• darachduffy


Here is an extract from an Andrew Huberman podcast that links blinking, time, dopamine


Andrew Huberman '

"what we are specifically going to talk about are what are called attentional blinks not actual eye blinks we're going to talk about that in a few minutes but we're going to talk about attentional blinks

i'm paraphrasing here because goldman and davidson wrote about this so beautifully i'd rather paraphrase from them than try and just make up a new way to say it that is less interesting or less good but i want to credit them attentional blinks are really easy to understand if you think about a where's waldo task you know this task where's waldo where you know theirs a bunch of people and objects and things in a picture and somewhere in there is waldo with the striped hat and the glasses and kind of a skinny dude and you have to find waldo and so it's a visual search and it's visual search for an object that has distinct features but is embedded in this ocean of other things that could easily be confused as well though so you tend to look look look look look look then you find waldo kids can do this they enjoy doing this adults may or may not enjoy it but they can do it too they find waldo when you find waldo or when you search for a target in some other visual search task at that moment your nervous system celebrates a little bit and it celebrates through the release of neurochemicals that make you feel good you found it and you pause now the pause is interesting because when you pause what we know from many experiments is that in that moment of pause and mild celebration however mild you are not able to see another waldo sitting right next to it so what this means is in attending to something in searching and in identifying a visual target your attention blinked it shut off for a second and there's a more formal and more laboratory type way that we look at this the more typical way to do this is to give someone a string of letters or a string of numbers and beforehand you tell them be on the lookout for the letters r and z okay you're just going to watch this string of numbers go by and there will be a letter r in there and there will be a letter z in there and try and spot them both and what you find is when you present that string of numbers and then they see the r they see the r they register it consciously and they tend to miss the z just like in the waldo type example now of course the numbers are going by pretty quickly but they can spot the r they could also spot the z if you told them beforehand just spot the z and the numbers are moving through at the same rate in both conditions so what that means is that in every case you are capable of seeing the r or the z it's when you try and see both that seeing the first one prevents you from seeing the second one it's what we call an attentional blink we do this all the time and people with adhd tend to have many more attentional blinks than people that don't and this is true for children and for adults this is an important point so important that i want to emphasize it twice in case you intentionally blinked if you see something that you're looking for or you're very interested in something you are definitely missing other information in part because you're over focusing on something and this leads to a very interesting hypothesis about what might go wrong in adhd.

Where we've always thought that they cannot focus and yet we know they can focus on things they care very much about well maybe just maybe they are experiencing more attentional blinks than people who do not have adhd and indeed there are data now to support the possibility that that's actually what's happening and that should be exciting to anyone that has adhd it should also be exciting to anyone that cares about increasing their focus and their ability to attend what this is saying is that these circuits that underlie focus in our ability to attend and our ability to eliminate distraction they aren't just failing to focus that's just a semantic way of describing the outcome they are over focusing on certain things and thereby missing other things and so our distractibility or the distractibility of somebody with adhd could exist because they are over focusing on certain elements and they are therefore missing other elements that they should be attending to so what they really need is this property that we call open monitoring now open monitoring is something that's described in the book that i just referred to (Altered Traits) and that typically is associated with people who have done a lot of meditation so-called vipassana meditation or have spent a lot of time learning how to do what's called open gaze visual analysis and open gaze thinking but there's a simpler version of this that allows us to bypass all that first of all your visual system has two modes of processing it can be highly focused a soda straw view so looking for the r in this string of numbers in the example that i just gave or if you're very excited about something you're in that soda straw view of the world and you're missing other things okay that's high levels of attention however there's also a property of your visual system that allows you to dilate your gaze to be in so-called panoramic vision panoramic vision is something you can do right now no matter where you are and i can do it right now you won't know that i'm doing it but even though i'm still looking directly at you i'm consciously dilating my gaze so that i can see the ceiling the floor and the walls all around me that panoramic vision is actually mediated by a separate stream or set of neural circuits going from the eye into the brain and it's a stream or set of circuits that isn't just wide-angle view it also is better at processing things in time its frame rate is higher so you've seen slow motion video and you've seen standard video slow motion video gives you that slow motion look because it's a higher frame rate. Your thin slicing time okay!!!!!!!!!!!

