My partner has had idiopathic hypersomnia (sleeps 12 hours most days, as much as 18 hours some days) for a few years now, and so far nothing we’ve tried has worked without awful side effects (e.g. constant heart palpitations and panic attacks.)
I had been looking into orexin agonists (along with other things like H3 autoreceptor antagonists) back when they were just a concept. It’s good to see them finally reaching commercialization. Although they’re not approved by our own (Canadian) regulatory body quite yet.
Now that they’re approved in the US, though, I’m looking very much forward to seeing how these drugs perform in off-label-ish treatment of the various other sleep disorders that I’m sure clinicians will now begin throwing them at.
Have they tried GHB? I know it's used in narcolepsy patients with great success. If you "microdose" it, it's also one of the best drugs on the planet. Slippery slope, though.
Please don’t ever recommend this extremely addictive drug to strangers on the internet again
GHB’s sodium salt (sodium oxybate, Xyrem/etc) is a legal prescription drug in several countries, used for treating narcolepsy, alcoholism, and also as an anaesthetic.
I don’t see what’s the problem with someone taking any drug legally prescribed to them by their doctor. Lots of prescription drugs are potentially addictive, but that’s a risk to be weighed against the potential benefits.
https://en.wikipedia.org/wiki/Sodium_oxybate
Calm down, we’re all adults here, or pretending to be.
I am calm. GHB has wreaked havoc in The Netherlands, it is something tweakers consume. Recommending microdosing GHB in my eyes is like recommending microdosing heroin.
https://www.jellinek.nl/en/alcohol-drugs-behavior/ghb/
> GHB is difficult to dose. The difference between a dose with pleasant effects and the dose at which someone becomes overwhelmed by sleep and becomes unconscious is very small. People quickly take too much GHB. The combination with alcohol enhances the effects of GHB. This means that people can become unconscious even with a small dose of GHB.
very OT: lately I'm seeing "wreaked" a lot but what about "wrought".
Everything is addictive to the right/wrong person. GHB is no more addictive than alcohol [IMO] , just much more dangerous at high doses. Although safer at low doses.
Given that some will freak out about GHB, is there any information on whether beta-hydroxybutyrate (BHB) would help?
BHB is quite similar to GHB, but is a naturally produced ketone.
(I did try google)
It sounds like is a genuine treatment for those who suffer from narcolepsy, and everything else is merely speculative and has seem pretty bad side-effects.
There is evidence that some forms of ADHD are effectively just the brain falling asleep rapidly and then waking up. This form cam be attenuated with norepinephrine reuptake inhibitor alone. Presents with ADHD like symptoms. But it’s a new thing most likely. Called “Cognitive Disengagement Syndrome”.
Wow. First i've heard of this but the description sound so relatable. Very interesting, and makes total sense to differentiate from ADHD
For the record, since I am on a mix of concerta and effexor, effexor alone does nothing to alleviate my symptoms (at the 150mg dosage). Although for me the adhd medication is no problem. It is actually effexor that torments me, because I have extreme withdrawal symptoms if I go even one day without it.
Effector is for dépression not ADHD. Do you get brain zap when you miss a dose ? Other medications don't have this problem, at least for many of not most people
it's possible your doctor is treating you for depression as well as ADHD
Or maybe venlafaxine is to counteract any anxiety that the upper may cause. Well that's the theory my doctor had anyway. (I took venlafaxine with ADHD meds because of this)
Well, they're filming the next season of black mirror right now, it's probably not too late to throw this one in there.
Its going to be 12 episodes of "What if Datacenter took my water" and similar isnt it?
Yeah, they need a bit of fiction there after all.
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Interesting comment: https://news.ycombinator.com/item?id=49264602
> IMO the much more likely explanation is that the brain uses contrastive learning somewhere. [...] Instead of using calculus and outer products to calculate derivatives, you feed real data and false data forward through the network and each neuron tracks and trains on the difference.
