To paraphrase, this paper says "people who drank a triple espresso didn't do as well at sudoku". They gave pretty high doses of stimulants to test subjects and then tried to peel them off the walls and have them solve a short, difficult cognitive task.

The more practical question of whether popping stimulants can help people get through mountains of undemanding, tedious work is left as scientifically unexplored territory. Hopefully the research team will get a line on some Adderall and knock out the necessary papers soon.

yeah, the doses are high: given single doses of one of 30 mg of MPH, 15 mg of DEX, and 200 mg of MOD.

from the mayo clinic: https://www.mayoclinic.org/drugs-supplements/methylphenidate....

''' Adults—20 to 30 milligrams (mg) given in divided doses 2 or 3 times a day, taken 30 to 45 minutes before meals. Your doctor may adjust your dose as needed. However, the dose is usually not more than 60 mg per day. '''

That's also assuming the retarded pill, which is already too much for a first time dosage. If this was unretared, no doubt the patients felt completely wired. And of course, the authors conveniently fail to measure physical well being. Just insane that Science publishes this imo.

That would also make a very interesting study. Or an episode of Mr Beast.

Students don't use ritalin to achieve high quality cognitive effort, they use it to achieve high quantity cognitive effort. To pass a university exam I don't need to be able to come up with some novel high quality reasoning about a topic, I need to regurgitate 12 weeks worth of lectures on demand. The only way I could do that is by sitting down for 10hrs a day and reading the shit out of those lecture notes, ritalin is quite useful for that.

I think the comment you're replying to is talking about studying on Adderall, not taking the test on Adderall.

Plus: many, many disciplines require memorization of quite a few facts to pass the course. CS included - you might have just had an easy time/forgotten about your freshman and sophomore courses that covered more basic elements like syntax, best practices, basic algos, etc.

They let participants solve the knapsack problem under the influence of common ADHD meds like ritalin, dexamphetamine, modafinil.

Interesting results were observed. Participants who performed below average while on placebo tended to improve on the task when on one of the drugs. Those that performed above average tended to have decreased performance on the task.

> Participants who performed below average while on placebo tended to improve on the task when on one of the drugs. Those that performed above average tended to have decreased performance on the task.

It's relatively known/accepted that these drugs have a different effect on people with ADHD and people without.

Did they just diagnose a bunch of people with ADHD through treatment?

> Did they just diagnose a bunch of people with ADHD through treatment?

Seems so. Isn't this an open secret that by far the most cost-effective, accurate and immediate way of diagnosing ADHD is to put someone on low dose of stimulants and seeing what happens? The effect is usually apparent in hours.

My experience with Modafinil is that it is helpful for dealing with tasks that have been sitting in my Todo List for months (my most procrastinated tasks). Not necessarily the most complex tasks, as I usually like doing those, but kind of tasks like cleaning my 3000 mails mailbox or writing a SOP for my business. The 1-day modafinil will clear up so much of my todolist that I'll be free the next weeks/months to tackle the most complex problems. And for solving complex problems, I find microdosing better as it gives different perspectives/POVS

Do you have ADHD? If so, modafinil isn't meant to be all that effective versus methylphenidate.

The study might be flawed, but there are lots of opinions here from a lot of people who don't suffer from ADHD who really should reach out to us who do, and find out that it really is a '"disorder" or "disability" for the person experiencing it'

Ritalin fundamentally changes my approach to life, allows me to present and focused in ways I've never experienced before, and have since come to realise I'd been missing my whole life

I was about to respond to a comment that got flagged about this. A lot of this opinion I suspect stems from platforms like TikTok where non-psychiatrists are able to perpetuate the stereotype that ADHD is a "quirky", surface-level trait that makes for a neat partner/employee/friend.

Your experience is a common one, and ADHD is both under-diagnosed and badly represented, making for a toxic perception which some of the crowd here doesn't seem immune to.

