Brain drugs, a review (performance enhancement, side effects, and addiction)

 From the Free Press,  tasting notes on a variety of performance enhancing drugs for concentration, finally converging on what sounds like nicotine addiction.

I Tried Wall Street’s Famous Brain Drugs
My experimental high and crash through the not-quite-legal, sort of effective, occasionally heart-pounding medicine cabinet of Wall Street and Silicon Valley’s productivity optimizers.  by  Park MacDougald

"Vyvanse:
The brand name for lisdexamfetamine, a prodrug that, once ingested, slowly converts to dextroamphetamine, one of the active ingredients in Adderall. Originally developed as a longer acting and less easily abused alternative to dextroamphetamine, lisdexamfetamine is now the third most commonly prescribed stimulant in the United States, according to the Drug Enforcement Agency (DEA), with around 15 million prescriptions dispensed in 2023. With insurance, a 30-day supply of Vyvanse can run around $60.

...

" Strattera:  Generic name atomoxetine, Strattera is a selective norepinephrine reuptake inhibitor initially developed by Eli Lilly to treat depression, but later approved by the Food and Drug Administration (FDA) as an ADHD treatment when it was found to be ineffective for its intended use. Strattera is far less commonly prescribed than Adderall, Vyvanse, or Ritalin—4.3 million prescriptions were dispensed in 2023, per the DEA—but may be favored for patients with a history of addiction, due to its low potential for abuse. It’s also cheap; with my insurance, a month’s supply of Strattera cost less than $10.

...

"Dextroamphetamine: Basically like Adderall but without levoamphetamine, a less potent amphetamine isomer that helps to smooth the overall effects of the drug. Dextroamphetamine, or “dexy,” has been available since the 1930s, and was issued to U.S. bomber pilots in World War II to help keep them awake on nighttime missions. It’s still around today, but far less common than Adderall or Ritalin (methylphenidate). Around 915,000 dextroamphetamine prescriptions were dispensed in the United States in 2023, according to the DEA.

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"Modafinil: Unlike the other drugs on this list, Modafinil is not primarily an ADHD treatment. It’s a non-amphetamine stimulant and “wakefulness-promoting agent” developed in France during the 1970s and 1980s as a treatment for narcolepsy, but its current claim to fame is for its use by the U.S. Air Force to manage pilot fatigue on long missions (it’s also frequently prescribed for night-shift workers). Prescription modafinil is generally cheap with insurance, but the variant I bought—a supplement containing adrafinil, a closely related substance—cost $40 for a jar of 30 pills.

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 "Zyn: Zyn is the original brand of smokeless tobacco pouches, introduced by a Swedish company, Swedish Match, as a tobacco-free alternative to Snus in 2014 (its major competitor, Velo, is also Swedish, though both companies are now owned by international tobacco conglomerates). In the United States, Zyn is sold in tins of 3 mg or 6 mg pouches, though the European version of the product—which I purchase from my local Yemeni-owned bodega in New York City—also comes in 9 mg, 11 mg, and 13.5 mg varieties. Retail, in New York, a tin costs around $9—up from $5–$6 only a few years ago.

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"For me, however, 6 mg of Zyn—rising to 9 mg in times of crisis—has become a necessity akin to drinking water. I no longer know what Zyn “feels like,” per se, since I only feel its absence, in the form of scattered attention, forgetfulness, and low-level irritability. When I am on deadline or otherwise swamped with work, I rarely go 10 minutes without a pouch in my mouth."