ADHD meds (psychostimulants) are fast-acting anti depressants. I hope the regiment works out regardless of the underlying condition they're helping you manage, but just another perspective.
A sense of euphoria can be a side effect of early treatment, but that's not to be confused with an actual anti-depressant effect.
Some (unfortunately many) users get stuck chasing that initial sense of euphoria with continued dose escalation requests, or by playing games to only take doses on certain days of the week or even by doubling up doses on some days. This is a road you don't want to go down.
Stimulants do have an anti-depressant quality in a similar sense to SNRIs. They stimulate release of extracellular neural serotonin and norepinephrine (SNRIs block reuptake of serotonin and norepinephrine. Before the accidental discovery of the first front-line antidepressants in the 50s, they were prescribed for depression.
However, for the reasons you mentioned, they aren’t very good antidepressants. It’s easy to mistake the early euphoria of amphetamine for reduction in depression. Without careful management, it’s easier to become tolerant or even addicted to amphetamine.
What studies? The information that I’ve found on PubMed and clinicaltrials.gov indicates that this is a poorly studied question, not a decided one.
A 2015 survey (Raymond Pary, MD, et al) found evidence that many psychostimulants were effective adjuncts for MDD and Bipolar depression. The results weren’t extraordinary but they were statistically significant. The authors noted in the results that the topic was generally poorly studied and double-blind clinical trials were limited.
In 2010-2011 Shire ran Phase II FDA trials on Vyvanse as an adjunct to traditional antidepressants for MDD with mediocre but also statistically significant positive results. Considering the age of most psychostimulants in use, that’s a fairly recent result from a clinical trial.
I certainly agree that psychostimulants are not a good choice to treat depression but that’s a far cry from “formally trialed for depression... don’t work”.
With the exception of MDMA, MDMA has show to have effective outcomes on depression and PTSD in short term studies. They problem is they have to be interleaved with SSRI's or the down state is far worse. That has been the issue with MDMA, it drops a depressed person lower than they where on the down ramp. Therefore there are concerns that it could place someone who was not suicidal in that low of a state. Studies have shown regulating this with SSRI's can mitigate the down state.
> or by playing games to only take doses on certain days of the week
This is something I’ve always done, under the close supervision of my doctor. I’m not sure if he initially recommended it or not, but it’s been extremely effective for me in terms of keeping my effective dosage low and limiting tolerance.
My prescribed dosage of Vyvanse stayed consistent for about a year after beginning taking it, but began to escalate after that. I didn’t like that and was resistant to continuing to increase it. I went from 40mg initially to 70mg at the highest. I’m back down to 50mg today and am able to keep it at that level by limiting taking it less often. I typically end up taking it 4-5 days per week.
There are significant long-term side effects of these medications - limiting tolerance building and keeping the effective dose as low as possible is a viable means of reducing the chance of experiencing them.
Why do you assert that this is a “road you don’t want to go down”? Is it merely because my reason for doing so is so different?