I was on the verge of losing my job and probably my family before getting diagnosed. Getting on medication was almost an overnight 180 on all the issues I was having... and a bunch more that I wasn't even close to ready to solve yet.

(The following is _my_ experience. So read it that way. I'm not going to prefix every sentence with "for me...".)

It's not some fun th--squirrel!--ing where you occasionally act a little quirky or get a little sidetracked.

Everything I tried to do every day felt like I was trying to break through a brick wall. Except if I _did_ manage to break through, there was just another brick wall. And another. And another. Getting _anything_ done was _exhausting_. Most days I could do _a_ thing, and then I was completely and utterly exhausted.

The thing is, it didn't matter _what_ that one thing was, how long it took, or anything else. Doing a load of laundry through to completion felt like about the same amount of effort as when the power went out for 8 days and I was trying to cobble together a solution to get the water (well + septic pumps) running again. The issue was not the task itself, but just the effort to force my brain into actually commanding my body to do it.

I want to really reiterate that... because it's not that "survival situation" comes easy to me. It's that simply trying to get a load of laundry through to completion felt the same to me as being in a situation where we my family and myself were lacking one of the basic requirements for human life.

Career-wise... people always note that when shit hits the fan I'm always the one that's calm and have my head screwed on straight. I'm pretty straightforward with everyone that it's because in my day-to-day life pretty much everything registers as a 9.5-10.0/10 on the stress scale, so this isn't anything new for me... navigating this situation is the same as trying to navigate basic life tasks for me.

The work impacts were fairly obvious as far as productivity due to inability to stay on task. The impacts in my personal life were much less obvious--it's not fair to my wife nor my kid that a simple thing like a day trip to a museum is eliciting basically a "someone has a gun pointed at me" response from me.

I'd fought through this for _decades_ before it finally caught up with me as far as my work and my wife getting fed up with my shit.

Got diagnosed by a psychiatrist. Got on an extremely low dose of Vyvanse. (Like, I'm a fully grown adult and started out at the dose they'd give to a child.)

Even just that though... Suddenly the layer after layer of brick wall I'd been dealing with turned to drywall. It was still something to push through, but after decades of banging my head against bricks... throwing myself through drywall felt like playing life on easy mode. I was happy in a way I don't remember ever being. My self control was through the roof not just in focus but in things like "not drinking excessively every night". I spent more than one consecutive night sober for the first time in decades.

After decades it finally became _very_ clear why I couldn't operate like other people. It wasn't a personal or moral failing, it was that I was playing the game on Death March difficulty and comparing my struggles with a lot of people playing on "Just the story!" mode. The decades of self-abuse and damage to my self-worth do not get undone easily.

In a sense I should be sad about the fact that I lived life so held back for so long. But bigger picture I'm grateful. Many people struggle more than I do or aren't quite as stubborn as I am and hit this point and have these epiphanies and have to look back at a life with little success or little happiness and wonder what could have been. I've done quite well for myself in spite of everything.

But I can tell you with a great deal of certainty that had this happened earlier I would have spent a lot of years much happier.

I always appreciate hearing from people who are "like me." You've done well putting this into words, I'm going to save this.

It really is crazy how this medicine helps. I'm on a relatively low dose as well, having tried a few non-stimulants before with rather underwhelming success. I was always scared of going on a stimulant but it's been life-changing.

I agree. I've been frustrated to see a lot of comments about people performing worse on medication. What they don't seem to account for is that, for me, the difference isn't between performing at 80% or 100% on a particular task, taking medication allows me to do things that otherwise I simply wouldn't be able to bring myself to do. Sure, my thinking might be a little bit less creative, but I'm also not dealing with the fact that actually starting any new task is literally impossible, I don't end up spending half the work day procrastinating, and I don't end up "working" 16 hours every day trying to get 8 hours of productivity out of myself.

Ditto. It’s hard to shake the feeling of what life could have been with an earlier diagnosis. Things are still challenging, but they are challenging for the right reasons.