You can use panoramic vision to access the state that we call open monitoring when people do that they are able to attend to and recognize multiple targets within this string of numbers they can see the r and they can see the z and they can see additional things so this is something that can be trained up and people can practice whether or not they have adhd or not what it involves is learning how to dilate your gaze consciously that's actually quite easy for most people whether or not you wear corrective lenses or contacts or not you can consciously go into open gaze and then you can contract your field of view as well there have also been studies done where people were taught to think in a particular way for a very short period of time and that forever changed their ability to limit or reduce the number of these attentional blanks there are now published accounts in the literature of a simple practice done for about 15 minutes where subjects were asked to just sit quietly eyes closed and do what is sort of akin to meditation but to not direct their mind into any particular state or place but simply to think about their breathing and to focus on their so-called interoception focus on how their body feels if their mind drifted to bring it back okay so it's basically meditation for about 15 minutes that might not seem like a significant or unusual practice or that it would have any impact at all but remarkably just doing that once for 17 minutes significantly reduced the number of attentional blinks that people would carry out.

In other words their focus got better in a near permanent way without any additional training there's something about that practice of reducing the amount of visual information coming in and learning to pay attention to one's internal state what we call interoception that allow them an awareness such that when they needed to look for visual targets when they need to focus on multiple things in sequence they didn't experience the same number of attentional blinks and i should mention not incidentally as people age and their working memory gets worse and their ability to focus gets worse the number of attentional blinks that they carry out goes up and there are now studies exploring whether or not this simple meditation-like practice of 15 to 20 minutes or so of sitting and just quietly resting and paying attention to one's breathing and internal state can also offset some of that age-related what is called cognitive decline so what these data tell me is that regardless of whether or not you're a child or you're an adult whether or not you have adhd or not whether or not you're experiencing age-related cognitive decline or you would simply like to avoid age-related cognitive decline a simple practice of taking 17 minutes sitting and paying attention to your internal state just enterocepting registering your breathing registering the contact of your skin with whatever surface you're on can forever rewire your brain to be able to attend better and possibly even offset some of that age-related attentional drift.

Now i don't expect anyone to start meditating regularly i don't expect anyone to do anything they don't want to do but i think most of us could handle one meditation session of 17 minutes or so and so if ever there was a tool that stood to rewire our attentional circuitry in a powerful way this seems to be it and in addition the ability to engage in panoramic vision to dilate our gaze this so-called open monitoring that allows the brain to function in a way that it can detect more information faster that's a powerful tool as well and the beauty of that tool is that it works the first time and it works every time now how exactly it works is a little bit unclear is it for instance orchestrating this synchrony or asynchrony between the default mode network and the task related networks we don't know those studies have not yet been carried out . Nonetheless the effects are significant they are long lasting and they appear to exist after just one session of this quiet 17-minute interoception which to me makes it seem like a very worthwhile thing to do for everybody.

