My romance with ADHD meds.

Health and medicine explained.
May 10 2005 7:26 AM

The Adderall Me

My romance with ADHD meds.

Illustration by Mark Stamaty.
Click image to expand.

Depressives have Prozac, worrywarts have Valium, gym rats have steroids, and overachievers have Adderall. Usually prescribed to treat Attention Deficit Hyperactivity Disorder (read Sydney Spiesel in Slate on the risks and benefits), the drug is a cocktail of amphetamines that increases alertness, concentration, and mental-processing speed and decreases fatigue. It's often called a cognitive steroid because it can make people better at whatever it is they're doing. When scientists administered amphetamines to college shot-putters, they were able to throw more than 4 percent farther. * According to one recent study, as many as one in five college students have taken Adderall or its chemical cousin Ritalin as study buddies.

The drug also has a distinguished literary pedigree. During his most productive two decades, W.H. Auden began every morning with a fix of Benzedrine, an over-the-counter amphetamine similar to Adderall that was used to treat nasal congestion. James Agee, Graham Greene, and Philip K. Dick all took the drug to increase their output. Before the FDA made Benzedrine prescription-only in 1959, Jack Kerouac got hopped up on it and wrote On the Road in a three-week "kick-writing" session. "Amphetamines gave me a quickness of thought and writing that was at least three times my normal rhythm," another devotee, John-Paul Sartre, once remarked.

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If stimulants worked for those writers, why not for me? Who wouldn't want to think faster, be less distracted, write more pages? I asked half a dozen psychiatrists about the safety of using nonprescribed Adderall for performance-enhanced journalism. Most of them told me the same thing: Theoretically, if used responsibly at a low dosage by someone who isn't schizophrenic, doesn't have high blood pressure, isn't on other medications, and doesn't have some other medical condition, the occasional use of Adderall is probably harmless. Doctors have been prescribing the drug for long enough to know that, unlike steroids, it has no long-term health consequences. Provided Adderall isn't snorted, injected, or taken in excessive amounts, it's not highly addictive—though without doctor oversight, it's hard to know whether you're in the minority of people for whom the drug may be dangerous.

As an experiment, I decided to take Adderall for a week. The results were miraculous. On a recent Tuesday, after whipping my brother in two out of three games of pingpong—a triumph that has occurred exactly once before in the history of our rivalry—I proceeded to best my previous high score by almost 10 percent in the online anagrams game that has been my recent procrastination tool of choice. Then I sat down and read 175 pages of Stephen Jay Gould's impenetrably dense book The Structure of Evolutionary Theory. It was like I'd been bitten by a radioactive spider.

The first hour or so of being on Adderall is mildly euphoric. The feeling wears off quickly, giving way to a calming sensation, like a nicotine buzz, that lasts for several hours. When I tried writing on the drug, it was like I had a choir of angels sitting on my shoulders. I became almost mechanical in my ability to pump out sentences. The part of my brain that makes me curious about whether I have new e-mails in my inbox apparently shut down. Normally, I can only stare at my computer screen for about 20 minutes at a time. On Adderall, I was able to work in hourlong chunks. I didn't feel like I was becoming smarter or even like I was thinking more clearly. I just felt more directed, less distracted by rogue thoughts, less day-dreamy. I felt like I was clearing away underbrush that had been obscuring my true capabilities.

At the same time, I felt less like myself. Though I could put more words to the page per hour on Adderall, I had a nagging suspicion that I was thinking with blinders on. This is a concern I've heard from other users of the drug. One writer friend who takes Adderall to read for long uninterrupted stretches told me that he uses it only rarely because he thinks it stifles his creativity. A musician told me he finds it harder to make mental leaps on the drug. "It's something I've heard consistently," says Eric Heiligenstein, clinical director of psychiatry at the University of Wisconsin. "These medications allow you to be more structured and more rigid. That's the opposite of the impulsivity of creativity." On the other hand, lots of talented people like Auden and Kerouac have taken amphetamines precisely because they find them inspiring. Kerouac and the Beats ingested the drug in such heroic quantities that it didn't just make them more focused, it completely transformed their writing. According to legend, On the Road was drafted in a 120-foot-long single-spaced paragraph that burbled down a single continuous scroll of paper.

Adderall is supposed to be effective for four to six hours. (An extended-release version of the drug, which as Spiesel explains was recently banned in Canada, lasts 12 hours.) But I found the effects gradually wore off after about three. About six hours after taking the drug, I would feel slightly groggy, the way I sometimes get in the early afternoon when my morning coffee wears off. But when I'd lie down for an afternoon nap, I couldn't go to sleep. My mind was still buzzing. This withdrawal effect is common. Adderall users often complain that they feel tired, "stupid," or depressed the day after. After running on overdrive, your body has to crash.

For me, the comedown was mild, a small price to pay for an immensely productive day. But there are larger costs, and risks, to Adderall. Though the Air Force furnishes amphetamine "go pills" to its combat pilots in Iraq and Afghanistan, possessing Adderall (or a fighter jet) without a prescription is a felony in many states. And the drug has been known, in rare cases, to make people obsessive compulsive, and even occasionally to cause psychosis. Several years ago, a North Dakota man blamed Adderall for making him murder his infant daughter and won an acquittal.

There's also the risk that Adderall can work too well. The mathematician Paul Erdös, who famously opined that "a mathematician is a device for turning coffee into theorems," began taking Benzedrine in his late 50s and credited the drug with extending his productivity long past the expiration date of his colleagues. But he eventually became psychologically dependent. In 1979, a friend offered Erdös $500 if he could kick his Benzedrine habit for just a month. Erdös met the challenge, but his productivity plummeted so drastically that he decided to go back on the drug. After a 1987 Atlantic Monthly profile discussed his love affair with psychostimulants, the mathematician wrote the author a rueful note. "You shouldn't have mentioned the stuff about Benzedrine," he said. "It's not that you got it wrong. It's just that I don't want kids who are thinking about going into mathematics to think that they have to take drugs to succeed."

Erdös had good reason to worry. Kerouac's excessive use of Benzedrine eventually landed him in a hospital with thrombophlebitis. Auden went through a withdrawal in the late 1950s that tragically curtailed his output. That's some trouble I don't need. Perhaps I could get a regular supply of Adderall by persuading a psychiatrist that I have ADHD—it's supposed to be one of the easiest disorders to fake. But I don't think I will. Although I did save one pill to write this article.

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