I'm sorry, I wasn't notified of your reply. But I'm not clear on where I said I don't want to treat people? Why are you talking about me "taking away" anything? My position is that psychoactive drugs are being recommended too much, especially in indications like anxiety and depression. And that's not even touching the subject of hospital care, where you will still see cases of sedative/anxiolytic abuse (from the doctors' side!) to better manage an unpleasant patient.

Other people in this thread have made claims that evidence of treatment efficacy is sufficient grounds to treat. If that were the case, we wouldn't need to have phases 1 and 2 of clinical trials. The critical axiom of medicine and healthcare is "do no harm", and that applies on a population level as well. Psychoactive drugs can have serious side effects and they shouldn't be viewed as pills you pop just to get some spring in your step.

To reiterate, I'm not against pharmacological treatment of conditions like ADHD, GAD, depression etc. As you say, sometimes it is the only viable option. But that was not my point; my point was that these are powerful substances that we don't fully understand and we should treat them with respect, not throw them at people from all angles.

E: I just realized, I disagree with the statement that there is no way to fight ADHD without stimulants. And I'm not talking about "just focus harder" or similar nonsense, rather prevention. Any medical professional worth their salt knows prevention is better than treatment, and there is good evidence (as far as I remember) that some chemicals, lifestyle factors etc. play a role in ADHD as risk factors.

ITT: People who don’t understand how much ADHD meds help people in personal life (hobbies, hygiene, etc.), not just for work and school.

Seriously, some of you still have a D.A.R.E. mindset when it comes to stimulants

I will indulge my inner pendant and point out that there are a couple of non-stimulant treatments for ADHD that have their place, but they all have in common that none of them are as effective as stimulants are.

There's a reason stimulants have been first line treatment for what we call ADHD now since some dude first gave some hyperactive kids Benzedrine in the 1930s. I'll dig out the study if I can find it. They work, they're well tolerated, and they're safe. Even if they weren't, I'd rather be able to function and take them than have fucking RFK or whoever tell me I can't for my own good.

And there's another point to make here: we only know stimulants work for ADHD because some dudes decided to give them to kids and see what happened. There's a lot of throwing shit at the wall and seeing what sticks in psychopharmacology, or used to be. Moving away from that model hasn't made treatments any better, either. I have a psychopharmacology textbook from the 1950s in my collection that treats serotonin's presence in brain tissue as a mere curiosity. Everything was adrenergic then, and only a fool would think serotonin does anything but affect bowel function and platelet aggregation, according to this textbook. No one even knew dopamine was found in human brain tissue at that point, either, and it would be decades before its function as anything but a metabolite of noradrenaline would be recognized. I see today the same imperious tone being taken towards serotonin in the literature now that it's had its moment in the sun, just as other neurotransmitters got sidelined when there was big money in serotonin. BDNF and tPA are sexy in the literature right now. In 10 years it will be something else entirely.

None of this has anything to do with what works, or what doesn't. Potentially safe and effective treatments for various conditions have been mothballed because there's not enough market share for their development to be profitable. Shit, "cries a lot" is on the depression screening because SSRIs are great at suppressing the ability to cry, irrespective of whatever else they do. It's true that drugs are big business, but the supplement industry and the crunchy granola "holistic" fascist wellness shit are also absolutely raking in the cash. We don't hear about that enough in these discussions. Supplement dudes see the opportunity to get their bag, and they're taking it.

Regarding ADHD specifically I think we (in most of the western world at least) live in societies that demand a lot from the individual regarding planning, structure, bureaucratic work and timeliness - all things that are difficult for most people with ADHD. So yes, that would be taking away their ability to function as members of society.

In this sense, ADHD medication is still not a cure, but a tradeoff that allow us to keep having the same expectation of peoples ability to comply with the above values, regardless of who they are. As the expectations become more demanding, so does the need for ADHD medication.

My original point was not that it is good to take away medication and leave people to themselves, but that (in the case of ADHD) embracing neurodiversity and the demands we put on each other as a society could lessen the need for medication, thereby making less medication = good. Of course this is very much an oversimplification of what would be needed.

For me, the biggest problem is that there appears to be very little awareness in politics about this tradeoff. Keeping the same kind of societal demands and also wanting less medication is impossible and harmful.

There are non stimulant treatments like strattera and i think wellbutrin affects adhd? but I haven't personally tried them. I agree with you that stimulants are very helpful and shouldn't be gatekept from people who need them though. And they're coming after drugs like those too since they're an SNRI and NDRI respectively

some or most ADHD should just be accommodated but that's not the society most of us live in

I'm gonna indulge in a bit of snarkiness, because this comment frustrates me and I feel the need to refute it even after three days.

Did you know that thalidomide was very efficient in preventing early pregnancy vomiting? Or that benzodiazepines were much more efficient as anxiolytics than the preceding class of barbiturates. Antibiotics in general, we don't even need to mention them and their efficacy. Oh and if you want to help someone in shock with oliguria, load them up with diuretics, that's the most efficient method of inducing urine production after all!

My point is, understanding the causes of a condition is critical in finding an actual cure. You can have treatments, symptomatic or otherwise, even without it (see lithium for BPD, valproic acid for epilepsy, many others) and that's fine. But claiming that you don't need to understand the safety profile, potential side effects, risk groups, or anything other than efficacy is, as you say, horseshit.