So we just talked about attentional blinks which are essentially blinks of thinking it's your mind shutting off for a moment and missing information now let's talk about actual blinks the sort that you do with your eyelids now this might come across as somewhat obvious but you can do fast what are called spontaneous blinks and they are always coordinated between the two eyes or you can do long blinks like when you go to sleep at night you do one very long blink and i'm not being facetious when you go to sleep at night you are shutting your eyelids and you are limiting the amount of information coming in and your perception of time starts to drift as you go into sleep your perception of time changes from very fast at one moment to very slow meaning the frame rate at which you are analyzing information dreaming etc is variable when you are in sleep sometimes it's very fast meaning you experience things in slow motion sometimes it's very fast in waking too- your experience of time can sometimes be very fast sometimes be very slow typically the more alert you are the higher the frame rate your thin slicing your experience you've probably had this happen if you're ever very stressed and you're waiting for something or somebody it seems like it takes forever because your frame rate is higher you're analyzing time more finely conversely if you are very relaxed or even sleepy you wake up and you have to think about all the things you have to do it will seem like the world is going by very very fast and that you are moving very slow. Time is going at the same rate but your perception of time is what's changed believe it or not your perception of time is also changed on moment-to-moment basis by how often you blink this is a well-established literature in the world of neuroscience that unlike the literature and claims about blinking and sociopathy which have no basis the science of blinking as it relates to time perception has some very good data to support it i want to just emphasize one study in particular which is quite appropriately titled time dilates after spontaneous blinking this is a paper that was published in current biology the first author is terehoon t-e-r-h-u-n-e it's a wonderful paper they examine the relationship between fluctuations in timing and blinking and to make a long story short what they found is that right after blinks we reset our perception of time okay so blinks in that sense are a little bit like the curtain coming down on a scene between scenes in a play or takes in a movie you know when they clap the clap thing they start it take you know what do they say um action and then at the end they do the thing and they click it down and they say it's a take that's one take when you blink it's a take okay now what's interesting and will immediately make sense to you as to why this is important is that the rate of blinking is controlled by dopamine so what this means is that dopamine is controlling attention blinks relate to attention and focus and therefore the dopamine and blinking system is one way that you constantly modulate and update your perception of time and fortunately it's also one that you can control so the basic takeaway of this study was that blinking controls time perception but also that levels of dopamine can alter your sense of time and stay with me here and that blinking and dopamine are inextricably linked they are working together to control your attention when dopamine levels go up people tend to overestimate how long something lasted why because they are processing time more finely it's slow motion mode when dopamine levels are lower they tend to underestimate time intervals let's remember back to the very beginning of the episode what's going on in people with adhd they are not good at managing their time they tend to run late or they are disorganized they are not just disorganized in space meaning in the physical space around them they are disorganized in time their dopamine is low we know that as well and so they are underestimating time intervals and so it makes perfect sense that they would be late it makes perfect sense that they would lose track of time or the ability to focus this is really exciting because what it means is that children with adhd adults with adhd or people with normal levels of focus that want to improve their ability to focus can do so through a training that involves learning how often to blink and when and how to keep their visual focus on a given target and it turns out this study has actually been done

There's a study again i'll link to this study entitled improvement of attention in elementary school students through fixation-focused training activity i won't go through all the details but what they found was a short period of focusing on a visual target allowed these school children to greatly enhance their ability to focus on other types of information and a significant component of the effect was due to the way that they were controlling the shutters on their eyes their eyelids and controlling their blanks so what they did in the study is they had these kids focus their visual attention on some object that was relatively close like their hand for a minute or so which actually takes some effort if you try and do that they were allowed to blink however it's known from other work that if people can consciously override the desire to blink at least to the point where they feel like they have to or else their eyes would dry out that actually can increase attention even further and they had conditions where they would look at a point further across the room and even further across the room it only took a few minutes each day to do this 30 seconds in one condition or maybe a minute and then at another station of looking a little bit further out and a little bit further out however there was an important feature of this study that is definitely worth mentioning which is before they did this visual focus task or training they did a series of physical movements with the kids so that the kids could sort of eliminate or move out some of their desire to move and would thereby enhance their ability to sit still now it's long been known that kids need a recess they need time to run around and play and roll around do whatever it is that they do in order to be able to sit still at all adults probably need this too frankly but kids need it more because the circuits in the brain that control reflexive movements and and as we say kind of rhythmic undulating behavior and things like that that's an active suppression and kids have less of that circuitry built up until they hit about age 15 or 16. so they had the kids move around a bit and then do this focused training that brings me to another treatment that's actively used nowadays in schools for kids with adhd but also starting to be used by many kids and by parents in order to keep their kids focusing and not going crazy in the car or not acting out in general and that's the prevalence of these so-called fidgeter toys or things that kids can do actively and repetitively in order to move out some of their underlying reverberatory activity in their nervous system so what you will find is that some kids with adhd are now given a rubber band on their desk literally a rubber band that's attached to their desk and they're able to pull on it even snap it against the desk if i'd done that when i was a kid i think my teachers would throw me out of class but i think it's great that they're allowing them to do this now as a way of moving some of their physical energy out or engage their physical energy rather as opposed to trying to sit statue still all the time and attend and turns out that does enhance these children's ability to focus mentally when they have some physical activity to attend to and it turns out it also can work for adults.