> single-dose trial of standard adult doses of the three drugs (30 mg of MPH, 15 mg of DEX, and 200 mg of MOD) and PLC, administered before being asked to solve eight instances of the knapsack task. Doses are at the high end of those administered in clinical practice, reflecting typical doses in nonmedical settings, where use tends to be occasional rather than chronic.

I’ve taken methylphenidate aka Ritalin (MPH) and dexteroampheramine aka Adderall (DEX) and my largest prescription was less than half of these doses.

If I take a dose of 15mg of MPH after a break of 10 days, I’ll be jittery, irritable, and a bit over-active. I imagine taking 30mg for someone neurotypical who’s never taken it before would be closer to a subdued but sustained hit of cocaine. I wouldn’t imagine anyone performing well in this trial, I probably wouldn’t either with a 30-day break beforehand. I don’t know where they’re getting this “typical adult dose for non-prescription use”… I have a neurotypical friend who takes 10mg of adderall as a party drug at raves.

My ex used to give her friends low doses of her ADHD medication for tech interviews and every one of them said the outcome was significantly better than they expected based on other interviews and preparation. I'm not sure what this says about the interview process, but it does indicate that for real-world applications it's more complicated than "stimulant = bad". They say they chose doses that "reflect typical doses in nonmedical settings", but those doses don't reflect what she gave her friends for performance _at all_. Let's reproduce this experiment with starting doses rather than straw-man high doses and see what happens.

Well yeah, because stimulants raise your confidence level quite a bit. No doubt it worked better. Not that that's a bad thing, it's just an objective side effect of the drug.

So normal individuals without diagnosed ADHD performed worse taking these medications but individuals with diagnosed ADHD performed less worse and or as equal as the individuals without ADHD when those individuals were not medicated....

What the authors completely forgot to measure or even so much as discuss is the effect of participants physical well-being on performance when under the influence of these drugs.

They solely focus on the patients cardiac profile, I'm assuming for safety as these drugs can raise blood pressure quite a bit. Also, the sample size is strikingly small for a 4 cohort study on the effects of a drug on behavior (n = 30, 17 males, 23 females, but subdivided into 4 groups).

Performance enhancing drugs can have a myriad of effects on physical well being. The amount dispensed to participants was at least for Ritalin strikingly high. 30mg is a dose you get after at least 1-2 months of raising the dosage from 10mg, and that' the _retarded_ pill. If these were unretarded tablets, no doubt the participants must have felt completely wired up. The results look to me as if you drugged a bunch of people, told them to do something and they performed worse, but not much worse, probably because they were complaining of side effects. I know that's a polemic interpretation of the results, but I feel like I'm entitled to it, given the authors one sided discussion.

I have ADHD. I was given adderall. I found that my programming and mathematical skills suffered pretty badly while on it

I could clean my house like a mofo, though

Happy for you. In my case, both go up significantly. In programming/math skills it may not be about skills themselves - but rather that meds are what makes it possible for me to apply them consistently for anything that isn't a personal hobby project with no external expectations.

My HN problem gets worse on stimulants, though. I usually describe this as Ritalin making me "sticky" - as in, I'll happily continue doing whatever it is I'm doing when on it, whether it's productive work or commenting on HN.

> In programming/math skills it may not be about skills themselves - but rather that meds are what makes it possible for me to apply them consistently for anything that isn't a personal hobby project with no external expectations.

Exactly, application of skills is often more important than skill level, and that's what a lot of people with ADHD struggle with. I do not get a sense of reward or accomplishment when I finish tasks, or at least I get very, very little of that feeling of pride. So give me something I'm intrinsically motivated at in the moment, and everything else shuts down and I can focus on it entirely. Once that intrinsic motivation goes away, difficult jumps up so much and pretty much the only motivator that consistently worked to cut through that was stress.

