First: Stimulant drugs typically release or inhibit reuptake of both dopamine and norepinephrine. Dopamine actually converts into norepinephrine in the brain, complicating things further. L-DOPA, which is described in this article, is not a stimulant drug: it only raises dopamine concentration, and nothing else. It's the direct precursor molecule for dopamine.
Raising norepinephrine along with dopamine can create a focused and patient effect in some people (and sometimes a somewhat euphoric effect); raising just dopamine will generally create a euphoric, relaxing, reward-seeking effect. I don't know the entire pharmacology behind why that is. I seem to recall that DA and NE may be able to directly modulate each other.
Dexedrine (dextroamphetamine), another ADHD medication, has a higher dopamine:norepinephrine ratio than Adderall does (i.e. it releases proportionally more dopamine). It doesn't work for some ADHD sufferers, because they become too euphoric.
Second: Stimulant medication is also more about trying to maintain steady levels of dopamine in the brain at all times, rather than constantly or intermittently fluctuating levels. If you were to take Adderall just once per week, for example, you would probably not get a lot of chronic relief. Taking small doses of L-DOPA every day could maybe help some ADHD sufferers after a week or two (though this is mostly just a theory on my part), for example, but this can lead to psychosis and many other dangerous problems, so is highly discouraged.
Someone please feel free to correct me if I got anything wrong here. I don't have formal education in medicine or neurobiology.
When I said "not get a lot of symptom relief", I meant regarding general life functioning, not short-term response. Obviously Adderall will provide quick relief for an ADHD sufferer; it just won't help them in the long-term unless they take it regularly.
Which is why many ADHD sufferers take stimulant medication regularly. However, that doesn't mean the medication doesn't provide relief that improve general life functioning.
Similarly, chronic pain may be treated with morphine, which provides short-term pain relief and improves general life functioning when taken regularly.
> Stimulant medication is also more about trying to maintain steady levels of dopamine in the brain at all times
I don't think this is accurate. Rather, it depends on the attention and performance requirements of the sufferer. Children may only need symptom relief while in school, whereas adults may need relief through most of their waking hours.
It seems unlikely that someone would really need relief from ADHD symptoms while sleeping.
See my comment here: https://news.ycombinator.com/item?id=10368605
Based on the literature, it seems like a probable explanation.
Perhaps there's something else in ADHD people wiring that cause a different response, but even normal college students took ADHD medication to help focus.
> Attention-deficit drugs increase concentration in the short term, which is why they work so well for college students cramming for exams.
> Versions of these drugs had been given to World War II radar operators to help them stay awake and focus on boring, repetitive tasks.
> And when we reviewed the literature on attention-deficit drugs again in 1990 we found that all children, whether they had attention problems or not, responded to stimulant drugs the same way.
I've always been baffled how I didn't see this for myself years ago - after all, that's exactly what caffeine does for millions of people.
Worse, though, people with ADHD are prescribed stimulants for long-term use, and even after the medicine ceases to be effective - because your body adapts to it over time - you can't just stop taking it, because withdrawal sucks.
[1] http://www.nytimes.com/2012/01/29/opinion/sunday/childrens-a...
I get much less impulsive also, car rental managd my own mood much better. My blood pressure add resting heartrate has also improved since I started with the stimulants. A bit unusual according to my doctors.
YMMV - the medication is crude, but being without is not really an option - it's really nice to start being able to plan, and actually decide what actions to take instead of simply doing whatever feelt good at the time.
I should probably talk to my doctor to see if I have ADHD, instead of occasionally self-medicating.
Students low on the attention spectrum (but either just above ADHD diagnosis or without the resources to get diagnosed) are probably more likely to self-medicate.
So, the fact that some students who self-select for self-medication show improvements isn't necessarily evidence that someone in the middle or upper end of the attention spectrum will see improvements. However, it does suggest a need for research into the effects on randomly selected non-ADHD-diagnosed people.
Definitely not generally true.
Why do people continue saying this?
A lot of people just get better lives. YMMW.
As someone with adhd, my psychiatrist has explained it to me in terms of Dopamine. In his words, stimulant medications help to treat symptoms of adhd, in part, by creating dopamine when we either lack it or have a weakened response to it. This flood of dopamine keeps us from being impulsive, in his explanation.
In other words, I am more impulsive without stimulants and the explanation I was given is that my brain is too busy seeking out dopamine and thus always looking for excitement. By providing dopamine through medication, that seeking behavior diminishes and I am more focused and less impulsive.
So, something doesn't add up. Either my psychiatrist has been misinformed or there is a lot more going on here / my understanding is very off base.