I'll share with you a related anecdote because it illustrates the underlying mechanism i've had the great privilege of being able to do a number of surgeries brain surgeries during my career so one thing you find when you do brain surgery is that the brain is pretty small regardless of the species that you're working on and you're in there and you're trying to do something very specific and the more you try and hold your hands really steady the more they want to shake all right so it's not natural for any of our limbs to sit perfectly still depending on how much coffee you've had how well-rested you are and your sort of baseline level of autonomic arousal some of you may find that you can hold out your hand absolutely rock solid others will shake a little bit more doesn't mean you're nervous. If you're shaking it doesn't mean you're calm. If you're still, what it relates to is the amount of what we call pre-motor activity the number of commands to move that are being sent through the system and that's what i mean by reverberatory activity and it does seem that kids with adhd and adults with adhd have a lot of reverbatory activity in their nervous system and so that's that constant desire to move it's hard for them to sit still and therefore it's hard for them to attend to harness their attention when you do a surgery and you find that your hands are shaking what you learn from your mentors which i did and what works extremely well whether you're doing a surgery or not is that you simply tap your foot or you bounce your knee a little bit which you might think would make your hand shake even more but provided that it's subtle what it does it is it actually shuttles some of the activity from those pre-motor circuits to elsewhere in the body and then you're able to sit much more still with your hand you're able to perform the surgery with much more precision you are able to write with much better handwriting and for those of you who engage in public speaking if you're ever too nervous that's why pacing while you public speak helps if you're nervous that's why bouncing your knee behind the podium works as well that's why nodding your head and gesticulating can help it's not a matter of quote-unquote moving energy out of the body that doesn't actually happen what it is is you're engaging those pre-motor circuits that are sending through commands it's like trying to stuff a bunch of stuff through a funnel and it creates this tension so you're giving it an outlet for the neural circuitry to be able to move something so that you can keep other components of your body and your mental attention engaged and locked onto something what we call focus one thing related to this whole business of blinking and focus and training yourself to focus and not blinking etc is that most all of the drugs ritalin adderall and recreational drugs that increase dopamine even coffee and tea and other forms of caffeine they tend to make us blink less and when we get tired we tend to blink more now this is sort of a duh right but being wide-eyed with excitement or fear or with your eyes barely being able to keep them open now it should make perfect sense that these shutters on the front of your eyes they aren't just there for winking and they aren't just there for cosmetic purposes they are there to regulate the amount of information going into your nervous system and they are there to regulate how long you are bringing information into your nervous system and in what bins how widely or finally you are binning time is set by how often you blink and how widely or specifically you are grabbing attention from the visual world is set by whether or not you're viewing things very specifically like a crosshair or through a soda straw view like this or whether or not you're in this panoramic sort of whole environment mode this kind of fisheye lens or wide angle lens mode and in fairness to the pharmacology and the circuitry while dopamine and heightened levels of alertness and excitement tend to make us blink less and attend more


There's actually a study that's looked at the other neurochemical systems and drugs and how those relate to blinking and so this will all be obvious by the title of the paper i'm about to share with you this is a paper entitled decreased spontaneous eye blink rates in chronic cannabis users evidence for striatal cannabinoid dopamine interactions okay i'm not going to go into all the details here but one thing that is somewhat surprising is that many people with adhd use or abuse cannabis you might think well why would they do that because i thought that a increase in dopamine is actually what's going to lead to heightened levels of attention and that's what these people and children crave well it turns out that cannabis also increases dopamine transmission in the brain but because of the other chemicals it increases namely serotonin and some components of the cannabinoid and opioid system it creates that kind of alert but mellow feel and again here i'm i'm not a proponent of this i personally am not a thc or cannabis user it's just not my thing and obviously it's illegal some places and so you have to determine that for yourself. It does have medical purposes and in some places it is legal but thc increases dopamine and increases neurochemicals that can also create a state of calm so it's that sort of middle ground and this paper has a beautiful demonstration whereby not just while people are using cannabis but depending on how long they've been using cannabis across their lifespan the rates of eye blinking change so if you look at the number of years that people have been using cannabis on a regular basis either daily or up to excuse me weekly or up to daily what you find is that for people that have not been using cannabis at all or have only been using it for about two years their rates of eye blinks are much higher than people who've been using it chronically for 10 years in other words people who've been using cannabis for 10 years don't blink very often at all now cannabis has well-known effects in depleting memory but it does seem to engage the focus and blinking system in a way that increases focus so basically what i'm saying is marijuana seems to increase people's focus but then they can't remember what they were focusing on something i'd like to discuss just briefly is the so-called interroceptive awareness that's present in people with adhd both children and adults interceptive awareness is one sense of one's own internal state heartbeat breathing contact of skin with a given surface etc