Separately, do I understand the idea correctly:
- when learning on the real examples, just propagate forward
- when learning on the fake examples, first generate them by propagating white noise backward
That's a technique that was tried in machine learning and worked (although obviously not optimally or we'd all be using it by now) and then we hypothesised that animal brains use it because it would explain sleep.
I'm curious if there is an explanation for it not being more common to sleep like dolphins do, small parts of the brain at a time.
You may be thinking of sharks.
I like sleep - it's not a problem to be solved.
Since we’re talking narcolepsy here, your passengers might disagree
Just imagine yourself never needing (or even able to) sleep. It is actually a nightmare. Your bad day is now permanent.
There are levels to that:
1) don’t need to sleep, be able to sleep: the coolest thing in the universe.
2) don’t need to sleep, be unable to sleep: you would likely cope. Also, be an irreplaceable shift worker.
3) need to sleep, be able to sleep: this is where most of us are now, nothing to write home about.
4) need to sleep, be unable to sleep: the rest of your life is short and full of exponentially growing suffering.
By „don’t need to sleep” I mean that the body refreshes itself by different means and you still reap the benefits.
I can’t really imagine how it would feel, much like I can’t imagine being immortal. Most fiction describing those phenomena as „nightmare” usually is about a character who gains the ability but none of the protective mechanisms.
Despite the stigma surrounding semaglutide, its impact across various health conditions has been remarkable. Bringing that same level of innovation to cognitive disorders could be truly transformative for society
I've not detected a stigma around semaglutide.
Is it from these Valley Bros I read about experimenting with designer semaglutide on themselves? Or is there another stigma?
If this means I don't have to take Methylphenidate to function 100% all the time and as a result feel tremendously anxious 100% all the time. SIGN ME UP.
Adding guanfacine (Intuniv) to my methylphenidate took the weird anxious-angry edge off. Would be nice to not have to take one med to fix the side effects of the other, though.
Interesting, will check it out. Cheers!
My son takes the methylphenidate / guanfacine combo as well and it’s been a game changer.
FWIW, I was on MP for years and never really liked it. Tried all possible dosages and delivery methods. I switched to lisdexamfetamine a couple of years ago and never looked back. 0 side effects apart from my mouth.
It dries out your mouth a bit I heard.
You sure about that math?
I'm honestly not sure about anything man
Sleep less and sit more. What a species we’ve become.
A better modafinil? Sign me up.
"Others are exploring their use for treating sleep apnoea, which is a far more common disorder." CPAP biomedical equipment manufacturer watch out!
The second I read the print in Nature a bit ago I knew some version would show up here. I swear I’ve met deployed Marines less obsessed with staying awake through chemistry than some people here.
1. Virtue signaling.
2. Unhealthy desire to get rich (or work on interesting projects, which would be the better option).
With so much malformed/fake diagnosis out there for mental health the data, research and conclusions will be a mess obscuring and obfuscating truth.
The only way through will be anecdata. Science of one.
I await basic safety reports.
To get a job at our company take three pills of brainOzempic every day to maximize productivity.
We have our NeuroLinkBrain Implant plugin to AI agent , so that you can vibe code 24/7 . To maximize shareholder value.
I reckon I'll buy some landscaping machinery and a truck before I ever sign up for that distopian nightmare. At least sound ordinance would prevent 24/7 operation.
No more sound ordinance, just install Neuralink and receive free auto-mute during sleeping hours.
Isn't this already happening with ADHD drugs?
To some extent ADHD drugs are abused but to us neurodivergent people those stimulants (or in other cases just alpha 2 agonists) just help us do normal things that normal people can do without drugs, like laundry. Or reading a book, or be able to focus on literally anything that isn’t giving us a high level dopamine response.
The meds (both stimulant and non stimulant) help people with ADHD choose where to hyperfocus, but hyperfocus is an internal trait of the ADHD neurotype, so it isn’t just attributable to the drugs or something.
