| >Sorry for the slight divergence from the focus on ketamine, but more generally, does anyone know if this applies to other medications that alter the brain's function? Tolerance is a phemomenon where after using a drug regularly for enough time, you will eventually need higher doses to achieve the same effect. A tolerance effect exists for many classes of medication, but in this case there is something specific to Ketamine. With Ketamine, it can (reportedly) be much harder to reverse this built-up tolerance. That's what they mean by "even after prolonged periods of abstinence". Heavy abusers of Ketamine report having stopped for several years, and finding that the tolerance comes right back the first time they use it again. With stimulants, this tolerance goes down after a period of abstinence (e.g. switching to a n̶o̶n̶-̶s̶t̶i̶m̶u̶l̶a̶n̶t non-amphetamine ADHD medication like Metylphenidate for a few weeks is known to lower tolerance to other ADHD drugs). I would generally not worry about tolerance to stimulants at prescribed doses. You should try to avoid taking medication you don't need, but if you need the stimulants to function, the cost/benefit of stimulant medication for ADHD is highly favorable. Even if there is a slow tolerance effect, it can be reversed. Taking stimulants for ADHD is not dangerous like taking Ketamine for partying is dangerous. Stimulants have the highest efficacy of any known drug in psychiatry. The medical interventions with the lowest NNT are things like insulin for diabetus, or not very far down, stimulants for ADHD. It's more than fine. |
[0] https://en.wikipedia.org/wiki/Methylphenidate?wprov=sfti1#