I was actually worried about losing some effectiveness at hyperfocusing when I started ritalin (which was not something I needed to be concerned about, but whatever), and the thing that got me over that was thinking, "hey, you could actually be quite a bit worse at programming, and if the benefit you got from that was that you actually finished any of your projects, you would still be way more productive and produce much better work overall."

People honestly overestimate the importance of skill. Even if ritalin did lower my programming skills (which it doesn't), not being able to do boring things is way more limiting than not being able to produce exceptional work all the time.

> I usually describe this as Ritalin making me "sticky" - as in, I'll happily continue doing whatever it is I'm doing when on it, whether it's productive work or commenting on HN.

This is another point in favor of "these drugs affect different people differently and it's not really useful to generalize too much."

I don't see this effect at all. My experience with ritalin is that it makes my executive dysfunction goes down but it has little to no impact on my distractability or how focused I am. I jump between tasks exactly the same, I still hyperfixate on things, I still have a hard time sticking to tasks that are unenjoyable -- it's just easier for me to respond to external stimuli I set up (timers, lists, etc) that help to keep me more on track. I know other people have very different experiences.

My feeling is that people sometimes look at downstream behavioral changes and they want to draw an exact cause and effect to "the drug makes you do X, it makes you worse at Y." No, the drug affects my dopamine reuptake receptors and other specific parts of my brain chemistry. Because of my experiences in life and because of how my brain has adapted to having bad regulation of those chemicals and because of the pathways it's formed to help it adapt to that bad regulation, that leads to individualized reactions/behavioral changes. But motivation and focus are extremely complicated. If I think of my brain like a car, tuning or altering one part of the engine so I can drive it better is not going to make it drive identically to everyone else's car, and changing the same part in two different cars that are tuned differently might have different effects on how the cars feel to drive.

Yeah, people rambling about "system pouring stimulants into people to squeeze productivity out of them" confuse me a lot. I don't want stimulants for work, I do well without them. I want them so I can finally clean up my desk and work there rather than on a sofa with a laptop on my laps before my back breaks! (the one thing that make me miss working in an office :P)

....for people not suffering from ADHD.

I’m not so sure. I was prescribed adderal for 2 years and I definitely noticed I was a bit dumber on it, in general I was worse at problem solving, I was just super focused and so could work at a problem longer.

As an example, while on adderal my chess score dropped from ~1000 down to ~700 and within two weeks of getting off of it it went right back up.

My chess rating usually goes up when I’m procrastinating. My procrastination usually goes down when I’m on methylphenidate.

They dropped high clinical doses of stimulants onto unacclimated subjects and had them do 8 knapsack problems, 4-minute limit each. There was an increase in number of moves, decrease in average score, chance of finding the optimal solution was the same.

In other words, if you get a random person high and hand them a puzzle, they do a little bit worse. I'm not surprised.

Anyone who is not neurotypical, plans to take more than one dose per lifetime, or is working longer than 32 minutes may want to question if this study applies to them.

"Doses are at the high end of those administered in clinical practice, reflecting typical doses in nonmedical settings, where use tends to be occasional rather than chronic."

I think the point is to highlight that using these drugs as a one-off is not effective. To the surprise of no-one, poorly dosed medications perform poorly.

There's going to be very little crossover between 1) people who need to see this paper, and 2) people who are the types to read papers on dosage efficacy.

Multiplying out the average time for the tasks, they spent about 25 minutes total. If their goal was to recreate the conditions where people take these drugs in non-medical settings, they failed. It is not when you have a half hour of puzzles, and someone sitting next to you and scoring your work. It's when you have 24 hours of work and 16 hours to do it. Or, a 15 minute task that feels like pulling off your own fingernails.

> when you have 24 hours of work and 16 hours to do it

We used to call this a compressed work day.

Which compression algorithm is this? I bet it is pretty lossy.

Then the authors should have lead with the purpose in their abstract and also highlight this fact in their discussion. They choose not to. Instead, their paper is titled "Not so smart?“Smart”drugs increase the level butdecrease the qualityof cognitive effort", with the abstract leading with "The efficacy of pharmaceutical cognitive enhancers in everyday complex tasks remains to be established."