I.e. normal people use stimulants to go fast, while ND people with ADHD use them to go slow or have their brain actually be able to slow down.
A lot of people with ADHD that have success with medication can tell you that it's not just about work.
It also helps with non-work stuff that's just not fun to do, such as chores or filing your taxes. It even helps you stick with hobbies you actually enjoy but your brain gets bored of.
Don't tell me psychiatrist but I take my addon Ritalin at night so I can play games or read a book. I just can't do it without it
I don't doubt that. For me, however, drugs like concerta changed my life from near catatonia to almost-regular function. If you see me behaving "normally", that is because I have taken my prescription. Otherwise, you will not see me because I will be sleeping, or worse, you will see me.
on the recreational level, maybe, but from a therapeutic perspective for people who actually benefit from its prescribed use its absolutely game-changing to live a life without (or with mitigated) executive dysfunction.
You don’t look like a cultural
fit to our company, but try a course of Ozempic and reapply in 6 months.
Probs already there…
Absolutely, just not in writing :-\.
Nothing like losing 100 pounds to show you how profoundly lookist society is. It's been great.
People say "narcolepsy this" and "ADHD that" but we know y'all need off these drugs.
Is this supposed to be scary or amazing?
Your comment is probably the most disturbing thing I’ve ever read on this website
I dunno, there's been a whole lot of fascist bootlicking going on lately under the guise of good faith discussion. That's pretty disturbing to me.
Astroturfing crosses all boundaries eventually.
I know you're joking but I saw a company that had similar policies like fasting and stuff like that to improve productivity. They seemed to take it pretty seriously...
24/7 stock market, least sleep needed, most AI piled, I’m very excited!
Cryptocurrency markets are open 24/7 btw.
Everyone involved in a stock market agrees it's quite useful to have a separation between days, although you could have a 23.5/7 stock market with only half hour day-ends. That's when things like index rebalancing, addition, removal, stock splits occur. You say whoever holds stock X at end of a certain day holds stock Y+Z at the start of the next day (due to a company splitting up) and there's no need to argue about which millisecond a trade occurred. (It's your own damn fault if you were trying to buy the stock in the milliseconds before closing, but some exchanges run a special closing auction with a different algorithm to prevent races). It's also the time you can deploy software, which you can't do during the day. Maybe half an hour is too short for all this stuff. Or maybe it should be a 12 hour window once a week instead.
I think you can have a separation between days while still allowing 24/7 trading. Just schedule automatic operations like stock splits at midnight, and with a proper staging environment you can deploy software in the middle of the day, too (just give a heads-up first).
And of course, overnight trading is available on some stock exchanges now. (I’m not sure whether this is a new thing or has existed for a while, but I’ve only noticed it on TradingView for some papers about a year ago I think.)
wow. now i'm really excited for the future
I’m not about to stifle research into genuinely useful therapies just because some aspects of society will abuse the absolute shit out of them, and these therapies seem profoundly useful to those who suffer from the mentioned ailments.
Here’s the thing: what a lot of these drugs are doing are basically acting as equivalents to the store-bought neurotransmitters you’d find in things like SSRIs or -phetamines/stimulants. To people lacking in these substances, they’re game changers.
The problem right now is a mismatch between regulation, availability, and testing regimes. Regulations are meant to prevent dystopian shit like employers mandating (or encouraging) a drug regimen for employment through threat of punitive fines or prosecution, while the private insurance markets promote unaffordability domestically (as North America is where over half of pharma revenues come from) and testing regimes fail to identify who is best suited for a given drug. All three of these prongs will shake out in time, but cause new problems as a result.
Where we’re at right now is less of a click-baity headline from The Economist, and more at the start of a new frontier in medicine that capitalizes on decades of research. We’ve maximized the benefits of “low-hanging” chemical-based drugs, and have moved into more complex, nuanced, or targeted drugs developed through modern compute rather than traditional drug trials alone. Things will change very quickly, and then stagnate again when we’ve picked clean the easy fruits from these new branches.