For a long time there was this hypothesis this idea that people with adhd weren't just not in touch with how they felt that somehow they weren't registering all the stuff that was going on inside them changes in heart rate and so forth and so they were behaving in a way that was dysregulated or appeared dysregulated and that if they could just learn to attend to their internal state better that somehow they would function better in the world. Now before we described a process literally a 17-minute interreceptive exercise that does seem to lead to improvements in one's ability to focus for a longer period of time however it's very unlikely that that was due to increasing interoceptive awareness per se it probably wasn't because people gain a much heightened or improved ability to understand what's going on internally in fact you can imagine how that might actually prevent one's ability to pay attention to things in the outside world so while there is benefit to just sitting there and being in stillness as they say or focusing on one's breathing in internal state for sake of then accessing information in the external world a really nice study called interoceptive awareness and attention deficit hyperactivity disorder explored whether or not interoceptive awareness was different in people with adhd or did not have adhd and the findings were essentially that there's no difference that people with adhd children and adults they are aware of what's going on inside them just as much as anyone else is and the typical measure of interoceptive awareness is one's ability to count their own heartbeats this is actually challenging for some individuals and very easy for other individuals regardless of their attentional capacity some people just can really feel their heartbeat without taking their pulse other people cannot and these studies are pretty straightforward to do you ask people to sit there and to count their heartbeats and then you are monitoring their heartbeats and you get to gauge how accurate they are so it's important to understand that people with adhd are in touch with how they feel it's really a question of whether or not they can take the demands that are placed upon them and enter a cognitive state a mental state that allows them to access the information they need to access in other words whether or not they can focus but it is absolutely wrong to think that the child that's getting up 11 times during a short six minute interaction at the table or whether or not a child who somehow has to venture off every moment or a co-worker of yours who's an adult who's constantly fidgeting or moving things around that somehow they are unaware that they are oblivious. They are not oblivious to how they feel chances are they are very challenged in the situations that they're in and they're doing everything they can to try and regulate their attention so i think it's an important study to highlight because it really underscores the fact that something else is going on and that something else has everything to do with this ability to coordinate these task directed networks and to coordinate that in the proper way with that default mode network and that is a process as you now know that's regulated exquisitely by certain neurochemicals and in particular the neurochemicals dopamine norepinephrine and serotonin and a fourth one i'd like to throw into the mix which is acetylcholine

Acetylcholine is very vital for cognitive focus so now i want to switch back to talking about some of the drugs that are typically used to access those systems prescription drugs and i want to talk about some of the new and emerging non-prescription approaches to increasing the levels of dopamine acetylcholine and serotonin in the brain using various supplement type compounds because several of them are showing really remarkable efficacy in excellent peer-reviewed studies so before moving to some of the newer atypical compounds and things sold over the counter i'd like to just briefly return to the classic drugs that are used to treat adhd these are the ones I mentioned earlier methylphenidate also called ritalin modafinil armodafanil is another one and adderall again all of these work by increasing levels of dopamine and norepinephrine typically they are taken orally in pill form or sometimes in capsule form the dosages that are appropriate vary according to severity of the condition for a given person and the age of the person this is a complicated landscape for each individual they have to figure out the pharmacology that's best for them some individuals are even layering long or time to release ritalin with adderall and in smaller doses it can get quite complex or it can be quite straightforward if you are really interested in these drugs and how they work and you'd like to get a glance at a table of all the results from all the studies of which there are now hundreds there's an excellent review about these drugs and their use and their comparison to similarly structured drugs in particular mdma and cocaine and amphetamine meaning street amphetamine to really illustrate the similarities of action and some of the problems associated with long-term use i don't expect you to read this article in full i'm here so that you don't have to go read these articles but in case you want a ton of information the paper is esposito at all frontiers in biosciences it's an excellent excellent review of the entire literature it is quite long i can put a link to that study in our caption and it essentially describes all the studies that have been done peer-reviewed and published and it refers to these drugs in an interesting way it doesn't just refer these drugs as for treatment of adhd it actually refers to them using language that ordinarily i'm not very fond of but i'll agree to here which is so-called smart drugs or nootropics it also covers caffeine which again as i mentioned earlier increases dopamine norepinephrine and to some extent serotonin but what i like about this review so much is that in putting these drugs of abuse methamphetamine and cocaine right alongside these drugs like ritalin and adderall and also caffeine we start to realize that the distinction between drugs of abuse and the distinction between drugs of treatment is actually very fine and sometimes even a blurry line and in thinking about whether or not one wants to use these prescription i want to emphasize prescription not drugs of abuse but prescription drugs for treatment of one's own attentional capacity i think it is important to understand the extent to which they all carry more or less the same side effects the one exception being caffeine caffeine side effects can be anxiety if you ingest too much of it insomnia if you drink it too late in the day but typically it will not cause the major side effects of the other drugs such as high propensity for addiction and abuse amphetamines of any kind as well as cocaine can cause sexual side effects because they're vasoconstrictors so you know men have trouble achieving erection there can often be the intense desire or libido for sex but an inability to actually perform so that's an issue with any kind of stimulant so these drugs are not without their consequences in addition and here i'd lump caffeine back into the into the mix in addition they almost all carry cardiac effects right they increase heart rate but they also have effects on constriction of blood vessels and arteries and veins and so forth in ways that can create cardiovascular problems.

