in a very intricate crosstalk with one another.

  The Importance of Balancing Treatment for ADHD

  • The treatment of ADHD with stimulants should never be done at the expense of other critical biological systems, such as the immune system or hormone system.
  • It is important to note that the treatment of ADHD with stimulants should be done under the supervision of a board-certified qualified psychiatrist.
  • Kids and adults who take medication for ADHD are not predisposed to psychosis or other forms of addiction.
  • It is important to be aware of the potential withdrawal symptoms when someone stops taking a stimulant or tapers off the drug, and to note that the effects of withdrawal can be similar to those of a hangover.

  Psychosis Induced by Stimulants

  • Stimulants, such as Adderall, Ritalin, and Vyvanse, can induce psychosis.
  • Factors that predispose someone to psychosis include having a first relative with schizophrenia or bipolar disorder, or having had psychotic episodes themselves.
  • Sympathomimetic drugs, such as amphetamines, increase the likelihood of psychotic episodes.
  • Individuals who have a predisposition to psychosis or are not aware of it can have psychotic episodes when taking Adderall.
  • Methylphenidate, Ritalin, and Vyvanse have a lower potential for inducing psychosis compared to amphetamines.

  The Effects of Stimulants on ADHD

  • Stimulants, such as Adderall, Ritalin, and Vyvanse, are commonly used to treat attention deficit hyperactivity disorder (ADHD).
  • These drugs work by increasing the levels of dopamine and norepinephrine in the brain, which helps to improve focus and attention in individuals with ADHD.
  • However, the kinetics or the time course of dopamine and norepinephrine release caused by a given drug is strongly correlated with its abuse potential and addictive potential.
  • Methamphetamine, which increases dopamine five times more than any other drug, has a very fast onset and a very fast drop in dopamine levels, making it dangerous in terms of addiction and psychotic episodes.
  • Dopamine kinetics plays a crucial role in the addiction and psychotic potential of drugs, and it's important to consider the duration and stability of the dopamine peak when evaluating the potential risks and benefits of stimulants for ADHD treatment.

  Introduction

  • The video is about the effects of stimulants, such as Adderall, Ritalin, and Vyvanse, on attention deficit hyperactivity disorder (ADHD).
  • The speaker, Andrew Huberman, discusses the science behind these drugs and how they work to improve the symptoms of ADHD.
  • He addresses common questions about these compounds, such as their addictive potential and their impact on sleep, health, and reproductive health.
  • The speaker emphasizes that this podcast is separate from his teaching and research roles at Stanford and is part of his effort to provide zero-cost consumer information about science and science-based tools to the general public.

  Addiction Risk

  • The speaker cautions against using any of the compounds that have been discussed thus far unless it's been prescribed to you by a physician for the specific purpose of ADHD.
  • He emphasizes that taking these drugs just out of the blue can result in a huge amplitude dopamine response, which can set in motion all the same things that someone who is using these drugs recreationally would have.
  • The speaker mentions that a lot of psychiatrists will start with a very low dosage or the lowest possible dosage to see how someone responds to that low dosage and then over time might or might not increase that dosage.
  • He also notes that it is the repeated taking of that drug by the child with ADHD or by the adult with ADHD that actually leads to lesser and lesser peaks in dopamine each time, which is not to say that the person becomes entirely desensitized to the effects of the drug but rather that the system equilibrates through what's called homeostatic plasticity.

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  Watch the video on YouTube:
  Adderall, Stimulants & Modafinil for ADHD: Short- & Long-Term Effects | Huberman Lab Podcast - YouTube