Sorry, but that's just attention grabbing nonsense. Should have said "for people undiagnosed with cognitive impairments".

> Anyone who is not neurotypical, plans to take more than one dose per lifetime, or is working longer than 32 minutes may want to question if this study applies to them

I suppose it's a fair counterpoint to folks who take these drugs occasionally in pursuit of gains. Granted, their tasks take longer than thirty-two minutes--that's why they're popping Adderrall.

Occasional might also be different from one-off. If you'd one-off anything your brain might be very much busy with thinking about: What's happening next? Am I feeling the effects now? Is this it?

It might end up you're distracted more than anything because it's a new feeling.

Say you never drank alcohol in your life. Somebody gives you a beer. A beer doesn't have that strong an effect, but if you don't know what's coming your mind still might be very busy figuring out what's happening. And while you expect some drop in intellectual ability from alcohol, an experienced occasional user will probably not have as severe a drop from one beer as the person that never tried any.

The occasional user will know the experience after a while, but not have a tolerance. That's who's interesting to study.

They were given the meds and then sat for 90 minutes. Someone without a tolerance taking 15mg of dextroamphetamine will not be wondering if they're feeling the effects.

GP isn't talking about "wondering if", but rather being distracted by thoughts like "WTF is going on?", "wooow!", "WOOOWOWOWOW!", "is it supposed to be like this?", "oh look at me I NAILED this task", "I think I have been hungry for the past 3 hours but I don't really care, WOW this is nice", etc. You get used to it in a day or two, and most of the "WOW factor" disappears just as fast - point being, one's very first day or two of taking such drugs aren't good as a benchmark.

BTW. with the beer example, it's been measured that part of intoxication effect comes from expectations. As in, you give people non-alcoholic drinks while telling them they're regular ones, and they'll show the usual signs of alcohol influence - worse coordination, stuttering speech, etc. - and snap out of it once told they've been drinking placebo. Reverse also seems true, i.e. early effects are weaker when people think they're drinking placebo while getting the real deal.

(And, N=1, personally I've observed I can "fix" the effect of a beer or two on movement and speech if I consciously remind myself that there's an expectations component to intoxication effect. Of course this works only up to a certain BAC level :).)

Spot on. Your last line is what I came here to say.

I remember taking Adderall, it made me feel like I could do anything. However, when I went back and looked at the work product, it was like work done by a crazy person. I went through bad withdrawal, thinking I could not do my work or anything, unless I took Adderall. Then suddenly I took Adderall and I was smart again. A terrible false prophet.

I certainly believe that's your experience, but it's not a universal one. I take Adderall for ADHD and I don't really notice any difference at all in how I feel. The main difference is that when there's something I should do, I just do it rather than procrastinating and dreading it. It's not some stimulant fueled mania or anything, more like "oh, there's some trash on the table. Oh, the trash can is full, I'll remove the bag and take it to the bin. Now I'll continue on with my day" instead of "oh, there's some trash there. Better spend the next 12 hours doing anything else while feeling guilty and ruminating on the fact that I'm a failure of a human because I can't even do something as simple as throw some trash away, before promptly forgetting that the trash exists and ignoring it for the next 2 weeks"

The expectation is not necessarily to perform better on a test because of the medicine directly, but to be able to study more effectively and achieve a higher score as a result of being able to focus better on the required boring tasks. Of course it doesn't make you smarter directly.

Totally fits with my experiences. I wrote large parts of my bachelor thesis on ritalin, as I lacked motivation otherwise. It resulted in high quantity, low quality content. The high quantity did offer a good starting point to refine the content while being sober.

Funny thing is, "high quantity, low quality" is exactly what's commonly advised as the right way to get good at creative work and cognitive work in general. See e.g. that famous Ira Glass quote on developing taste.