Now caffeine is a bit of a complicated one i talked about this on a podcast long ago but i'll just remind you that it turns out that if you are caffeine adapted in other words if you are used to drinking caffeine then the ingestion of caffeine most often will cause vasodilation it will actually allow more blood flow through however if you are not caffeine adapted it will cause vasoconstriction due to an increased stress response so if you're familiar with caffeine caffeine can actually have a little bit more of a relaxation response although if you drink enough of it it will make you amped up these other drugs almost always lead to vasoconstriction increased heart rate dilation of the pupils less blinking heightened levels of attention which looks very much like stress and at its extremes looks very much like the effects of street drugs like cocaine and amphetamine because of the large amounts of dopamine they're released in the brain people tend to crave that state over and over and yet with each subsequent use are able to get less and less of that euphoric feeling or that really really focused feeling so one thing that's being explored quite extensively now in the treatment of adhd are drug schedules whether or not people should take adderall every day or every other day whether or not they should take it only every once in a while whether or not young children can take it just a few times and engage in behavioral training of the sort that i talked about before where they're doing maybe it's a 17 minute meditation type exercise but more likely it would be the movement followed by the visual focusing because that's only done for 20 or 30 or 60 seconds. Why would you do that? Well in a chemically enhanced state your brain is more plastic the circuits are able to modify and learn better that's the optimal time to engage in focus in a very deliberate way so just taking a drug and expecting focus to just work at any point and being able to turn focus on and off at will that's an unrealistic expectation right more likely the best use of things like adderall modafinil armodafanil and ritalin is going to be to combine those treatments with behavioral exercises that actively engage the very circuits that you're trying to train up and enhance and then perhaps i want to highlight perhaps tapering off those drugs so that then one can use those circuits without any need for chemical intervention so despite any controversy that might be out there i think it's fair to say that the consumption of omega-3 fatty acids can positively modulate the systems for attention and focus so then the question becomes how much epa how much dha does that differ for uh what's helpful for depression etc and actually it does differ in reviewing the studies for this it appears that a threshold level of 300 milligrams of dha turns out to be an important inflection point so typically fish oils or other sources of omega-3s will have dha and epa and typically it's the epa that's harder to get at sufficient levels meaning you have to take quite a lot of fish oil in order to get above that 1000 milligram or 2 000 milligram threshold to improve mood and other functions but for sake of attention there are 10 studies that have explored this in detail and while the epa component is important the most convincing studies point to the fact that getting above 300 milligrams per day of dha is really where you start to see the attentional effects now fortunately if you're getting sufficient epa for sake of mood and other biological functions almost without question you're getting 300 milligrams or more of dha so that usually checks that box just fine what's interesting is that there's another compound phosphatal sterine that has been explored for its capacity to improve the symptoms of adhd again i don't think this is any direct way but rather in a modulatory way but it appears that phosphodiesterine taken for two months for 200 milligrams per day was able to reduce the symptoms of adhd in children it has not been looked at in adults yet at least as far as i know but that this effect was greatly enhanced by the consumption of omega-3 fatty acids so now we're starting to see synergistic effects of omega-3 fatty acids and phosphatidyl steering again that was 200 milligrams per day this is something that sold over the counter in capsule form at least in the us uh there were two studies both were double blind studies i carried out for any anywhere from one to six months on both boys and girls and it really was boys and girls not men and women this was kids age one to six or seven to twelve and uh it was a fairly large number of subjects so 147 subjects in one case and 36 in the other the takeaway is that getting sufficient levels of epa's in particular this 300 milligram threshold of dha plus if you are interested in it and it's right for you 200 milligrams of phosphodietal steering can be an important augment for improving the symptoms of adhd

