Scott Alexander examines the history, chemistry, and efficacy of various amphetamine-based ADHD medications, comparing their strengths and weaknesses. Longer summary

Scott Alexander explores the history and differences between various amphetamine-based ADHD medications. He traces the origins of Adderall to a 1950s diet pill, then compares it to other drugs like Dexedrine, Vyvanse, Evekeo, and Desoxyn (methamphetamine). The post discusses the chemical differences, patient preferences, and effectiveness of these medications, noting that pure d-amphetamine (Dexedrine) seems generally superior to the Adderall mixture. Scott also touches on the controversy surrounding methamphetamine use in ADHD treatment, explaining that the main differences between therapeutic use and abuse are dosage and administration method rather than inherent properties of the drug. Shorter summary

Scott Alexander analyzes the PANDA Study, a large real-world antidepressant trial, discussing its methodology, results, and implications for understanding antidepressant efficacy. Longer summary

This post discusses the PANDA (Prescribing ANtiDepressants Appropriately) Study, the largest non-pharma antidepressant trial ever conducted. The study aimed to measure the real-world efficacy of antidepressants, specifically sertraline, in a naturalistic setting. Scott Alexander analyzes the results, which show small to low-medium effect sizes for various depression and anxiety measures. He notes that while the effects are modest, they are not clinically insignificant. The study found that patient-reported improvement had a higher effect size than researcher-measured tests, potentially indicating a disconnect between clinical measures and patient experiences. Scott discusses the implications of these findings for antidepressant efficacy and suggests that targeted treatment approaches might yield better results. Shorter summary

Scott Alexander analyzes online drug ratings, finding patients prefer older antidepressants while doctors prefer newer ones, and explores potential explanations for this paradox. Longer summary

Scott Alexander analyzes patient ratings of antidepressants from online databases, finding that older drugs like MAOIs are rated higher than newer ones. He then compares this to doctor ratings, discovering a negative correlation between patient and doctor preferences. The post explores possible explanations for these paradoxical results, including confounding factors and the hypothesis that newer antidepressants may actually be less effective. Scott extends the analysis to other drug classes, finding the negative doctor-patient correlation holds broadly, while the preference for older drugs is specific to psychiatric medications. Shorter summary