riley

riley , 2 days ago

@Aerliss They looked heavily into psysiological diagnostic criteria, and there aren't any obvious one (at least, using machinery availablbe in the 20th century). As far as I know, the closest potential method to purely physiological diagnosis right now involves clustering of positron-emission tomography brain maps, and even that has notorious error rates. If a clear distinction should exist, it's probably in the way ADHD synapses handle neurotransmitters, and with the current medical diagnostic tools, it's not readily observable.

On the other hand, the very concept of pursuing a diagnosis by purely physiological methods is kind of insulitng. Why should we dismiss the patient's experience?

@PossiblyAutistic @dzwiedziu @actuallyautistic

riley , 2 days ago

@PossiblyAutistic The first-line ADHD medicines are known to have such a strong calming effect on ADHD people that in some ADHD people, it causes prolongation of the QT interval, a cardiological measurement. If your QT interval happens to be long to begin with, some doctors take this as a sign that you should perhaps not be prescribed first-line medicines, because if the QT interval should get too long, some hearts have been known to stop beating entirely. And contrariwise, sometimes the doctors would like to know that your QT is sufficiently short before prescribing.

Another thing some doctors care about is blood pressure. In NT people, stimulants can drive blood pressure up, so if it's high to begin with, the theory goes, stimulants can be dangerous to you. This is nowadays less commonly considered a counterindication than it used to, unless your BP is in the extreme heights, because it turns out that untreated ADHD drives BP up, and treatment actually often (but not always) slightly reduces it. But until you know what your doctor is like, it might be handy to know about the old prejudices.

So, basically — if your cardiologist gives you a note saying that you your heart is largely okay, your psychiatrist might want to see that note. Not for diagnostics, but for treatment options.

@dzwiedziu @actuallyautistic

riley , 2 days ago

@PossiblyAutistic Btw, fun blood pressure fact (and, perhaps, a fun rabbit hole): the rat model on which ADHD is modelled for research is spontaneously hypertensive rats. There's a strain of lab rats that was originally developed because their blood pressure tends to go high on its own; and these rats' brains turned out to behave a lot like the brains of people with ADHD, so scientists now often use these rats for testing potential new ADHD medicines or other treatments on.

https://psycnet.apa.org/record/2011-16062-009

@dzwiedziu @actuallyautistic

riley , 1 day ago

@Aerliss Making ADHD medicines OTC again, as they used to be, would solve all the complexities of diagnosis. If they alleviate the symptoms, you take them, and that's it.
@PossiblyAutistic @dzwiedziu @actuallyautistic

riley , 1 day ago

@PossiblyAutistic Ask your GP about it, then. Sometimes, they take ECG readings in their offices. Or, they might reckon that your heart is fine, and give you a note about it, or alternatively, refer you to a specialist cardiologist to do your ECG and maybe a sonogram.

@dzwiedziu @actuallyautistic

riley , 1 day ago

@mfru Yep. Stimulants tend to have a calming effect on ADHD nervous systems, including the outside-of-the-skull-and-spine parts, or the PNS.

@PossiblyAutistic @dzwiedziu @actuallyautistic

riley , 1 day ago

@uint8_t Yep!

@Aerliss @PossiblyAutistic @dzwiedziu @actuallyautistic

riley , 1 day ago

@maggiejk So, make more of them. It's not like the process is somehow hard or complicated for Big Pharma. Let the rich weirdoes take Uncle Scrooge style dives in granulated amphetamines, for all I care; without artificial limits, it wouldn't deprive anybody else of the medicines' benefits.

@Aerliss @PossiblyAutistic @dzwiedziu @actuallyautistic

riley , 1 day ago

@maggiejk Also, the concept of "abusing" a medicine is offensively paternalistic. If you're not the patient, who are you to second-guess as to whether they're getting benefits from it?

There's a small number of medicine with clear external costs to using them wrongly, such as antibiotics. You'll note that none of them are harshly warred upon by the Warriors On Drugs. What does it tell us?

@Aerliss @PossiblyAutistic @dzwiedziu @actuallyautistic

riley , 1 day ago

@mfru If you want to google about it, the fancy term for this phenomenon is postural orthostatic hypotension.

@PossiblyAutistic @dzwiedziu @actuallyautistic

riley , 11 hours ago

@PossiblyAutistic I know. I live in Germany, so I keep needing to get new triplicate yellow prescriptions.

But this has not always been the case. Before the War On Drugs, all three of the most common ADHD medicines were OTC, in both Germany and Nixonland. (One of the three has mostly fallen out of professional use, in favour of a safer molecule with one less methyl group, but is still commonly made, and sold, by unlicensed pharmaceutics hobbyists.)

@Aerliss @dzwiedziu @actuallyautistic

riley , 11 hours ago

@dzwiedziu

And promotes addiction. Not only through the lootbox effect that happens when supply is uncertain, but it's well established that untreated ADHD significantly raises addiction risk. Stimulant treatment much reduces the risk, bringing it close to the population's average.

The War On Drugs is inherently bigoted against neurodivergent people, and does the opposite of what its selling point is. It should be terminated, the system of governments boneheadedly refusing to regulate recreational chemicla markets should be reformed in favour of reasonable regulations and quality controls, and everybody convicted of belonging to one of the demographic groups that, some people once reckoned — without the aid of modern computerised demographic research, I should point out — might not vote for Nixon by proxy of consumption of recreational substances should be retroactively amnestied.

@PossiblyAutistic @Aerliss @actuallyautistic

riley , 10 hours ago

@PossiblyAutistic Germany has a solid network of ADHS support groups. Perhaps contact your nearest one or two, and ask for advice/recommendations?

@dzwiedziu @actuallyautistic

riley , 10 hours ago

@PossiblyAutistic If you tell your German GP that you want to know if there's concerns that might prevent you from taking stimulant medicines, they don't need to do specific tests to assess this. They have seen you before, they have some idea of what your health situation is like, and on that basis, if there's no serious concerns, they might write you a quick note saying that they believe your heart is okay.

But then again, in German you probably don't need it before your psychiarist asks for one. But listen to your ADHS support group's advice; sometimes, there can be local weirdnesses about these things.

@dzwiedziu @actuallyautistic

riley , 1 month ago

@theautisticcoach Strangely, society doesn't mind people having a special interest in hoarding money.

@actuallyautistic