You'll also find literature out there and many claims about so-called gingko bilboa which has been shown to have minor effects in improving the symptoms of adhd not nearly as effective as ritalin and adderall ginkgo balboa is not appropriate for many people i am one such person i don't have adhd but when i've taken ginkgo even at very low doses i get absolutely splitting headaches some people do not experience those headaches but it's known to have very potent vasoconstrictive and vasodilating properties that vary depending on when you took the compound so for those of you that are exploring ginkgo balboa and you will see a lot of claims about ginkgo bilboa for attention in adhd definitely take the vasodilation vasoconstriction headache issue into consideration so i'd like to talk about the drug modafinil and the closely related drug are modafinil that's ar modafinil because modafinil and armodafanil are gaining popularity out there both for treatment of adhd and narcolepsy but also for communities of people that are trying to stay awake long periods of time so it's actively used in the military by first responders it's gaining popularity on college campuses and people are using it more and more as an alternative to adderall and ritalin and excessive amounts of coffee it does increase focus and to a dramatic extent modafinil typically was very expensive you know i don't know if it's still this expensive but when one has a prescription for it it could still cost as much as eight or nine hundred dollars or even a thousand dollars a month our modafinil is a far less expensive version that's chemically slightly different than modafinil regardless of price people are taking modafinil and armodafanil want to emphasize that unlike ritalin and adderall modafinil and armodafanil are weak dopamine reuptake inhibitors and that's how they lead to increases in dopamine so whereas ritalin and adderall amphetamine and cocaine lead to big increases in dopamine also through reuptake mechanisms and so forth modafinil is is a weaker dopamine reuptake stimulator and so what that means is that it leaves more dopamine around to be active at the synapse the the gaps between neurons however it also activates other systems it acts on the orexin system which is actually a peptide that we talked about in the episode on hunger because it regulates hunger and appetite and it regulates sleepiness and feelings of sleepiness in fact the excuse me erection also called hypocretin system the erection hypocretin system is what's disrupted in narcolepsy that was the important discovery of my colleagues emmanuel mignon and seiji nishino at stanford some years ago they identified the biological basis of narcolepsy and it's a disruption in this orexin hypocretin system and modafinil is one of the primary treatments for narcolepsy it also has these other effects on the dopamine system and on the norepinephrine system even though it doesn't lead to quite as intense levels of dopamine and arousal and focus it does have the property of raising levels of attention and focus and that's why people are using it so it's a somewhat milder form of adderall or modafinil for some people works as well as modafinil and as i mentioned before it's much lower cost for other people it doesn't i have an experience meaning i do have an experience that i'll share with you with armodafanil a few years ago i was suffering from jet lag really terribly and i was traveling overseas i went to a meeting to give a talk i took half of the prescribed dose of armadaphenyl it was just prescribed to me i took that half dose and i gave my lecture and then i stayed around to answer questions and then four hours later a friend of mine came up to me and said you know you've been talking for four and a half hours and uh there are only a few people still here luckily there were still a few people be a lot weirder if the room was completely empty so it wasn't being recorded so i have firsthand knowledge of the sorts of cognitive effects that it can create i personally would not want to be in that state for sake of studying or learning or for doing this podcast for instance and i can honestly say that today all i've ingested is some coffee and some yerba mate tea and some water i'm not on any of the compounds that i've described during the course of today's episode you might ask why i took half the recommended dose of armodaphenyl and the reason is that i'm somebody who's fairly hypersensitive to medication of any kind what you find if you look in the literature is that about five percent of people are hyper hyper sensitive to medication they require far lower doses of any medication than other people in order to experience the same effects i'm somebody that i think is sort of modest hyper if that sort of oxymoronic statement but a modest hypersensitivity to medication so i've almost always been able to get by on taking less of whatever was prescribed for me and feel just fine or in this case to feel like it was still too much it turned out that the right dose of our modafinil for me was zero milligrams now'

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